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Autonomic system -- concussion and sport

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82 papers 25 to 100 followers
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
https://www.readbyqxmd.com/read/29778304/postural-orthostatic-tachycardia-syndrome-in-children-and-adolescents
#1
REVIEW
Jeffrey R Boris
Postural orthostatic tachycardia syndrome (POTS) affects up to 3,000,000 people in the United States, with at least one-third of them developing POTS before the age of 18. POTS as a disorder is similar in adult and pediatric populations, but there are factors specific to pediatric patients that affect how it presents and how it is experienced that make pediatric POTS different. This review discusses the both the similarities in this population to their adult counterparts and the unique challenges faced by pediatric POTS patients, including management of schooling and education as well as the complex interactions between these pediatric patients and their parents...
May 12, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29773483/sleep-disorders-in-patients-with-postural-tachycardia-syndrome-a-review-of-the-literature-and-guide-for-clinicians
#2
REVIEW
Mitchell G Miglis, Fiona Barwick
Fatigue is common in POTS, and patients often report unrefreshing sleep. These symptoms are directly correlated with a reduced quality of life, however the treatment of sleep disorders in this population remains a challenge. This article will review the current literature on the prevalence of sleep disorders in POTS, their association with the underlying pathophysiology of POTS, and current treatment paradigms.
May 8, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29705015/evaluation-of-postural-tachycardia-syndrome-pots
#3
REVIEW
Brent P Goodman
The diagnostic evaluation of a patient with suspected postural tachycardia syndrome (POTS) requires a thoughtful diagnostic approach utilizing a careful clinical history and examination, laboratory, and autonomic testing. This article outlines the importance of a thorough history in identifying mechanism of symptom onset, clinical features, associated clinical conditions or disorders, and factors that may result in symptom exacerbation. The clinical examination involves an assessment of pupillary responses, an evaluation for sudomotor and vasomotor signs, and an assessment for joint hypermobility...
April 22, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29678416/surgical-and-dental-considerations-in-patients-with-postural-tachycardia-syndrome
#4
Mohammed Ruzieh, Mark Dziuba, James P Hofmann, Blair P Grubb
No abstract text is available yet for this article.
April 13, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29668716/earlier-time-to-aerobic-exercise-is-associated-with-faster-recovery-following-acute-sport-concussion
#5
David Wyndham Lawrence, Doug Richards, Paul Comper, Michael G Hutchison
OBJECTIVE: To determine whether earlier time to initiation of aerobic exercise following acute concussion is associated with time to full return to (1) sport and (2) school or work. METHODS: A retrospective stratified propensity score survival analysis of acute (≤14 days) concussion was used to determine whether time (days) to initiation of aerobic exercise post-concussion was associated with, both, time (days) to full return to (1) sport and (2) school or work...
2018: PloS One
https://www.readbyqxmd.com/read/29670568/the-dynamics-of-concussion-mapping-pathophysiology-persistence-and-recovery-with-causal-loop-diagramming
#6
Erin S Kenzie, Elle L Parks, Erin D Bigler, David W Wright, Miranda M Lim, James C Chesnutt, Gregory W J Hawryluk, Wayne Gordon, Wayne Wakeland
Despite increasing public awareness and a growing body of literature on the subject of concussion, or mild traumatic brain injury, an urgent need still exists for reliable diagnostic measures, clinical care guidelines, and effective treatments for the condition. Complexity and heterogeneity complicate research efforts and indicate the need for innovative approaches to synthesize current knowledge in order to improve clinical outcomes. Methods from the interdisciplinary field of systems science, including models of complex systems, have been increasingly applied to biomedical applications and show promise for generating insight for traumatic brain injury...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29674994/a-cross-sectional-study-on-cerebral-hemodynamics-after-mild-traumatic-brain-injury-in-a-pediatric-population
#7
Corey M Thibeault, Samuel Thorpe, Michael J O'Brien, Nicolas Canac, Mina Ranjbaran, Ilyas Patanam, Artin Sarraf, James LeVangie, Fabien Scalzo, Seth J Wilk, Ramon Diaz-Arrastia, Robert B Hamilton
The microvasculature is prominently affected by traumatic brain injury (TBI), including mild TBI (concussion). Assessment of cerebral hemodynamics shows promise as biomarkers of TBI, and may help inform development of therapies aimed at promoting neurologic recovery. The objective of this study was to assess the evolution in cerebral hemodynamics observable with transcranial Doppler (TCD) ultrasound in subjects suffering from a concussion at different intervals during recovery. Pediatric subjects between the ages of 14 and 19 years clinically diagnosed with a concussion were observed at different points post-injury...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29660949/concussion-and-the-autonomic-nervous-system-an-introduction-to-the-field-and-the-results-of-a-systematic-review
#8
Jon L Pertab, Tricia L Merkley, Alex J Cramond, Kelly Cramond, Holly Paxton, Trevor Wu
BACKGROUND: Recent evidence suggests that autonomic nervous dysfunction may be one of many potential factors contributing to persisting post-concussion symptoms. OBJECTIVE: This is the first systematic review to explore the impact of concussion on multiple aspects of autonomic nervous system functioning. METHODS: The methods employed are in compliance with the American Academy of Neurology (AAN) and PRISMA standards. Embase, MEDLINE, PsychINFO, and Science Citation Index literature searches were performed using relevant indexing terms for articles published prior to the end of December 2016...
April 7, 2018: NeuroRehabilitation
https://www.readbyqxmd.com/read/29636724/sport-related-concussion-alters-indices-of-dynamic-cerebral-autoregulation
#9
Alexander D Wright, Jonathan D Smirl, Kelsey Bryk, Sarah Fraser, Michael Jakovac, Paul van Donkelaar
Sport-related concussion is known to affect a variety of brain functions. However, the impact of this brain injury on cerebral autoregulation (CA) is poorly understood. Thus, the goal of the current study was to determine the acute and cumulative effects of sport-related concussion on indices of dynamic CA. Toward this end, 179 elite, junior-level (age 19.6 ± 1.5 years) contact sport (ice hockey, American football) athletes were recruited for preseason testing, 42 with zero prior concussions and 31 with three or more previous concussions...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29628432/cognitive-and-psychological-issues-in-postural-tachycardia-syndrome
#10
REVIEW
Vidya Raj, Morwenna Opie, Amy C Arnold
Postural tachycardia syndrome (POTS) is one of the most common forms of chronic orthostatic intolerance. In addition to orthostatic symptoms, many POTS patients report incapacitating cognitive dysfunction or "brain fog" even while lying down or seated. Consistent with these subjective reports, there is accruing objective evidence of specific cognitive difficulties in POTS, with studies showing mild to moderate cognitive impairment using standardized neuropsychological assessment batteries. The precise profile of cognitive dysfunction in POTS patients has been shown to vary among these studies potentially due to the neuropsychological tests used, postural position, comorbidities and length of illness, inclusion of adolescent versus adult patients, and sites of recruitment...
March 27, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29605837/pathophysiology-of-noncardiac-syncope-in-athletes
#11
REVIEW
Georgios A Christou, Konstantinos A Christou, Dimitrios N Kiortsis
The most frequent cause of syncope in young athletes is noncardiac etiology. The mechanism of noncardiac syncope (NCS) in young athletes is neurally-mediated (reflex). NCS in athletes usually occurs either as orthostasis-induced, due to a gravity-mediated reduced venous return to the heart, or in the context of exercise. Exercise-related NCS typically occurs after the cessation of an exercise bout, while syncope occurring during exercise is highly indicative of the existence of a cardiac disorder. Postexercise NCS appears to result from hypotension due to impaired postexercise vasoconstriction, as well as from hypocapnia...
March 31, 2018: Sports Medicine
https://www.readbyqxmd.com/read/29574665/exercise-blood-pressure-guidelines-time-to-re-evaluate-what-is-normal-and-exaggerated
#12
Katharine D Currie, John S Floras, Andre La Gerche, Jack M Goodman
Blood pressure responses to graded exercise testing can provide important diagnostic and prognostic information. While published guidelines outline what constitutes a "normal" and "abnormal" (i.e., exaggerated) blood pressure response to exercise testing, the widespread use of exaggerated blood pressure responses as a clinical tool is limited due to sparse and inconsistent data. A review of the original sources from these guidelines reveals an overall lack of empirical evidence to support both the normal blood pressure responses and their upper limits...
March 24, 2018: Sports Medicine
https://www.readbyqxmd.com/read/29403426/heart-rate-variability-in-healthy-non-concussed-youth-athletes-exploring-the-effect-of-age-sex-and-concussion-like-symptoms
#13
Melissa Paniccia, Lee Verweel, Scott Thomas, Tim Taha, Michelle Keightley, Katherine E Wilson, Nick Reed
Background: Heart rate variability (HRV) is a non-invasive neurophysiological measure of autonomic nervous system regulation emerging in concussion research. To date, most concussion studies have focused on the university-aged athlete with no research examining healthy active youths. Corroborating changes in HRV alongside traditional subjective self-report measures (concussion symptoms) in the non-concussed state provides a foundation for interpreting change following concussion. The objectives were to (1) explore the influence of age and sex on HRV and (2) examine the relationship between HRV and baseline/pre-injury concussion symptom domains (physical, cognitive, emotional, and fatigue) in healthy youth athletes...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29523389/postural-tachycardia-syndrome-diagnosis-physiology-and-prognosis
#14
REVIEW
Amy C Arnold, Jessica Ng, Satish R Raj
Postural tachycardia syndrome (POTS) is a heterogeneous clinical syndrome that has gained increasing interest over the past few decades due to its increasing prevalence and clinical impact on health-related quality of life. POTS is clinically characterized by sustained excessive tachycardia upon standing that occurs in the absence of significant orthostatic hypotension and other medical conditions and or medications, and with chronic symptoms of orthostatic intolerance. POTS represents one of the most common presentations of syncope and presyncope secondary to autonomic dysfunction in emergency rooms and in cardiology, neurology, and primary care clinics...
February 28, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29492579/systolic-and-diastolic-regulation-of-the-cerebral-pressure-flow-relationship-differentially-affected-by-acute-sport-related-concussion
#15
Alexander D Wright, Jonathan D Smirl, Kelsey Bryk, Paul van Donkelaar
OBJECTIVE: To determine whether acute sports-related concussion (SRC) exerts differential effects on cerebral autoregulatory properties during systole versus diastole. MATERIALS AND METHODS: One hundred and thirty-six contact-sport athletes tested preseason; 14 sustained a concussion and completed follow-up testing at 72 hours, 2 weeks, and 1 month post-injury. Five minutes of repetitive squat-stand maneuvers induced blood pressure (BP) oscillations at both 0.05 and 0...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29488253/visual-problems-associated-with-traumatic-brain-injury
#16
REVIEW
Richard A Armstrong
Traumatic brain injury (TBI) and its associated concussion are major causes of disability and death. All ages can be affected but children, young adults and the elderly are particularly susceptible. A decline in mortality has resulted in many more individuals living with a disability caused by TBI including those affecting vision. This review describes: (1) the major clinical and pathological features of TBI; (2) the visual signs and symptoms associated with the disorder; and (3) discusses the assessment of quality of life and visual rehabilitation of the patient...
February 28, 2018: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/29367218/orthostatic-blood-pressure-recovery-patterns-in-suspected-syncope-in-the-emergency-department
#17
Veera K van Wijnen, Dik Ten Hove, Reinold O B Gans, Wybe Nieuwland, Arie M van Roon, Jan C Ter Maaten, Mark P M Harms
INTRODUCTION: Orthostasis is a frequent trigger for (pre)syncope but some forms of orthostatic (pre)syncope have a worse prognosis than others. Routine assessment of orthostatic BP in the ED can detect classic orthostatic hypotension, but often misses these other forms of orthostatic (pre)syncope. This study aimed to determine the frequency of abnormal orthostatic BP recovery patterns in patients with (pre)syncope by using continuous non-invasive BP monitoring. METHODS: We performed a prospective cohort study in suspected patients with (pre)syncope in the ED of a tertiary care teaching hospital between January and August 2014...
April 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29357955/demographics-of-a-large-paediatric-postural-orthostatic-tachycardia-syndrome-program
#18
Jeffrey R Boris, Thomas Bernadzikowski
OBJECTIVE: The aim of this study was to identify and evaluate demographic and clinical features of paediatric patients with postural orthostatic tachycardia syndrome in a tertiary hospital speciality clinic. METHOD: This is a retrospective review of clinical data obtained during initial outpatient evaluation. RESULTS: A total of 708 patients met the evaluation criteria. Female patients outnumbered males, 3.45:1. Caucasians were over-represented at 94...
January 23, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29359277/response-of-cerebral-blood-flow-and-blood-pressure-to-dynamic-exercise-a-study-using-pet
#19
Mikio Hiura, Tadashi Nariai, Muneyuki Sakata, Akitaka Muta, Kenji Ishibashi, Kei Wagatsuma, Tetsuro Tago, Jun Toyohara, Kenji Ishii, Taketoshi Maehara
Dynamic exercise elicits fluctuations in blood pressure (BP) and cerebral blood flow (CBF). This study investigated responses in BP and CBF during cycling exercise and post-exercise hypotension (PEH) using positron emission tomography (PET). CBF was measured using oxygen-15-labeled water (H2 15 O) and PET in 11 human subjects at rest (Rest), at the onset of exercise (Ex1), later in the exercise (Ex2), and during PEH. Global CBF significantly increased by 13% at Ex1 compared with Rest, but was unchanged at Ex2 and during PEH...
February 2018: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/29277373/exertional-tolerance-assessments-after-mild-traumatic-brain-injury-a-systematic-review
#20
REVIEW
Catherine Quatman-Yates, Anna Bailes, Sara Constand, Mary Claire Sroka, Katharine Nissen, Brad Kurowski, Jason Hugentobler
OBJECTIVE: To review the literature to identify and summarize strategies for evaluating responses to physical exertion after mild traumatic brain injury (mTBI) for clinical and research purposes. DATA SOURCES: PubMed and EBSCOhost through December 31, 2016. STUDY SELECTION: Two independent reviewers selected studies based on the following criteria: (1) inclusion of participants with mTBI/concussion, (2) use of a measurement of physiological or psychosomatic response to exertion, (3) a repeatable description of the exertion protocol was provided, (4) a sample of at least 10 participants with a mean age between 8 and 65 years, and (5) the article was in English...
December 23, 2017: Archives of Physical Medicine and Rehabilitation
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