Neuroimaging to enhance understanding of cardiovascular autonomic changes associated with mild traumatic brain injury: a scoping review

ABSTRACT

Background

Cardiovascular changes, such as altered heart rate and blood pressure, have been identified in some individuals following mild traumatic brain injury (mTBI) and may be related to disturbances of the autonomic nervous system and cerebral blood flow.

Methods

We conducted a scoping review according to PRISMA-ScR guidelines across six databases (Medline, CINAHL, Web of Science, PsychInfo, SportDiscus and Google Scholar) to explore literature examining both cardiovascular parameters and neuroimaging modalities following mTBI, with the aim of better understanding the pathophysiological basis of cardiovascular autonomic changes associated with mTBI.

Results

Twenty-nine studies were included and two main research approaches emerged from data synthesis. Firstly, more than half the studies used transcranial Doppler ultrasound and found evidence of cerebral blood flow impairments that persisted beyond symptom resolution. Secondly, studies utilizing advanced MRI identified microstructural injury within brain regions responsible for cardiac autonomic function, providing preliminary evidence that cardiovascular autonomic changes are a consequence of injury to these areas.

Conclusion

Neuroimaging modalities hold considerable potential to aid understanding of the complex relationship between cardiovascular changes and brain pathophysiology associated with mTBI. However, it is difficult to draw definitive conclusions from the available data due to variability in study methodology and terminology.

KEYWORDS:

• Mild traumatic brain injury
• concussion
• heart rate
• autonomic nervous system
• neuroimaging
• magnetic resonance imaging

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors contributions

JT, SH, and MF conceptualized the study and participated in initial study design. JT and SH conducted Title/Abstract and Full Text screening. JT extracted the data, with secondary checking by SH. JT prepared all tables and figures. JT drafted the initial manuscript. All authors reviewed and further contributed the manuscript. JT coordinated manuscript revisions.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2023.2211352.

Additional information

Funding

The primary author (JT) receives financial support through an Australian Government Research Training Program (RTP) Scholarship, administered by Curtin University, and a Perron Institute for Neurological and Translational Science partial stipend scholarship.