Open AccessAutonomic dysfunction in adults following mild traumatic brain injury: A systematic review
Author(s) -
Leah J. Mercier,
Jennifer Batycky,
Christina Campbell,
Kathryn Schneider,
Jonathan D Smirl,
Chantel T. Debert
Publication year - 2022
Publication title -
neurorehabilitation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.611
H-Index - 65
eISSN - 1878-6448
pISSN - 1053-8135
DOI - 10.3233/nre-210243
Subject(s) - traumatic brain injury , psycinfo , medicine , cinahl , heart rate , heart rate variability , checklist , physical therapy , valsalva maneuver , physical medicine and rehabilitation , medline , blood pressure , psychology , psychiatry , psychological intervention , political science , law , cognitive psychology
BACKGROUND: Increasing evidence suggests autonomic nervous system (ANS) dysfunction may occur following mild traumatic brain injury (mTBI). Measures of heart rate, heart rate variability, blood pressure and baroreceptor sensitivity can be used to evaluate ANS dysfunction following mTBI. OBJECTIVE: Summarize the evidence for ANS dysfunction in adults following mTBI. METHODS: A search of Embase, MEDLINE, Cochrane Central Register, PsycINFO, CINAHL and SPORTDiscus databases was conducted. Search topics included: mTBI and ANS. Identified abstracts were independently reviewed by 2 reviewers followed by full text screening. Risk of bias was assessed using a modified SIGN checklist. A structured synthesis was performed. RESULTS: Thirty-nine studies (combined 1,467 participants diagnosed with mTBI) evaluating ANS function were included. ANS function was evaluated under various conditions including: rest, during exertion, cold pressor test, Valsalva maneuver, using face cooling and eyeball pressure paradigms. Short-term or ultra-short-term recordings were most common. The majority of studies (28/39) were rated as “unacceptable” for quality of evidence. CONCLUSIONS: Altered parameters of ANS function have been reported in multiple conditions following mTBI, both acutely and in the post-acute/chronic stages of recovery. However, due to methodological limitations, conclusions regarding the severity and timing of ANS dysfunction following mTBI cannot be drawn.