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Autonomic system -- concussion and sport

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29 papers 0 to 25 followers
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
Peter Taggart, Hugo Critchley, Stefan van Duijvendoden, Pier D Lambiase
Advances in investigative techniques have led to an increasing awareness and understanding of the role of central neural control in the autonomic nervous system regulation of the heart. Substantial evidence exists for a role of the higher centres in neuro-cardiac control including the effect of focal brain stimulation and acute brain lesions on cardiac electrophysiology, blood pressure, contractile function and the development of arrhythmias. Mental stress and strong emotions have long been associated with sudden cardiac death...
August 2016: Autonomic Neuroscience: Basic & Clinical
Manish Kalla, Neil Herring, David J Paterson
A hallmark of cardiovascular disease is cardiac autonomic dysregulation. The phenotype of impaired parasympathetic responsiveness and sympathetic hyperactivity in experimental animal models is also well documented in large scale human studies in the setting of heart failure and myocardial infarction, and is predictive of morbidity and mortality. Despite advances in emergency revascularisation strategies for myocardial infarction, device therapy for heart failure and secondary prevention pharmacotherapies, mortality from malignant ventricular arrhythmia remains high...
August 2016: Autonomic Neuroscience: Basic & Clinical
Karen Barlow, Lorenzo D Marcil, Helen L Carlson, Deborah Dewey, Frank P MacMaster, Brian L Brooks, Marc Lebel
The biology of post-concussive symptoms is unclear. Symptoms are often increased during activities, and have been linked to decreased cerebrovascular reactivity and perfusion. The aim of this study was to examine cerebral blood flow (CBF) in children with different clinical recovery patterns following mild traumatic brain injury (mTBI). This was a prospective controlled cohort study of children with mTBI (ages 8 to 18 years) who were symptomatic with post concussive symptoms at one month post-injury (symptomatic, n=27) and children who had recovered quickly (asymptomatic, n=24)...
August 23, 2016: Journal of Neurotrauma
Florent Besnier, Marc Labrunée, Atul Pathak, Anne Pavy-Le Traon, Céline Galès, Jean-Michel Sénard, Thibaut Guiraud
Patients with cardiovascular disease show autonomic dysfunction, including sympathetic activation and vagal withdrawal, which leads to fatal events. This review aims to place sympathovagal balance as an essential element to be considered in management for cardiovascular disease patients who benefit from a cardiac rehabilitation program. Many studies showed that exercise training, as non-pharmacologic treatment, plays an important role in enhancing sympathovagal balance and could normalize levels of markers of sympathetic flow measured by microneurography, heart rate variability or plasma catecholamine levels...
August 16, 2016: Annals of Physical and Rehabilitation Medicine
James Q Truong, Kenneth J Ciuffreda
PURPOSE: To determine if mTBI adversely affects the pupillary light reflex (PLR). METHODS: The PLR was evaluated in mTBI and compared to normal individuals under a range of test conditions. Nine pupil parameters (maximum, minimum and final pupil diameter, latency, amplitude and peak and average constriction and dilation velocities) and six stimulus conditions (dim pulse, dim step, bright pulse, bright step, bright red step and bright blue step) were assessed in 32 adults with mTBI (21-60 years of age) and compared to 40 normal (22-56 years of age)...
2016: Brain Injury: [BI]
G André Ng
Sudden cardiac death as a result of lethal ventricular arrhythmias is a major cause of death in cardiac diseases such as heart failure and prior myocardial infarct. Activity of the autonomic nervous system is often abnormal where sympathetic activity is upregulated and vagal activity reduced in these conditions. The abnormal autonomic state has been shown to be a strong prognostic marker of increased mortality and propensity to lethal arrhythmias, for which there is no effective prevention. Research effort over the years has established good evidence for a causal link between autonomic disturbance and ventricular arrhythmias...
August 2016: Autonomic Neuroscience: Basic & Clinical
Ingo Helmich, Alisa Berger, Hedda Lausberg
INTRODUCTION: Postural instability has been shown to characterize individuals who suffered from long-term symptoms after mild traumatic brain injury (mTBI). However, recordings of neural processes during postural control are difficult to realize with standard neuroimaging techniques. Thus, we used functional NearInfraRed Spectroscopy (fNIRS) to investigate brain oxygenation of individuals with persistent post-concussion symptoms (pPCS) during postural control in altered environments. METHODS: We compared brain oxygenation and postural sway during balance control in three groups: individuals suffering from pPCS, individuals with a history of mTBI but without pPCS, and healthy controls...
July 6, 2016: Medicine and Science in Sports and Exercise
Lisa Letzkus, Jessica Keim-Malpass, Christine Kennedy
BACKGROUND: Children who suffer from moderate-to-severe brain injury can develop a complicating phenomenon known as paroxysmal sympathetic hyperactivity (PSH), characterized by autonomic instability and identified clinically as a cluster of symptoms that can include recurrent fever without a source of infection, hypertension, tachycardia, tachypnea, agitation, diaphoresis and dystonia. Studies with adults have demonstrated that this cluster of symptoms is associated with poorer clinical outcomes (prolonged hospitalizations, poorer cognitive and motor function)...
2016: Brain Injury: [BI]
Aaron R Murray, Lucy Atkinson, Mohd K Mahadi, Susan A Deuchars, Jim Deuchars
The human ear seems an unlikely candidate for therapies aimed at improving cardiac function, but the ear and the heart share a common connection: the vagus nerve. In recent years there has been increasing interest in the auricular branch of the vagus nerve (ABVN), a unique cutaneous subdivision of the vagus distributed to the external ear. Non-invasive electrical stimulation of this nerve through the skin may offer a simple, cost-effective alternative to the established method of vagus nerve stimulation (VNS), which requires a surgical procedure and has generated mixed results in a number of clinical trials for heart failure...
August 2016: Autonomic Neuroscience: Basic & Clinical
Arrani Senthinathan, Lynda M Mainwaring, Michael Hutchison
OBJECTIVE: To assess heart rate variability (HRV) in athletes with concussion across three phases of recovery. DESIGN: A prospective matched control group design included the collection of HRV and symptoms measured by the Rivermead Post-Concussion Questionnaire. These measures were taken at 3 phases of recovery [(1) symptomatic; (2). asymptomatic; and (3) one-week after return-to-play (RTP)]. The same protocol was completed by noninjured athletes. SETTING: Interuniversity sports teams at a single institution...
July 1, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Christopher J Brush, Ryan L Olson, Peter J Ehmann, Brandon L Alderman
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
Michal Katz-Leurer, Hemda Rotem, Maayan Shofer, Shirley Meyer
AIM: To assess heart rate (HR) and heart rate variability (HRV) at rest, during exercise and during the recovery phase post-exercise in children at the chronic phase post-severe TBI as compared to age-matched typically-developed (TD) controls. SETTING: Out-patient clinic. PARTICIPANTS: Ten children (two girls, eight boys), 3-5 years post-severe TBI, aged 7-11 years with residual deficits and 20 TD children matched for age. INTERVENTIONS: HR and HRV were determined at rest, during step test for 3 minutes, during walking on a treadmill for 6 minutes and during the recovery periods post-exercise sessions...
2016: Brain Injury: [BI]
Vanessa Ponnusamy, Andrew P Owens, Sanjay Purkayastha, Valeria Iodice, Christopher J Mathias
The prevalence and costs of the obesity epidemic and obesity-related conditions, including diabetes mellitus, is consistently increasing worldwide. Bariatric medicine is attempting to address this with weight loss and exercise programmes, and with increasing frequency, various forms of bariatric surgery. There has been considerable success reported after bariatric surgery but not without. We describe 14 patients with orthostatic intolerance (OI) post bariatric surgery. We report on OI (postural dizziness, palpitations and fainting), the results of cardiovascular autonomic testing and the associated and/or causative findings as well as reviewing the literature to consider the possible mechanisms...
July 2016: Autonomic Neuroscience: Basic & Clinical
Julie Stang, Trine Stensrud, Petter Mowinckel, Kai-Hakon Carlsen
PURPOSE: High prevalence of asthma and bronchial hyperresponsiveness (BHR) are reported in swimmers and cross-country skiers. It has been suggested that increased parasympathetic nervous activity is involved in asthma development in endurance athletes. We aimed to assess the associations of BHR to parasympathetic activity in healthy and asthmatic swimmers and cross-country skiers, and healthy non-athletes. METHODS: Parasympathetic activity was measured by pupillometry and heart rate variability (HRV) at the onset of exercise with the cardiac vagal index (CVI) calculated, in 28 cross-country skiers (♂18/♀10), 29 swimmers (♂17/♀12), and 30 healthy non-athletes controls (♂14/♀16) on two different days...
June 9, 2016: Medicine and Science in Sports and Exercise
Zachary R Patterson, Matthew R Holahan
Mild traumatic brain injuries (mTBI) have been associated with long-term cognitive deficits relating to trauma-induced neurodegeneration. These long-term deficits include impaired memory and attention, changes in executive function, emotional instability, and sensorimotor deficits. Furthermore, individuals with concussions show a high co-morbidity with a host of psychiatric illnesses (e.g., depression, anxiety, addiction) and dementia. The neurological damage seen in mTBI patients is the result of the impact forces and mechanical injury, followed by a delayed neuroimmune response that can last hours, days, and even months after the injury...
2012: Frontiers in Cellular Neuroscience
David M Sletten, Guillermo A Suarez, Phillip A Low, Jay Mandrekar, Wolfgang Singer
OBJECTIVE: To develop a concise and statistically robust instrument to assess autonomic symptoms that provides clinically relevant scores of autonomic symptom severity based on the well-established 169-item Autonomic Symptom Profile (ASP) and its validated 84-question scoring instrument, the Composite Autonomic Symptom Score (COMPASS). PATIENTS AND METHODS: We assessed the internal consistency of COMPASS using Cronbach α coefficients based on the ASP of 405 healthy control subjects recruited and seen in the Mayo Clinic Autonomic Disorders Center between March 1, 1995, and March 31, 2010...
December 2012: Mayo Clinic Proceedings
Jin Ho Kang, Jong Kyu Kim, Seok Hyun Hong, Chang Hyun Lee, Byoong Yong Choi
OBJECTIVE: To quantify autonomic dysfunction in fibromyalgia patients compared to healthy controls using heart rate variability (HRV). METHODS: Sixteen patients with fibromyalgia and 16 healthy controls were recruited in this case control study. HRV was measured using the time-domain method incorporating the following parameters: total heartbeats, the mean of intervals between consecutive heartbeats (R-R intervals), the standard deviation of normal to normal R-R intervals (SDNN), the square root of the mean squared differences of successive R-R intervals (RMSSD), ratio of SDNN to RMSSD (SDNN/RMSSD), and difference between the longest and shortest R-R interval under different three conditions including normal quiet breathing, rate controlled breathing, and Valsalva maneuver...
April 2016: Annals of Rehabilitation Medicine
Roma Bhatia, Sarah J Kizilbash, Shelley P Ahrens, Jill M Killian, Stephanie A Kimmes, Erin E Knoebel, Prasuna Muppa, Amy L Weaver, Philip R Fischer
OBJECTIVES: To determine the clinical course of adolescent-onset postural orthostatic tachycardia syndrome (POTS) and to assess health-related quality of life, 2-10 years after diagnosis. STUDY DESIGN: Pediatric patients, 13-18 years of age, diagnosed with POTS at Mayo Clinic, Rochester, from 2003 to 2010 were mailed a questionnaire if they were at least 18 years of age at the time of the mailing. The primary outcome measures were norm-based, age- and sex-adjusted, 36-Item Short Form Health Survey physical composite score and mental composite score...
June 2016: Journal of Pediatrics
John Leddy, Andrea Hinds, Dan Sirica, Barry Willer
Concussion affects the autonomic nervous system and its control of cerebral blood flow, which may be why uncontrolled activity can exacerbate symptoms after concussion. Traditionally, patients have been advised to restrict physical and cognitive activity until all symptoms resolve. However, recent research suggests that prolonged rest beyond the first couple of days after a concussion might hinder rather than aid recovery. Humans do not respond well to removal from their social and physical environments, and sustained rest adversely affects the physiology of concussion and can lead to physical deconditioning and reactive depression...
March 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Michael F La Fountaine, Michita Toda, Anthony J Testa, Vicci Hill-Lombardi
The arterial pulse wave (APW) has a distinct morphology whose contours reflect dynamics in cardiac function and peripheral vascular tone as a result of sympathetic nervous system (SNS) control. With a transition from rest to increased metabolic demand, the expected augmentation of SNS outflow will not only affect arterial blood pressure and heart rate but it will also induce changes to the contours of the APW. Following a sports concussion, a transient state cardiovascular autonomic dysfunction is present. How this state affects the APW has yet to be described...
2016: Frontiers in Neurology
2016-04-06 21:12:09
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