New Study Publication: Concussions and Autonomic Dysregulation in kids

We're excited to share that members of our team recently published a new study in JAMA Network Open examining how often children show signs of autonomic dysregulation after a concussion. Autonomic dysregulation refers to problems with how the body adjusts heart rate and blood pressure when moving from lying down to standing.

In this study, Dr. Veronik Sicard (a postdoctoral fellow at the CHEO Research Institute) and other members of the TRANSCENDENT team looked at health data from 451 children and teens who were seen at a concussion clinic within 45 days of their injury. They tested how the children's and teens' heart rate and blood pressure changed when they went from lying down to standing up (using a tilt table) and asked them if they felt any new or worsened symptoms like dizziness or fatigue while performing the movement.

What did they learn? About 1 in 10 kids showed signs of autonomic dysregulation using pediatric criteria, and nearly 1 in 4 had symptoms triggered by standing. Interestingly, only a small number of children showed both signs of autonomic dysfunction and symptom worsening. This suggests these are two separate responses and may reflect different issues related to concussion recovery.

---

“After a concussion, one in four children and teens feel worse when they stand up, and about 1 in 10 show hidden changes in how their body regulates heart rate and blood pressure. We’re now exploring how often this happens in adults up to 85 years. " - Dr. Sicard

---

The authors also found that certain groups of kids may be more likely to experience these responses. For example, children with neurodevelopmental conditions were more likely to show autonomic changes. At the same time, girls and those with mental health concerns or memory issues after injury were more likely to feel worse when standing up. This research suggests that monitoring children's responses when transitioning from lying down to standing up could be a valuable and straightforward tool in early concussion care. It may help identify those at risk of prolonged symptoms and point toward more personalized recovery strategies.

Congratulations to the entire team on this wonderful work! Read the full study here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2836696