Aaron J Zynda, Alicia M Trbovich, Faith Kehinde, Christopher Burley, Michael W Collins, David O Okonkwo, Anne Mucha, Sarah Ostop, Cyndi Holland, Courtney Perry, Melissa N Womble, Sabrina Jennings, Sheri Fedor, Christina Dollar, Kori J Durfee, R J Elbin, Anthony P Kontos
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Eighteen (17.0%) were in both anxiety groups. Results supported a significant group x time interaction in participants with pre-existing anxiety for increased diastolic BP (F[1,97] = 5.03, p = 0.03) and VAS (F[1,99] = 5.05, p = 0.03) while controlling for covariates. Participants with pre-existing anxiety (median = 8[4]) and post-injury anxiety (median = 8[5]) completed fewer BCBT stages than those without pre-existing (median = 11[6], p < 0.01) and post-injury (median = 10[6], p = 0.03) anxiety.</p><p><strong>Conclusions: </strong>Adults with pre-existing and post-injury anxiety experienced altered physiological responses to exercise post-concussion and completed fewer stages of the BCBT. Anxiety should be considered by clinicians when interpreting findings from exercise intolerance tests such as the BCBT.</p><p><strong>Trial registration: </strong>www.</p><p><strong>Clinicaltrials: </strong>gov ; identifier: NCT04549532; https://clinicaltrials.gov/study/NCT04549532.</p>","PeriodicalId":19191,"journal":{"name":"Neurological Sciences","volume":" ","pages":"3909-3918"},"PeriodicalIF":2.4000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Role of anxiety in exercise intolerance and autonomic nervous system dysfunction post-concussion.\",\"authors\":\"Aaron J Zynda, Alicia M Trbovich, Faith Kehinde, Christopher Burley, Michael W Collins, David O Okonkwo, Anne Mucha, Sarah Ostop, Cyndi Holland, Courtney Perry, Melissa N Womble, Sabrina Jennings, Sheri Fedor, Christina Dollar, Kori J Durfee, R J Elbin, Anthony P Kontos\",\"doi\":\"10.1007/s10072-025-08204-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare autonomic nervous system (ANS) response using the Buffalo Concussion Bike Test (BCBT) between adult post-concussion patients with and without pre-existing and post-injury anxiety.</p><p><strong>Design: </strong>Cross-sectional cohort study of participants from the Targeted, Multidomain (T-MD) Treatment for Concussion Randomized Controlled Trial.</p><p><strong>Setting: </strong>Two concussion specialty clinics.</p><p><strong>Participants: </strong>Ages 18-49 years, 8 days to 6 months from injury, without a history of cardiovascular/neurological/vestibular disorders. 256 participants were eligible, 120 declined, 136 enrolled, and 30 were excluded.</p><p><strong>Exposures: </strong>Participants completed the BCBT at a baseline study visit following initial clinical evaluation.</p><p><strong>Main outcomes and measures: </strong>Number of BCBT stages completed and Visual Analogue Scale (VAS), heart rate (HR), blood pressure (BP), and Ratings of Perceived Exertion (RPE) pre- and post-BCBT.</p><p><strong>Results: </strong>106 participants (age = 25.5 [12.5], 66 [62.3%] female) were included, 44 (41.5%) with pre-existing anxiety, 61 (57.6%) without pre-existing anxiety, 33 (31.1%) with post-injury anxiety, and 73 (68.9%) without post-injury anxiety. Eighteen (17.0%) were in both anxiety groups. Results supported a significant group x time interaction in participants with pre-existing anxiety for increased diastolic BP (F[1,97] = 5.03, p = 0.03) and VAS (F[1,99] = 5.05, p = 0.03) while controlling for covariates. Participants with pre-existing anxiety (median = 8[4]) and post-injury anxiety (median = 8[5]) completed fewer BCBT stages than those without pre-existing (median = 11[6], p < 0.01) and post-injury (median = 10[6], p = 0.03) anxiety.</p><p><strong>Conclusions: </strong>Adults with pre-existing and post-injury anxiety experienced altered physiological responses to exercise post-concussion and completed fewer stages of the BCBT. 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引用次数: 0
摘要
目的：利用布法罗脑震荡自行车测试（bbct）比较成年脑震荡后患者自主神经系统（ANS）的反应。设计：来自脑震荡靶向多域（T-MD）治疗随机对照试验参与者的横断面队列研究。环境：两个脑震荡专科诊所。参与者：年龄18-49岁，受伤后8天至6个月，无心血管/神经/前庭疾病史。256名受试者符合条件，120人被拒绝，136人入选，30人被排除。暴露：参与者在初始临床评估后的基线研究访问中完成bbct。主要结局和测量方法：BCBT完成阶段数、视觉模拟量表（VAS）、心率（HR）、血压（BP）和BCBT前后感知运动评分（RPE）。结果：共纳入106例（年龄25.5[12.5]，女性66例[62.3%]），其中有既往焦虑者44例（41.5%），无既往焦虑者61例（57.6%），有伤后焦虑者33例（31.1%），无伤后焦虑者73例（68.9%）。两组均有18例（17.0%）。结果支持在控制协变量的情况下，存在焦虑的参与者在舒张压升高（F[1,97] = 5.03, p = 0.03）和VAS （F[1,99] = 5.05, p = 0.03）方面存在显著的组时间交互作用。先前存在焦虑（中位数= 8[5]）和损伤后焦虑（中位数= 8[5]）的参与者完成的BCBT阶段少于没有先前存在焦虑的参与者（中位数= 11[6]），p结论：患有先前存在焦虑和损伤后焦虑的成年人在脑震荡后运动时的生理反应发生改变，完成的BCBT阶段更少。临床医生在解释运动不耐受测试（如bbct）的结果时应考虑到焦虑。试验注册：www.Clinicaltrials: gov；标识符:NCT04549532;https://clinicaltrials.gov/study/NCT04549532。
Role of anxiety in exercise intolerance and autonomic nervous system dysfunction post-concussion.
Objective: To compare autonomic nervous system (ANS) response using the Buffalo Concussion Bike Test (BCBT) between adult post-concussion patients with and without pre-existing and post-injury anxiety.
Design: Cross-sectional cohort study of participants from the Targeted, Multidomain (T-MD) Treatment for Concussion Randomized Controlled Trial.
Setting: Two concussion specialty clinics.
Participants: Ages 18-49 years, 8 days to 6 months from injury, without a history of cardiovascular/neurological/vestibular disorders. 256 participants were eligible, 120 declined, 136 enrolled, and 30 were excluded.
Exposures: Participants completed the BCBT at a baseline study visit following initial clinical evaluation.
Main outcomes and measures: Number of BCBT stages completed and Visual Analogue Scale (VAS), heart rate (HR), blood pressure (BP), and Ratings of Perceived Exertion (RPE) pre- and post-BCBT.
Results: 106 participants (age = 25.5 [12.5], 66 [62.3%] female) were included, 44 (41.5%) with pre-existing anxiety, 61 (57.6%) without pre-existing anxiety, 33 (31.1%) with post-injury anxiety, and 73 (68.9%) without post-injury anxiety. Eighteen (17.0%) were in both anxiety groups. Results supported a significant group x time interaction in participants with pre-existing anxiety for increased diastolic BP (F[1,97] = 5.03, p = 0.03) and VAS (F[1,99] = 5.05, p = 0.03) while controlling for covariates. Participants with pre-existing anxiety (median = 8[4]) and post-injury anxiety (median = 8[5]) completed fewer BCBT stages than those without pre-existing (median = 11[6], p < 0.01) and post-injury (median = 10[6], p = 0.03) anxiety.
Conclusions: Adults with pre-existing and post-injury anxiety experienced altered physiological responses to exercise post-concussion and completed fewer stages of the BCBT. Anxiety should be considered by clinicians when interpreting findings from exercise intolerance tests such as the BCBT.
期刊介绍：
Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.
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