Introduction

The cardiac autonomic control system (CACS) is frequently impaired post-traumatic brain injury (TBI). However, the prevalence of vestibular/oculomotor impairment is less studied. These two systems interact during position change and contribute to blood-pressure regulation through the vestibulo-sympathetic reflex. Aim: To assess the CACS, the vestibular/oculomotor systems and their integrative function in adolescents post-TBI compared to typically-developing (TD) adolescents. Methods: 19 adolescents in the subacute stage following a severe TBI (14–117 days post injury) and 19 age and sex matched TD controls were recruited. Heart Rate Variability (HRV) was assessed at rest and during a modified tilt-test. A quantified version of the Vestibular/Ocular-Motor Screening (VOMS) was also administered. Results: At rest, the TBI group had higher HR and lower HRV values (p < .001). All participants with TBI demonstrated impairments in the VOMS (median of positive tests: 5 [range 2–9]) compared to only 6 out of 19 in the TD participants (median 0 [0–2]) (z = −5.34; p < .001). In response to the modified tilt test, the HRV increased significantly in the lifting period and decreased significantly once in standing only in the TBI group (z = −2.85, p = .025). Conclusion: Adolescents post severe TBI demonstrated impairments in the CACS, positive tests on the VOMS and significantly greater changes in the modified tilt test as compared to TD.

Clinical trial gov. number: NCT03215082

中文翻译：

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严重的颅脑外伤后，青少年的心脏自主神经系统和前庭/动眼系统的综合功能，并且通常会发展为对照。

介绍

心脏自主控制系统（CACS）经常受到创伤后脑损伤（TBI）的损害。然而，前庭/动眼功能障碍的患病率研究较少。这两个系统在位置改变过程中相互作用，并通过前庭交感神经反射促进血压调节。目的：与典型发育期（TD）青少年相比，评估TBI后青少年中的CACS，前庭/动眼系统及其整合功能。方法：招募了19名严重TBI（受伤后14-117天）之后的亚急性期青少年，以及19名年龄和性别相匹配的TD对照。在休息时和改良的倾斜测试过程中评估心率变异性（HRV）。还进行了前庭/眼动筛查（VOMS）的量化版本。结果：静息时，TBI组的HR较高，HRV较低（p <.001）。所有TBI参与者均表现出VOMS受损（阳性测试中位数：5 [范围2–9]），而TD参与者中只有19个参与者中有6个（中值0 [0-2]）（z = −5.34；p <.001）。响应改良后的倾斜测试，HRV在提升期间显着增加，仅在TBI组站立时一次显着降低（z = -2.85，p = .025）。结论：与TD相比，严重TBI后的青少年表现出CACS受损，VOMS阳性试验以及改良倾斜试验的明显变化。

政府临床试验 编号：NCT03215082