Heart Rate Variability in Healthy Non-Concussed Youth Athletes: Exploring the Effect of Age, Sex, and Concussion-Like Symptoms

Abstract

BackgroundHeart rate variability (HRV) is a non-invasive neurophysiological measure of autonomic nervous system regulation emerging in concussion research. To date, most concussion studies have focused on the university-aged athlete with no research examining healthy active youths. Corroborating changes in HRV alongside traditional subjective self-report measures (concussion symptoms) in the non-concussed state provides a foundation for interpreting change following concussion. The objectives were to (1) explore the influence of age and sex on HRV and (2) examine the relationship between HRV and baseline/pre-injury concussion symptom domains (physical, cognitive, emotional, and fatigue) in healthy youth athletes.MethodHealthy, youth athletes 13–18 years of age [N = 294, female = 166 (56.5%), male = 128 (43.5%)] participated in this cross-sectional study. Age, sex, and concussion-like symptoms were collected as part of a baseline/pre-injury assessment. The Post-Concussion Symptom Inventory-SR13 (PCSI-SR13) was used to collect domain scores for physical, cognitive, emotional, and fatigue symptoms. HRV was collected for 24 h. HRV measures included time (SDNN, RMSSD, and pNN50) and frequency (HF, HFnu, LF, LFnu, and total power) domain HRV measures. Variables were logarithmically transformed to increase robustness of linear regression models.ResultsOlder youth participants displayed significantly higher HRV compared to younger participants (p < 0.05). Females displayed significantly lower HRV compared to males (p < 0.05). A significant interaction effect between concussion-like symptoms and HRV indicated differential patterns as a function of sex (p < 0.05). Youth athletes who reported more cognitive symptoms had lower HRV (p < 0.05).ConclusionHRV was found to have a significant relationship with a traditional clinical measure (subjective self-report of concussion-like symptoms) utilized in concussion assessment and management. Baseline/pre-concussion trends in HRV were significantly associated with age and sex, highlighting the value in understanding key demographic factors within the context of concussion-like symptoms.

Heart rate variability following youth concussion: how do autonomic regulation and concussion symptoms differ over time postinjury?

“…Baseline HRV variables were also accounted for in the models as variation exists among healthy individuals. 29 The statistical threshold for significance was set to p<0.05.…”

Nutritional Neuroscience as Mainstream of Psychiatry: The Evidence- Based Treatment Guidelines for Using Omega-3 Fatty Acids as a New Treatment for Psychiatric Disorders in Children and Adolescents

“…ANS alterations result in vagal withdrawal, reflected by a decrease in HRV indices, and a decrease HRV has been associated with emotional dysregulation, and decreases in psychological flexibility and social engagement manifestations, which have been closely associated with prefrontal hypoactivity [ 101 ], one of the mechanisms contributing to the development of depression. Moreover, adolescents with depression or anxiety have lower HRV than controls [ 102 ], while those treated with antidepressants have been associated with a higher HRV [ 103 ]. In addition, n-3 PUFAs deficiency has also been associated with autonomic dysregulation [ 104 ].…”

Highly sensitive index of cardiac autonomic control based on time-varying respiration derived from ECG

“…Finally, although the method proposed here is based on an indirect modulation of sympathovagal activity, by assuming a shift toward sympathetic dominance with cognitive stress, we think it can be applied in many other fields. Particularly, the analysis of sympathovagal balance is a powerful tool for the assessment of health risks (45,66). Especially in highly trained athletes, known to present lower spontaneous breathing frequency (54), the activity of the autonomous nervous system measured with HRV markers can predict overtraining states (49,51).…”

“…The vast number of publications dealing with heart rate variability (HRV), in association with cardiac autonomic regulation, points to the need among physiologists, neuroscien-tists, psychologists, and clinicians to capture sensitive markers of sympathetic and vagal (parasympathetic) functions in humans (32,33,43,71). Over decades, experiments have repeatedly confirmed the relevance of the cardiac autonomic status as an indicator of global health (45,66), psychological status (2), and physical fitness (17). It is also believed that cardiac autonomic regulation fluctuates with physical (48) and cognitive workload (34), making HRV analysis a suitable tool for human monitoring.…”