The Journal of Head Trauma Rehabilitation最新文献

{"title":"Head Impact Burden and Change in Neurocognitive Function During a Season of Youth Football.","authors":"Sean C Rose,&nbsp;Keith O Yeates,&nbsp;Darren R Fuerst,&nbsp;Patrick M Ercole,&nbsp;Joseph T Nguyen,&nbsp;Natalie M Pizzimenti","doi":"10.1097/HTR.0000000000000441","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000441","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association of repetitive subconcussive head impacts with functional outcomes in primary and high school tackle football players.</p><p><strong>Setting: </strong>Youth football fields and an outpatient sports neurology clinic.</p><p><strong>Participants: </strong>A total of 112 primary school (n = 55, age 9-12 years) and high school (n = 57, age 15-18 years) football players.</p><p><strong>Design: </strong>A prospective cohort study.</p><p><strong>Main measures: </strong>Helmet-based sensors were used to record head impacts during practices and games during the 2016 football season. Impact g-forces were summed to yield a measure of cumulative impact. History of self-reported premorbid medical diagnoses was obtained preseason. Players completed assessments of a variety of outcomes both pre- and postseason: neuropsychological test performance, symptoms, vestibular and ocular-motor screening, balance, parent-completed attention-deficit hyperactivity disorder (ADHD) symptoms, and self-reported behavioral adjustment.</p><p><strong>Results: </strong>Average cumulative impact was 3700 (standard deviation = 2700) g-forces for the season and did not differ between age groups (P = .594). Cumulative impact did not predict pre- to postseason change scores on any outcome measures (all P > .05). Instead, younger age group and reported history of premorbid ADHD predicted change scores on several cognitive testing measures and parent-reported ADHD symptoms, while reported history of premorbid anxiety and depression predicted change scores on symptom reporting.</p><p><strong>Conclusions: </strong>In youth tackle football, subconcussive head impacts sustained over the course of a single season may not be associated with neurocognitive functional outcomes. The absence of a significant association may reflect the relatively short follow-up interval, and signals the need for studies across multiple seasons.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"87-95"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000441","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36585151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Virtual Reality Interventions for Improvement of Neurocognitive Performance After Traumatic Brain Injury: A Systematic Review.","authors":"Susruta Manivannan, Mohammad Al-Amri, Mark Postans, Laura Jayne Westacott, William Gray, Malik Zaben","doi":"10.1097/HTR.0000000000000412","DOIUrl":"10.1097/HTR.0000000000000412","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate current evidence for the effectiveness of virtual reality (VR) interventions in improving neurocognitive performance in individuals who have sustained a traumatic brain injury (TBI).</p><p><strong>Methods: </strong>A systematic literature search across multiple databases (PubMed, EMBASE, Web of Science) for articles of relevance. Studies were evaluated according to study design, patient cohort, VR intervention, neurocognitive parameters assessed, and outcome. VR interventions were evaluated qualitatively with respect to methodology and extent of immersion and quantitatively with respect to intervention duration.</p><p><strong>Outcomes: </strong>Our search yielded 324 articles, of which only 13 studies including 132 patients with TBI met inclusion criteria. A wide range of VR interventions and cognitive outcome measures is reported. Cognitive measures included learning and memory, attention, executive function, community skills, problem solving, route learning, and attitudes about driving. Several studies (n = 10) reported statistically significant improvements in outcome, and 2 studies demonstrated successful translation to real-life performance.</p><p><strong>Conclusions: </strong>VR interventions hold significant potential for improving neurocognitive performance in patients with TBI. While there is some evidence for translation of gains to activities of daily living, further studies are required to confirm the validity of cognitive measures and reliable translation to real-life performance.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E52-E65"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36343028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Sex on Recovery From Persistent Postconcussion Symptoms in Children and Adolescents Participating in an Active Rehabilitation Intervention.","authors":"Jérôme Gauvin-Lepage,&nbsp;Debbie Friedman,&nbsp;Lisa Grilli,&nbsp;Isabelle Gagnon","doi":"10.1097/HTR.0000000000000402","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000402","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the extent to which biologic sex contributes to the severity of postconcussion symptoms (PCSs) in concussed youth, who are slow to recover and who receive an active rehabilitation intervention (ARI) as part of their standard care.</p><p><strong>Setting: </strong>The concussion clinic of a pediatric trauma center in Canada.</p><p><strong>Participants: </strong>A total of 355 youth with persistent PCS (188 girls and 167 boys) as per the following criteria: (1) diagnosed with a concussion (or mild traumatic brain injury) as per the 2004 World Health Organization definition; (2) aged 8 to 17 years (mean = 14.34, standard deviation [SD] = 2.22 years); (3) presenting with at least 1 PCS interfering with daily activities (mean total PCS score at initial assessment = 24.50, SD = 18.88); and (4) on ARI 4 weeks postinjury (mean = 30.46, SD = 3.74 days).</p><p><strong>Design: </strong>A retrospective analysis of a prospective cohort.</p><p><strong>Main measures: </strong>PCS severity, measured by the PCS Scale (PCSS) included in the Sports Concussion Assessment Tool-3, was the dependent variable. PCSs were assessed 3 times over a 4-week period.</p><p><strong>Results: </strong>Boys presented with significantly fewer symptoms than girls 4 weeks postinjury, at initiation of the ARI (PCSS total score mean: ♂ = 19.9, ♀ = 28.5, P < .001, confidence interval = -14.8 to -6.4), at 2 and 4 weeks of follow-up, but the rate of recovery was slightly faster for girls over the follow-up period.</p><p><strong>Conclusion: </strong>Despite differences between the PCSS score reduction after 4 weeks of intervention, our results favored to a slightly faster recovery for girls over the follow-up period. Although our findings are not strong enough to suggest distinct sex-specific intervention, both boys and girls benefit from participating in an ARI.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"96-102"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36343021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Disturbance in Children With Moderate or Severe Traumatic Brain Injury Compared With Children With Orthopedic Injury.","authors":"Stefan Bogdanov,&nbsp;Naomi Brookes,&nbsp;Adrienne Epps,&nbsp;Sharon L Naismith,&nbsp;Arthur Teng,&nbsp;Suncica Lah","doi":"10.1097/HTR.0000000000000426","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000426","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize the sleep disturbance in children with moderate or severe traumatic brain injury (TBI), and to identify associated factors.</p><p><strong>Setting: </strong>An urban tertiary pediatric healthcare facility.</p><p><strong>Participants: </strong>Children aged 5 to 15 years with a moderate TBI (n = 21), severe TBI (n = 23), or an orthopedic injury (OI; n =38) comparable in age, gender, and socioeconomic status.</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Measures: </strong>Primary: Sleep Disturbance Scale for Children (SDSC). Secondary: Injury-specific factors (TBI severity, age at injury, and time since injury), and other factors of interest (sleep hygiene; pain intensity; difficulties with internalizing, externalizing, or attention/hyperactivity; parental distress; and parental knowledge of TBI).</p><p><strong>Results: </strong>On the SDSC, parents rated children with moderate TBI (but not severe TBI) as experiencing greater overall sleep disturbance, as well as excessive somnolence and sleep breathing disturbance, relative to OI controls. Children with severe TBI (but not moderate TBI) were rated as experiencing greater disturbance with initiating and maintaining sleep. The moderate and severe TBI groups did not differ on any of the sleep outcomes. Only 3 factors were associated with sleep disturbance in the combined TBI group: (1) lower TBI severity with greater excessive somnolence; (2) greater internalizing difficulties with greater overall sleep disturbance, and disturbance with initiating and maintaining sleep specifically; and (3) younger age at injury with greater overall sleep disturbance, and sleep breathing disturbance specifically.</p><p><strong>Conclusion: </strong>Children with moderate or severe TBI experience greater overall and/or specific forms of sleep disturbance. Different forms of sleep disturbance may be associated with different factors.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"122-131"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36343022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Spine Dysfunction Following Pediatric Sports-Related Head Trauma.","authors":"Michael J Ellis,&nbsp;Patrick J McDonald,&nbsp;Ashley Olson,&nbsp;James Koenig,&nbsp;Kelly Russell","doi":"10.1097/HTR.0000000000000411","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000411","url":null,"abstract":"<p><strong>Objective: </strong>To examine the prevalence of cervical spine injuries among children and adolescents referred with suspected and diagnosed sports-related concussion (SRC); and evaluate the effect of cervical spine dysfunction (CSD) on physician-documented clinical recovery following SRC.</p><p><strong>Setting: </strong>A multidisciplinary pediatric concussion program.</p><p><strong>Participants: </strong>A total of 266 patients (6-19 years) referred with suspected SRC.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Main measures: </strong>CSD defined as neurological symptoms localized to the cervical spine or the presence of neck pain, headache, or dizziness and abnormal cervical spine examination findings; physician-documented clinical recovery.</p><p><strong>Results: </strong>One patient was diagnosed with a T1 compression fracture. Of the 246 patients diagnosed with SRC, 80 (32.5%) met the clinical criteria for CSD including 4 patients with central cord neuropraxia and 1 with a spinal cord injury without radiographic abnormality (SCIWORA). Excluding patients with central cord neuropraxia OR SCIWORA, patients with SRC with CSD took longer to achieve physician-documented clinical recovery (28.5 days vs 17 days, P < .0001) and were 3.95 times more likely to experience delayed physician-documented clinical recovery (>4 weeks postinjury) compared with those without CSD.</p><p><strong>Conclusions: </strong>Patients with suspected and diagnosed SRC can present with a wide spectrum of coincident cervical spine injuries. Cervical spine dysfunction may be a risk factor for delayed clinical recovery.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"103-110"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36343026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attending Follow-up Appointments After Pediatric Traumatic Brain Injury: Caregiver-Perceived Barriers and Facilitators.","authors":"Kimberly Lever,&nbsp;Jin Peng,&nbsp;Jennifer P Lundine,&nbsp;Sarah Caupp,&nbsp;Krista K Wheeler,&nbsp;Eric A Sribnick,&nbsp;Henry Xiang","doi":"10.1097/HTR.0000000000000433","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000433","url":null,"abstract":"<p><strong>Objective: </strong>To examine barriers and facilitators for follow-up care of children with traumatic brain injury (TBI).</p><p><strong>Setting: </strong>Urban children's hospital.</p><p><strong>Participants: </strong>Caregivers of children (aged 2-18 years) discharged from an inpatient unit with a TBI diagnosis in 2014-2015.</p><p><strong>Design: </strong>Survey of caregivers.</p><p><strong>Main measures: </strong>Caregiver-reported barriers and facilitators to follow-up appointment attendance.</p><p><strong>Results: </strong>The sample included 159 caregivers who completed the survey. The top 3 barriers were \"no need\" (38.5%), \"schedule conflicts\" (14.1%), and \"lack of resources\" (10.3%). The top 5 identified facilitators were \"good hospital experience\" (68.6%), \"need\" (37.8%), \"sufficient resources\" (35.8%), \"well-coordinated appointments\" (31.1%), and \"provision of counseling and support\" (27.6%). Caregivers with higher income were more likely to report \"no need\" as a barrier; females were less likely to do so. Nonwhite caregivers and those without private insurance were more likely to report \"lack of resources\" as a barrier. Females were more likely to report \"good hospital experience\" and \"provision of counseling and support\" as a facilitator. Nonwhite caregivers were more likely to report \"need\" but less likely to report \"sufficient resources\" as facilitators.</p><p><strong>Conclusions: </strong>Care coordination, assistance with resources, and improvements in communication and the hospital experience are ways that adherence might be enhanced.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E21-E34"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000433","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36444952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inertial Sensors Reveal Subtle Motor Deficits When Walking With Horizontal Head Turns After Concussion.","authors":"Peter C Fino,&nbsp;Jennifer Wilhelm,&nbsp;Lucy Parrington,&nbsp;Samuel Stuart,&nbsp;James C Chesnutt,&nbsp;Laurie A King","doi":"10.1097/HTR.0000000000000418","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000418","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether horizontal head turns while seated or while walking, when instrumented with inertial sensors, were sensitive to the acute effects of concussion and whether horizontal head turns had utility for concussion management.</p><p><strong>Setting: </strong>Applied field setting, athletic training room.</p><p><strong>Participants: </strong>Twenty-four collegiate athletes with sports-related concussion and 25 healthy control athletes.</p><p><strong>Design: </strong>Case-control; longitudinal.</p><p><strong>Main measures: </strong>Peak head angular velocity and peak head angle (range of motion) when performing head turns toward an auditory cue while seated or walking. Gait speed when walking with and without head turns.</p><p><strong>Results: </strong>Athletes with acute sports-related concussion turned their head slower than healthy control subjects initially (group β = -49.47; SE = 16.33; P = .003) and gradually recovered to healthy control levels within 10 days postconcussion (group × time β = 4.80; SE = 1.41; P < .001). Peak head velocity had fair diagnostic accuracy in differentiating subjects with acute concussion compared with controls (areas under the receiver operating characteristic curve [AUC] = 0.71-0.73). Peak head angle (P = .17) and gait speed (P = .64) were not different between groups and showed poor diagnostic utility (AUC = 0.57-0.62).</p><p><strong>Conclusion: </strong>Inertial sensors can improve traditional clinical assessments by quantifying subtle, nonobservable deficits in people following sports-related concussion.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E74-E81"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36341995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Dynamic Symptom Response in Concussion: Children's Exertional Effects Rating Scale.","authors":"Maegan D Sady,&nbsp;Christopher G Vaughan,&nbsp;Gerard A Gioia","doi":"10.1097/HTR.0000000000000424","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000424","url":null,"abstract":"<p><strong>Objective: </strong>To introduce and evaluate a measure of momentary symptom response to cognitive activity, a core feature of concussion.</p><p><strong>Setting: </strong>Concussion clinic at a large regional children's hospital.</p><p><strong>Participants: </strong>Individuals aged 5 to 18 years, comprising 3 clinical groups: uninjured (n = 590), recently concussed but clinically recovered (n = 160), and recently concussed but not yet recovered (n = 570).</p><p><strong>Design: </strong>Participants completed pretest symptom ratings, underwent neurocognitive assessment and completion of questionnaires, and then completed posttest ratings. An exertional effects index was computed by subtracting pretest from posttest ratings.</p><p><strong>Main measures: </strong>Children's Exertional Effects Rating Scale, which includes 4 symptoms (Headache, Fatigue, Concentration Problems, and Irritability) rated pre- and postactivity.</p><p><strong>Results: </strong>Children's Exertional Effects Rating Scale was found to have adequate reliability and validity. There were negligible differences in ratings (pretest and exertional effects) between the Uninjured and Recovered groups, while individuals who were Not Recovered rated higher levels of pretest and exertional effects. Base rates showed that an exertional effects index of 4 or more points is rare in individuals who do not have a current concussion.</p><p><strong>Conclusion: </strong>Children's Exertional Effects Rating Scale is a psychometrically sound scale for evaluating momentary symptom increase in response to cognitive activity. Clinicians can use this scale as part of a multimodal battery for concussion assessment and treatment.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E35-E44"},"PeriodicalIF":2.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000424","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36449024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic Brain Injury and the Risk for Subsequent Crime Perpetration.","authors":"Robert H Bonow,&nbsp;Jin Wang,&nbsp;Douglas F Zatzick,&nbsp;Frederick P Rivara,&nbsp;Ali Rowhani-Rahbar","doi":"10.1097/HTR.0000000000000413","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000413","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether patients with traumatic brain injury (TBI) are at higher risk for subsequent crime perpetration compared with injured patients without TBI and those hospitalized for reasons other than injury.</p><p><strong>Setting and participants: </strong>Patients hospitalized in Washington State from 2006-2007.</p><p><strong>Design: </strong>A retrospective cohort study using linked statewide datasets.</p><p><strong>Main measures: </strong>Primary outcomes were arrest for any violent or nonviolent crime within 5 years of discharge. Adjusted subhazard ratios were calculated using regression models incorporating death as a competing risk.</p><p><strong>Results: </strong>Compared with uninjured patients (n = 158 247), the adjusted rate of arrest for any crime was greater among injured patients with TBI (n = 6894; subdistribution hazard ratios [sHR], 1.57; 95% confidence interval [CI], 1.49-1.62) and without TBI (n = 40 035; sHR, 1.55; 95% CI, 1.49-1.62). When patients with TBI were directly compared with injured patients without TBI, no effect of TBI on subsequent arrests was found (sHR, 1.02; 95% CI, 0.94-1.11). TBI did not increase the likelihood of either violent or nonviolent crime when these outcomes were examined separately.</p><p><strong>Conclusions: </strong>TBI survivors do not appear to be at increased risk for criminality compared with injured individuals without TBI. However, injured persons with or without TBI may be at elevated risk of crime perpetration compared with those who are uninjured.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E61-E69"},"PeriodicalIF":2.4,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000413","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40550627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced Resting and Increased Elevation of Heart Rate Variability With Cognitive Task Performance in Concussed Athletes.","authors":"Mu Huang,&nbsp;Justin Frantz,&nbsp;Gilbert Moralez,&nbsp;Tonia Sabo,&nbsp;Peter F Davis,&nbsp;Scott L Davis,&nbsp;Kathleen R Bell,&nbsp;Sushmita Purkayastha","doi":"10.1097/HTR.0000000000000409","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000409","url":null,"abstract":"<p><strong>Objective: </strong>To examine heart rate variability (HRV) at rest and with a 2-Back cognitive task involving executive function and sustained attention in athletes during the acute phase following concussion and compare them with the controls.</p><p><strong>Participants: </strong>Twenty-three male and female collegiate athletes (20 ± 1 years) following (4 ± 1 days) a sports-related concussion and 23 sports- and sex-matched noninjured controls.</p><p><strong>Procedure: </strong>Continuous R-R interval was acquired using 3-lead electrocardiogram for 3 minutes each at rest and during the 2-Back task. HRV was quantified as percent high-frequency (HF) power.</p><p><strong>Results: </strong>At rest, lower percent HF power was observed in the concussed athletes (23 ± 11) compared with the controls (38 ± 14; P = .0027). However, with the 2-Back task, an increase in HF power was observed in the concussed group (39 ± 12; P = .0008) from rest and was comparable with the controls (36 ± 15). No difference in HF power between rest and 2-Back task was observed in the controls.</p><p><strong>Conclusion: </strong>Lower HRV was observed at rest following concussion. An increase in HRV, suggestive of enhanced prefrontal cortex (PFC) functioning, was observed during a cognitive task in the concussed athletes. Therefore, cognitive tasks as early as 4 days after injury may increase PFC functioning from rest and expedite return to learn in collegiate athletes.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"45-51"},"PeriodicalIF":2.4,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40439807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}