Key result
Concussion is linked to ~43% higher Mayer wave proportion at 48 hours, signaling autonomic dysregulation.
Why the study?
Characterizing autonomic dysfunction in concussed individuals is inconsistent, and conventional autonomic metrics cannot differentiate the presence or absence of injury.
Does concussion injury alter Mayer wave activity and cardiovascular autonomic control in intercollegiate athletes?
Observational (n=38)
Does concussion injury alter Mayer wave activity and cardiovascular autonomic control in intercollegiate athletes?
Effect estimate: d = 1.12 (95% CI 0.42-1.61)
Absolute Event Rate: 3.36% vs 2.35%
p-value: p=<0.001
Mayer wave activity analysis reveals transient uncoupling of central autonomic mechanisms regulating the heart and peripheral vasculature early after sports concussion.
Should not yet change management; hypothesis-generating for Mayer wave metrics in post-concussion autonomic assessment.
Dysregulation of cardiovascular autonomic control is gaining recognition as a prevailing consequence of concussion injury. Characterizing the presence of autonomic dysfunction in concussed persons is inconsistent and conventional metrics of autonomic function cannot differentiate the presence/absence of injury. Mayer wave (MW) activity originates through baroreflex adjustments to blood pressure (BP) oscillations that appear in the low-frequency (LF: 0.04-0.15 Hz) band of the BP and heart rate (HR) power spectrum after a fast Fourier transform. We prospectively explored MW activity (∼0.1 Hz) in 19 concussed and 19 noninjured athletes for 5 min while seated at rest within 48 h and 1 week of injury. MW activity was derived from the LF band of continuous digital electrocardiogram and beat-to-beat BP signals (LFHR, LF-SBP, MWHR, and MW-SBP, respectively); a proportion between MWBP and MWHR was computed (cMW). At 48 h, the concussion group had a significantly lower MWBP and cMW than controls; these differences were gone by 1 week. MWHR, LFHR, and LF-SBP were not different between groups at either visit. Attenuated sympathetic vasomotor tone was present and the central autonomic mechanisms regulating MW activity to the heart and peripheral vasculature became transiently discordant early after concussion with apparent resolution by 1 week.
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Fountaine et al. (2021) conducted an observational in Concussion (n=38). Concussion injury vs. Non-injured matched athletes was evaluated on Mayer wave activity proportion (cMW) at 48 hours (d = 1.12, 95% CI 0.42-1.61, p=<0.001). Concussion injury was associated with a significantly elevated Mayer wave proportion (cMW) and lower MW-SBP compared to controls at 48 hours, indicating transient cardiovascular autonomic dysregulation.
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