Neurologists at Mayo Clinic in Arizona have taken a promising step toward identifying a test that helps support the diagnosis of concussion. Their research has shown that autonomic reflex testing, which measures involuntary changes in heart rate and blood pressure, consistently appear to demonstrate significant changes in those with concussion.
Appearing on their website, the information researchers are delving into is a new angle on concussions. It is widely known that traumatic brain injured (TBI) patients have autonomic system (ANS) deficits/abnormalities. However the group from Arizona thought an investigation into concussed patients was worth the effort. Low and behold their findings are a promising first step in possible assessment and management of the concussion.
One interesting note, was this notion on dizziness;
“Contrary to popular belief, the symptoms of ‘dizziness’ that patients feel just after a concussion may, in some cases, be symptoms of autonomic system impairment rather than a vestibular or inner ear disturbance,” says Bert Vargas, M.D., a Mayo neurologist.
No one is telling you to take blood pressures with assessment (ergo baselines), yet, but with this information could come not only objective testing but biomarkers associated with ANS changes;
“This study shows a possible electrophysiological biomarker that indicates that a concussion has occurred — we are hopeful that with more research this will be confirmed and that this may also be a biomarker for recovery,” he says.
The Concussion Blog 
when I suffered a concussion / brain injury via being rear-ended by an auto….
my blood pressure, that is typically around 115/70, top number was 150 + at the scene of the accident… (don’t recall the bottom number)
It is confirmation of John Leddy, MD and his team at the University of Buffalo. He had been testing interventions for some time. He is running a trial on retired professional hockey and football players.
His team had some interesting results in small studies. One of his most interesting findings had been that numerous subjects with PCS have undiagnosed neck injuries comorbidly or the mistaken for PCS.
Good stuff.
Have engaged in several conversations with Physical therapists re: if they are treating cervical spine injuries to also rule in / rule out the possibility of a brain injury / concussion.
I wish this research had been done 15 years ago, so that I would have known how many of my dozens of “bell rung” incidents in sports were actually, bonafide concussions.
Ryan,
Many individuals remain unaware that comprehensive info re the significance of concussions / brain injuries has existed for an extensive period of time…and were written during various times in the 1900’s.
May I suggest that you and other interested readers of this blog disgest the contents of the below articles. The info gleaned will be quite revealing and educational.
Unfortunately some of the citations “split” when I was copying and pasting…and do not know how to correct this error.
References
Anderson, D. (1992). The NFL’s quiet career killer. The New York Times. Retrieved May 12, 2000, from http://www.nytimes.com
Bird, P. (1987). Getting dinged. Athletic Journal, 28-29.
Brady, D. (1989). Should individuals who possess only one brain be allowed to box? (ERIC
Document Reproduction Service No. ED304435), 1-20.
Brady, D. (2004). A preliminary investigation of active and retired NFL players’ knowledge of concussions. Unpublished dissertation, The Union Institute and University.
Cantu, R. C. (1996). Head injuries in sport. British Journal of Sports Medicine, 30, 289–296.
Cantu, R. C. (1998). Second-impact syndrome. Clinics In Sports Medicine, 17, 37–44.
Damasio, A.R. (1994). Descartes’ error. New York: Avon Books.
Denny-Brown, D., & Russell, W.R. (1941). Experimental cerebral concussion. Brown, 64, 93-
164.
Dorsen, P.J. (1986). Should athletes with one eye, kidney, or testicle play contact sports? The
Physician and Sports Medicine, 14, 132-138.
Evans, R.W. (1987). Postconcussive syndrome: An overview. Texas Medicine, 83, 49-53.
Evans, R.W. (1994). The postconcussive syndrome: 130 years of controversy. Seminars in
Neurology, 14, 32-39.
Evans, R.W. (1996). Neurology and Trauma. Philadelphia: W.B. Saunders Company.
Evans, R.W. (2000). Postconcussion syndrome. In R.W. Evans, D.S.Baskin, & F.M. Yatsu
(Eds.), Prognosis of neurological disorders (pp. 366-380). New York: Oxford Press.
Evans, R.W., Evans, R. I., & Sharp, M. J. (1994). The physician survey on the post-concussion
and whiplash syndrome. Headache, 34, 268-274.
Journal, 47, 2427-2428.
Fleminger, S., Oliver, D., Lovestone, S., Rabe-Hesketh, S., & Giora, A. (2003). Head injury as a
risk factor for Alzheimer’s disease: The evidence 10 years on; a partial replication. Journal of Neurology, Neurosurgery, and Psychiatry, 74, 857-862.
Fuerst, M. (1997). Athletes speak out on concussion dangers. The Physician and Sports
Medicine, 25. Retrieved February 24, 2004, from
http://www.physsportsmed.com/issues1997/03mar/concuss.htm
Gerberich, S. G., Priest, J. D., Boon, J., Straub, C. P., & Maxwell, R.E. (1983). Concussion
incidences and severity in secondary school varsity players. American Journal of Public Health, 73, 1370-1375.
Goldberg, D. (2009). Concussions, professional sports, and conflicts of interest: Why the National Football League’s current policies are bad for its (players’) health. HealthCare Ethics Committee Forum, 20(4), 337–355.
Goldstein, M. (1990). Traumatic brain injury: A silent epidemic. Annals of Neurology, 27, 327.
Gronwall, D. (1989). Cumulative and persisting effects of concussion on attention and
cognition. In H.S. Levin, H.M. Eisenberg, & A. L. Benton (Eds.), Mild head injury (pp.153-162). New York: Oxford University Press.
Gronwall, D., (1991). Minor head injury. Neuropsychology, 5, 253-265.
Gronwall, D., & Wrightson, P. (1974). Delayed recovery of intellectual function after minor
head injury. The Lancet, September, 605-608.
Gronwall, D., & Wrightson, P. (1975). Cumulative effect of concussion. The Lancet, 2,
995-997.
Holbourn, A. H. (1943, October 9). Mechanics of head injuries. The Lancet, 438–441.
Hovda, D., Lee, S., Smith, M., VonStuck, S., Bergsneider, M., Kelly, D., & Shalmon, E. (1995). The neurochemical and metabolic cascade following brain injury: Moving from animal models to man. Journal of Neurotrauma, 12, 903–906.
Huizenga, R. (1994). You’re okay, it’s just a bruise. New York, NY: St. Martin’s Press.
Jordan, B. (1998). Genetic susceptibility to brain injury in sports: A role for genetic testing in athletes. Physician and Sports Medicine, 26. Retrieved Oct 12, 2002, from http://www.phys sportsmed.com/issues/1998/02feb/jordan.htm
Kelly, J., & O’Shanick, G. (2003, March). The diagnosis and management of concussion. Paper presented at the 54th annual meeting of the American Academy of Neurology, Denver, CO.
King, N. S., Crawford, S., Wenden, F. J., Moss, N., & Wade, D. T. (1995). Rivermead postconcussion symptoms questionnaire: A measure of symptoms commonly experienced after head injury and its reliability. Journal of Neurology, 242, 587–592.
Kieslich, M., Fiedler, A., Heller, C., Kreuz, W., & Jacobi, G. (2002). Minor head injury as cause and co-factor in the aetiology of stroke in childhood: A report of eight cases. Journal of Neurology and Neurosurgery Psychiatry, 73(1), 13–16.
Langlois, J. A. Rutland-Brown, W., & Wald, M. M. (2006). The epidemiology and impact of traumatic brain injury: A brief overview. Journal of Head Trauma Rehabilitation 21, 375–378.
Martland, H.S. (1928). Punch drunk. Journal of the American Medical Association, 91, 1103-
1107.
McKeag, D. B. (2003). Understanding sportsrelated concussion: Coming into focus but still fuzzy. Journal of the American Medical Association, 290, 2604–2605.
Ommaya, A., & Gennarelli, T. (1974). Cerebral concussion and traumatic unconsciousness. Brain, 97, 633–654.
Putukian, M., & Echemendia, R. J. (1998). Managing successive minor head injuries: Which tests guide return to play? The Physician and Sports Medicine, 24, 25–38.
Strich, S. J. (1961, August 26). Shearing of nerve fibers as a cause of brain damage due to head injury: A pathological study of twenty cases. The Lancet, 443–338.
Reblogged this on Broken Brain – Brilliant Mind and commented:
I’ve been reading, thinking, and writing about autonomic nervous system issues in connection with TBI for some time, now. The connection is pretty obvious to me, and I believe it also contributes to the development of PTSD after concussion/TBI. There is an important connection between the two, and I’m convinced that autonomic nervous system issues are significant contributors to both the trauma that comes from TBI (after the injury, not just before/during), and our physiological and psychological responses to it.
I’ve been reading, thinking, and writing about autonomic nervous system issues in connection with TBI for some time, now. The connection is pretty obvious to me, and I believe it also contributes to the development of PTSD after concussion/TBI. There is an important connection between the two, and I’m convinced that autonomic nervous system issues are significant contributors to both the trauma that comes from TBI (after the injury, not just before/during), and our physiological and psychological responses to it.
As a recent concussion(Nov.2015) patient at the Phoenix Mayo campus, I am surprised that I am still having many symptoms (heart burn, headaches, visual disturbances, balance loss, working memory difficulties, exercise tolerance loss,etc.) and they do not want to follow up on them (except for Dr. Bogle-who is amazing). I have chronicled every day since the accident so that the doctors and therapists could better assist me and it is difficult to understand why they have just dropped the ball.( could it be that this concussion was due to a motor vehicle accident? they don’t like medical leans-neither do I) They could have learned so much for their concussion program. They initially mentioned that they might want to use me as a case study, but instead, since I did not fall into their protocols, they want to dismiss me. My PLOF was very high functioning and they misunderstood how badly my brain injury was. I am still not well in many ways but thankfully still making progress to achieving wellness. (My BP still is higher than it used to be by a small margin now)
It is too bad some of them hold the premise that these issues may be just in my head and that I should “ignore them”. I certainly do not focus on them, but they keep cropping up.
Sounds like there is much for them to learn.
The issue is what do you do about it.. how is it corrected.
For me I have constant physical fatigue now, it’s getting better with time. Been almost 2+ yrs. my BP dipped badly after my last one.. 2 of which were minor. I’ve seen people get up and walk away unscathed and I, not so much.
My brain thinks even stopping short on the road at 3mph constitutes a concussion and the whole prOcess begins again. How can you fix this??