Heart rate variability in adults with mild traumatic brain injury: a population-based cross-sectional study

Autonomic nervous system disruptions following mild traumatic brain injury (MTBI) may play a role in elevated mortality risk. However, the relationship between MTBI-related autonomic dysfunction and mental health in the general population remains understudied. This study examined autonomic dysfunction and mental health symptoms among individuals reporting previous MTBI within a community sample. This population-based cross-sectional study was implemented among adults residing in Ulaanbaatar, Mongolia. Heart rate variability (HRV) analysis served as a non-invasive method for evaluating autonomic nervous system functioning. Mental health parameters including anxiety, depression, sleep disturbances, and quality of life were measured using validated instruments: Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and the brief version of World Health Organization Quality of Life (WHOQOL-BREF). The study enrolled 177 individuals (74 % female) averaging 39.85 ± 9.82 years. Sixteen individuals reported experiencing MTBI previously. After adjusting for age and sex, the population prevalence was 2.4 %. Elevated body temperature, increased heart rate, and higher anxiety levels were observed among MTBI-exposed participants relative to unexposed individuals, while HRV indices showed reductions. Regression analysis indicated associations between MTBI and reduced HRV measures. The results demonstrate that pNN50 and RMSSD were predicted by marital status, LF/HF ratio, and MTBI-exposed history (r2 = 0.33, P = 0.017 and r2 = 0.37, P = 0.005, respectively). In conclusion, individuals with MTBI history demonstrated reduced HRV and elevated anxiety relative to individuals without MTBI history. These findings indicate potential persistent effects of MTBI on autonomic function, mental health, and quality of life.