Autonomic Dysregulation in Adolescent Concussion: Characterization and Temporal Resolution of Neurological Outcomes

Although incidence is at epidemic levels, objective indicators of neurologic damage in adolescent concussion remain poorly described. Autonomic markers such as heart rate variability (HRV) have provided equivocal results; however, these predominantly are made under conditions of minimal physiologic stress. The current investigation employs postural stressors to examine underlying neurological outcomes associated with acute concussion and clinical recovery to test the hypothesis that concussion impairs dynamic autonomic adjustments in adolescents. We examined concussed adolescents (CONC; n = 35; 14 males; age 15 ± 1 yrs, range = 12–18 yrs) for up to 6 weekly visits from diagnosis. A group of age and activity level-matched non-concussed adolescents (CTRL; n = 35; 19 males; age 14 ± 2 yrs, range = 12–18 yrs) formed the reference control. HRV (root mean square of successive differences in R-R intervals (RMSSD)) and heart rate were assessed during a sit-to-stand protocol (two trials of seated posture (three mi...