Autonomic Dysregulation in Adolescent Concussion Is Sex- and Posture-Dependent.

Autor:	Balestrini CS; Schulich School of Medicine and Dentistry, London, ON, Canada., Moir ME; School of Kinesiology, Faculty of Health Sciences, London, ON, Canada., Abbott KC; School of Kinesiology, Faculty of Health Sciences, London, ON, Canada.; Children's Health Research Institute, London, ON, Canada ; and., Klassen SA; School of Kinesiology, Faculty of Health Sciences, London, ON, Canada., Fischer LK; School of Kinesiology, Faculty of Health Sciences, London, ON, Canada., Fraser DD; School of Kinesiology, Faculty of Health Sciences, London, ON, Canada.; Children's Health Research Institute, London, ON, Canada ; and., Shoemaker JK; School of Kinesiology, Faculty of Health Sciences, London, ON, Canada.; Department of Physiology and Pharmacology, Western University, London, ON, Canada .
Jazyk:	angličtina
Zdroj:	Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine [Clin J Sport Med] 2021 May 01; Vol. 31 (3), pp. 257-265.
DOI:	10.1097/JSM.0000000000000734
Abstrakt:	Objective: To study autonomic responses to postural changes in concussed adolescents. The influence of sex was also studied. Design: Longitudinal cohort observational study. Participants: Concussed adolescents (CONC; n = 65; 26 male adolescents; age 15 ± 1 years, range = 12-18 years) and a control (CTRL) group of nonconcussed adolescents of similar age and sport (CTRL; n = 54; 29 male adolescents; age 14 ± 1 years, range = 12-18 years). Interventions: Concussed participants were monitored through 6 weekly visits throughout usual physician care. Control participants underwent 2 visits separated by at least 1 week to account for intrapersonal variation in testing measures. Main Outcome Measures: Heart rate variability as the root mean square of successive differences in R-R intervals (RMSSD), heart rate (HR), and blood pressure [mean arterial pressure (MAP) and diastolic blood pressure (DBP)] were measured in supine, sitting, and standing postures. Results: A mixed analysis of variance revealed a group × sex × posture interaction (P = 0.04) where seated values of RMSSD were less in concussed female participants versus control female participants (42 ± 4 vs 61 ± 7 ms; P = 0.01; Mann-Whitney rank test). Compared with CTRL, CONC exhibited increased pretesting seated DBP (69 ± 1 vs 74 ± 1 mm Hg; P < 0.01), MAP (83 ± 1 vs 86 ± 1 mm Hg; P = 0.02), and baseline seated HR (72 ± 1 vs 77 ± 2 bpm; P = 0.03). Values of DBP (P = 0.03) and MAP (P < 0.01) improved at clinical discharge, whereas the RMSSD in female participants did not (P > 0.5). Data are mean ± SEM. Conclusions: A modest reduction in female cardiac autonomic regulation was observed during seated postures. Alterations in seated concussed DBP and MAP, but not RMSSD, resolved at clinical discharge (median = 37 days). The results indicate that, in adolescents, concussion may impair cardiovagal function in a sex- and posture-dependent manner. The findings also suggest that BP metrics, but not RMSSD, are associated with clinical concussion recovery. Competing Interests: The authors report no conflicts of interest. (Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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