Autonomic nervous system dysfunction in pediatric sport-related concussion: a systematic review

Area of Science:

• Neurology
• Sports Medicine
• Pediatrics

Background:

• Autonomic nervous system (ANS) dysfunction is increasingly recognized as a potential consequence of sport-related concussion.
• Understanding ANS changes in pediatric populations is crucial for effective diagnosis and management.
• Existing literature on this topic in young athletes requires synthesis and critical appraisal.

Purpose of the Study:

• To systematically review and synthesize the evidence regarding autonomic nervous system (ANS) dysfunction following sport-related concussion in pediatric populations.
• To identify the current state of research and highlight gaps in the literature.

Main Methods:

• A comprehensive literature search was performed across multiple databases including MEDLINE, SportDiscus, CINAHL, EMBASE, and PsycINFO.
• Studies were critically appraised using the Joanna Briggs Institute (JBI) critical appraisal tools.
• Data from included studies were extracted and qualitatively synthesized.

Main Results:

• Eleven studies met the inclusion criteria for the synthesis.
• Significant variability was observed in the methodologies used to assess ANS function across studies.
• Inconsistent findings regarding the direction of ANS function changes were noted, along with considerable variation in sample populations and timing of assessment post-concussion.

Conclusions:

• Concussion is associated with dysregulation of ANS function in pediatric athletes.
• Weaknesses in the current literature may stem from logistical and financial barriers to implementing valid ANS measurements in clinical and sports settings.
• Further research with standardized methodologies is warranted to better understand ANS dysfunction post-concussion in youth.