Journal
BRAIN INJURY
Volume 35, Issue 2, Pages 226-232Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/02699052.2021.1871951
Keywords
concussion; adolescent; orthostatic intolerance; orthostatic hypotension; autonomic nervous system
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Funding
- National Institute of Neurological Disorders and Stroke of the National Institutes of Health [R01 NS094444]
- NIH [01 R01 NS098494-01A1, 1R01 NS097549-01A1]
- National Center for Advancing Translational Sciences of the National Institutes of Health [UL1TR001412]
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This study found that adolescents commonly experience orthostatic intolerance after concussion, even if they do not meet the standard criteria for Orthostatic Hypotension. Symptoms of lightheadedness/dizziness were reported more frequently in the Concussion Group compared to controls.
Objective: Concussion is associated with dysautonomia, altered blood pressure (BP) control, and may cause Orthostatic Hypotension (OH). We measured prevalence of OH using the 1-minute supine-to-standing OH Test in adolescents with concussion and controls. Participants: Adolescents within 10 days of injury (Concussion Group, n = 297, 15.0 +/- 1.7 years, 59% male) were compared with controls (Control Group, n = 214, 15.0 +/- 1.5 years, 58% male). Methods: BP, heart rate (HR), and complaints of lightheadedness/dizziness were measured after 2-minute supine and 1-minute standing. Control Group was assessed once. Concussion Group was assessed twice; (1) initial visit (mean 6.0 +/- 3 days-since-injury) and (2) after clinical recovery (mean 46.3 +/- 42 days-since-injury). Results: Initial visit; Concussion Group reported feeling lightheaded/dizzy on postural change more often than the Control Group (37% vs 4%, p < .001) but did not differ in meeting standard OH criteria (3% vs 5%, p = .32). Experiencing symptoms did not correlate with meeting OH criteria, but correlated with abnormal vestibulo-ocular reflex. After clinical recovery; Concussion Group did not differ in experiencing lightheaded/dizziness on postural change than controls (4%, p = .65). Conclusion: Adolescents commonly experience orthostatic intolerance after concussion without meeting the standard criteria for OH.
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