Key result
Concussion is linked to impaired autonomic flexibility during cognitive and emotional tasks on HRV analysis.
Why the study?
Concussion research has predominantly examined heart rate variability (HRV) during physiological stressors rather than psychological tasks that engage impaired cognitive and emotional domains.
Does heart rate variability measurement during emotional and cognitive paradigms identify altered autonomic flexibility in adult concussion populations compared to control subjects?
Does heart rate variability measurement during emotional and cognitive paradigms identify altered autonomic flexibility in adult concussion populations compared to control subjects?
This scoping review reveals that adults with concussion exhibit altered heart rate variability during cognitive and emotional tasks, though significant methodological heterogeneity and a lack of studies highlight a critical evidence gap in using HRV as a psychological recovery biomarker.
Answers are grounded in this paper and cite their sources.
HRV during emotional/cognitive tasks may detect autonomic changes post-concussion; leaves open standardized protocols before clinical or research adoption.
Concussions often result in psychophysiological symptoms that reflect disruptions in brain-body systems, yet objective biomarkers remain limited. Heart rate variability (HRV) has emerged as a promising biomarker of autonomic adaptability and rehabilitation, including as an index of physiological recovery following concussion. However, concussion literature has predominantly emphasized HRV responses to physiological stressors, rather than psychological tasks that engage impaired domains such as attention, emotion regulation, and executive function. We systematically mapped the use of HRV during emotional and cognitive paradigms in adult concussion populations clarifying rationales for its application, the stimuli and measures employed, and state of science. We identified 6,791 records, four meeting inclusion criteria. Paradigms included emotional film clips and cognitive tasks, with HRV indices spanning time-, frequency-, and nonlinear domains. Across studies, individuals with concussion demonstrated altered autonomic flexibility compared to control subjects, including blunted modulation, atypical valence-related responses, and compensatory increases in vagal activity. Methodological heterogeneity limited cross-study comparability. This review highlights a critical evidence gap regarding HRV measurement in psychological contexts after adult concussion. Standardized HRV protocols, diverse samples, and longitudinal designs are needed to clarify recovery trajectories and further assess the value of HRV as a recovery biomarker after concussion.
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Boylan et al. (2026) conducted a review in Adult concussion. Emotional and cognitive paradigms (emotional film clips and cognitive tasks) vs. Control subjects was evaluated on Heart rate variability (time-, frequency-, and nonlinear domain indices) reflecting autonomic flexibility. Heart rate variability during emotional and cognitive tasks showed altered autonomic flexibility in concussed adults vs controls across 4 included studies (of 6,791 records).
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