The impact of concussion on the cardiac autonomic nervous system of adolescents: a systematic review.
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All Authors
Pathmanathan, K.
Maidment, E.
Walker, SM.
LTHT Author
Maidment, Ewan
LTHT Department
Doctors' Rotation
Non Medic
Publication Date
2025
Item Type
Journal Article
Systematic Review
Systematic Review
Language
Subject
Subject Headings
Abstract
INTRODUCTION: Concussions pose a serious threat to adolescents, with potential long-term effects. This systematic review considers whether cardiac autonomic nervous system dysfunction occurs post-concussion in adolescents.
METHODS: Eight databases were searched on 30/5/24 using terms related to adolescents, concussion, and the cardiac autonomic nervous system. Included were full-text English articles comparing heart rate, blood pressure, or heart rate variability among adolescents with concussion history and controls. JBI critical appraisal tools assessed methodological quality. Meta-analysis was not performed due to inter-study methodological variations.
RESULTS: Ten studies met the inclusion criteria. Two studies included participants with longer-term concussion histories. Eight studies involved exertion. Mixed results were found for all metrics. A greater percentage of results was significant during exertion; the lowest percentage was for resting heart rate variability (15%), whilst the highest was for heart rate under exertion (46.15%). Critical appraisal highlights methodological flaws. Studies often inappropriately manage confounding factors, and some selected controls inappropriately, such as using individuals with a history of concussion as controls.
DISCUSSION: Evidence suggests possible cardiac autonomic dysfunction post-concussion, more apparent under exertion. Methodological limitations prevent definitive conclusions. Future research should better manage confounding factors to determine whether cardiac autonomic assessment can assist concussion diagnosis and management.
Journal
Brain Injury