Objective assessments of concussion recovery are crucial for facilitating effective clinical management. However, predictive tools for determining adolescent concussion outcomes are currently limited. Research suggests that heart rate variability (HRV) represents an indirect and objective marker of central and peripheral nervous system integration. Therefore, it may effectively identify underlying deficits and reliably predict the symptomology following concussion. Thus, the present study sought to evaluate the relationship between HRV and adolescent concussion outcomes. Furthermore, we sought to examine its predictive value for assessing outcomes. Fifty-five concussed adolescents (12–17 years old) recruited from a local sports medicine clinic were assessed during the initial subacute evaluation (within 15 days postinjury) and instructed to follow up for a post-acute evaluation. Self-reported clinical and depressive symptoms, neurobehavioral function, and cognitive performance were collected at each timepoint. Short-term HRV metrics via photoplethysmography were obtained under resting conditions and physiological stress. Regression analyses demonstrated significant associations between HRV metrics, clinical symptoms, neurobehavioral function, and cognitive performance at the subacute evaluation. Importantly, the analyses illustrated that subacute HRV metrics significantly predicted diminished post-acute neurobehavioral function and cognitive performance. These findings indicate that subacute HRV metrics may serve as a viable predictive biomarker for identifying underlying neurological dysfunction following concussion and predict late cognitive outcomes.

ObjectiveTo investigate the relation between mechanism of injury and pediatric concussion outcomes. We hypothesize that individuals injured during sport (sport related concussions; SRC’s) will demonstrate better outcomes than those with non-sport injuries (mild Traumatic Brain Injuries; mTBI’s), specifically in terms of clinical symptoms, mental health, cognition, and cardio-autonomic function.BackgroundConcussions are a growing health concern; however, little is known how different injury etiologies (sport vs. non-sport) effect recovery. Therefore, it is critical to better understand how different injury etiologies effect recovery from concussion to more efficiently guide clinical practices.Design/MethodsData collected from a local pediatric concussion clinic were analyzed. SRC and mTBI participants were matched on key demographics (age, body mass index, education) and injury characteristics (time between injury and clinical evaluations, prior history of concussion, pre- and post-injury physical activity). Clinical symptoms were measured using the Rivermead Post-Concussion Symptom Questionnaire (R-PCS). Mental health was measured using the Beck Youth Inventory of Depression (BYI-D). Cognition was measured using a modified CogState Brain Injury Test Battery. Cardio-autonomic function was assessed via heart rate variability (HRV). Participants were evaluated during the acute phase of injury, and again in the post-acute phase.ResultsAt both time points, adolescents with mTBI reported greater clinical and depressive symptoms than those with an SRC (p’s < 0.05). During the acute phase, adolescents with SRC and mTBI significantly differed on multiple metrics of heart rate variability (p’s < 0.05). There were no group differences in cognition at either time point.ConclusionsOur results suggest those incurring a SRC may demonstrate better outcomes than those incurring an mTBI. Future longitudinal research including baseline measurements is necessary to determine the validity of these findings.