Anderson Forrest L, Hellwinkel Justin E, Montjoy Marguerite, Levi Max, Tu Bin, Noble James M, Ahmad Christopher S, Bottiglieri Thomas S
Department of Orthopedics, Columbia University Medical Center, New York, New York, USA.
Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA.
Neurotrauma Rep. 2020 Sep 29;1(1):88-92. doi: 10.1089/neur.2020.0003. eCollection 2020.
Athletes are known to under-report concussion symptoms due to competitive disincentives to report and conflation of concussion symptoms with other conditions associated with rigorous participation in sports. A quantitative biomarker for concussion has the potential to decrease the reliance on inconsistent patient-reported symptoms for the diagnosis of concussion. The objective of this project was to monitor heart rate variability (HRV) patterns of in-season athletes as a potential biomarker for concussion. Twenty in-season National Collegiate Athletic Association (NCAA) Division 2 collegiate soccer players were given a wristband heart rate sensor with instructions to wear the band full time (24/7) for the entire fall season (approximately 3 months). The athletes were prompted by email to complete a weekly survey on the severity and frequency of any concussion symptoms. The survey and HRV data were de-identified for confidentiality, and to increase the likelihood of accurate reporting the athletes were told their responses would not be used to disqualify them from athletics. Our hypothesis was that HRV would be diminished in those with recent concussion. One athlete (5% of the cohort) sustained a concussion during the study period. A marked decrease in HRV was identified 7 days following the concussion, which eventually returned to baseline. This normalization of HRV followed the timing of resolution of concussion symptoms. Participants who did not sustain a concussion exhibited minimal variance in HRV over time. This preliminary study shows that HRV has potential as a biomarker for symptom resolution after clinically apparent concussion. HRV is unlikely to serve as a concussion diagnostic due to the 7-day lag in HRV change after concussion.
众所周知，由于存在不愿报告的竞争因素，以及脑震荡症状与严格参与体育运动相关的其他状况相混淆，运动员往往少报脑震荡症状。一种用于脑震荡的定量生物标志物有潜力减少在诊断脑震荡时对患者报告的不一致症状的依赖。本项目的目的是监测赛季中运动员的心率变异性（HRV）模式，将其作为脑震荡的一种潜在生物标志物。20名参加美国大学体育总会（NCAA）二级联赛的大学足球运动员在赛季中佩戴了腕带式心率传感器，并被告知在整个秋季赛季（约3个月）全天（一周7天、一天24小时）佩戴。通过电子邮件提醒运动员每周完成一次关于任何脑震荡症状的严重程度和频率的调查。为保护隐私，对调查和HRV数据进行了去识别处理，并且为了提高如实报告的可能性，告知运动员他们的回答不会被用于取消他们的参赛资格。我们的假设是，近期发生脑震荡的运动员的HRV会降低。在研究期间，有一名运动员（占该队列的5%）发生了脑震荡。在脑震荡发生7天后，HRV出现了显著下降，最终恢复到基线水平。HRV的这种恢复正常与脑震荡症状的缓解时间一致。未发生脑震荡的参与者的HRV随时间变化极小。这项初步研究表明，HRV有潜力作为临床上明显脑震荡后症状缓解的生物标志物。由于脑震荡后HRV变化存在7天的延迟，HRV不太可能用作脑震荡的诊断指标。
