Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review

Autor:	Trevor C. Wu, Holly Paxton, Kelly Cramond, Jon L. Pertab, Alex J. Cramond, Tricia L. Merkley
Rok vydání:	2018
Předmět:	medicine.medical_specialty Neurology autonomic dysfunction Concussion MEDLINE Orthostatic intolerance Physical Therapy Sports Therapy and Rehabilitation Classification scheme Review Article Autonomic Nervous System 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation mild traumatic brain injury medicine Humans 030212 general & internal medicine Post-concussion syndrome Post-Concussion Syndrome business.industry Rehabilitation medicine.disease Autonomic nervous system Data extraction orthostatic intolerance Neurology (clinical) business 030217 neurology & neurosurgery
Zdroj:	Neurorehabilitation
ISSN:	1878-6448 1053-8135
DOI:	10.3233/nre-172298
Popis:	Background Recent evidence suggests that autonomic nervous dysfunction may be one of many potential factors contributing to persisting post-concussion symptoms. Objective This is the first systematic review to explore the impact of concussion on multiple aspects of autonomic nervous system functioning. Methods The methods employed are in compliance with the American Academy of Neurology (AAN) and PRISMA standards. Embase, MEDLINE, PsychINFO, and Science Citation Index literature searches were performed using relevant indexing terms for articles published prior to the end of December 2016. Data extraction was performed by two independent groups, including study quality indicators to determine potential risk for bias according to the 4-tiered classification scheme of the AAN. Results Thirty-six articles qualified for inclusion in the analysis. Only three studies (one Class II and two Class IV) did not identify anomalies in measures of ANS functioning in concussed populations. Conclusions The evidence supports the conclusion that it is likely that concussion causes autonomic nervous system anomalies. An awareness of this relationship increases our understanding of the physical impact of concussion, partially explains the overlap of concussion symptoms with other medical conditions, presents opportunities for further research, and has the potential to powerfully inform treatment decisions.
Databáze:	OpenAIRE
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