Why the study?
Individuals with persisting post-concussion symptoms with physiological subtype demonstrate exercise intolerance, but cardiac autonomic responses to face cooling in this population remained to be determined.
Do individuals with persisting post-concussion symptoms with physiological subtype demonstrate altered cardiovascular and autonomic responses to face cooling compared to healthy controls?
Do individuals with persisting post-concussion symptoms with physiological subtype demonstrate altered cardiovascular and autonomic responses to face cooling compared to healthy controls?
Individuals with persisting post-concussion symptoms with physiological subtype exhibit blunted cardiac and peripheral autonomic responses to face cooling, suggesting altered autonomic function.
May indicate autonomic dysfunction in PPCS-P; hypothesis-generating and requires prospective validation before clinical use.
Individuals with persisting post‐concussion symptoms with physiological subtype (PPCS‐P) demonstrate exercise intolerance due to exacerbation of concussion‐like symptoms during incremental exercise. We tested the hypothesis that individuals with PPCS‐P ( n = 12) would have a blunted cardiac autonomic response to face cooling compared to healthy controls (CTRL, n = 12). Participants were supine and performed a 5 min baseline, then experienced a 3 min face cold pressor test followed by 5 min of recovery. A three‐lead electrocardiogram was used to measure heart rate and root mean square of successive differences in R‐R intervals (RMSSD), finger photoplethysmography was used to measure mean arterial pressure (MAP), and laser‐Doppler flowmetry was used to measure finger skin blood flux. The PPCS‐P group had a lower exercise tolerance (9.9 ± 3.2 min, P < 0.001) and lower peak heart rate (170.0 ± 14.0 beats·min −1 , P < 0.001) compared to CTRL (19.6 ± 2.5 min; 193.0 ± 5.0 beats·min −1 ). PPCS‐P demonstrated a blunted mean heart rate (CTRL: ∆−4.0 ± 5.0 beats·min −1 , PPCS‐P: ∆2.0 ± 4.0 beats·min −1 ; group effect: P < 0.001) and mean RMSSD (CTRL: ∆26.6 ± 34.7 ms, PPCS‐P: ∆−1.8 ± 33.9 ms; group effect: P = 0.026) responses at 2 min of face cooling compared to CTRL. Both groups had a significant increase in MAP during face cooling, where at 2 min, MAP was higher in PPCS‐P (∆+13.2 ± 5.5 mmHg) compared to CTRL (∆+8.7 ± 6.9 mmHg, group effect: P < 0.001). Furthermore, PPCS‐P had a sustained lower finger skin blood flux (group effect: P < 0.001) during face cooling (PPCS‐P: ∆−48.2 ± 27.1%, CTRL: ∆−12.8 ± 24.7% at 2 min). These data suggest that individuals with PPCS‐P demonstrate altered cardiac and peripheral autonomic function during face cooling compared to healthy controls.
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Wallace et al. (2025) studied this question.
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