Citation

Hasen MA, Almojuela A, Zeiler FA. J. Neurotrauma 2019; 36(10): 1491-1504.

Affiliation

Health Sciences Centre, Section of Neurosurgery , GB-1 820 Sherbrook Street , Winnipeg, Manitoba, Canada , R3A1R9 ; umzeiler@myumanitoba.ca.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2018.6073

PMID

30343625

Abstract

BACKGROUND: The quantification and objective documentation of autonomic dysfunction in traumatic brain injury (TBI) is not well-studied nor extensively validated. Most of the description of autonomic dysfunction in the literature is in the form of vague non-specific clinical manifestations. Few studies proposed the use of objective measures of assessing the extent of autonomic dysfunction to link them to the outcome of TBI.

OBJECTIVE: Our goal was to perform a scoping systematic review of the literature on the objective documentation of autonomic dysfunction in terms of functional and physiological variables to be linked to outcome of TBI.

METHODS: PubMed/MEDLINE, BIOSIS, Scopus, Embase Cochrane Libraries and GlobalHealth databases were searched. Two reviewers independently screened the results. Full texts for citations passing this initial screen were obtained. Inclusion and exclusion criteria were applied to each article to obtain final articles for review.

RESULTS: The initial search yielded 2619 citations. Of 69 articles selected for final review, 14 were chosen based on the inclusion and exclusion criteria and will be included in the results of this paper. 9 of these articles assessed autonomic dysfunction using functional variables and 7 using physiological variables. Some studies included both functional and physiological variables. Of the 9 studies linked autonomic dysfunction to functional variables, 9 included heart rate variability (HRV), 3 included baroreflex sensitivity (BRS), and 2 included blood pressure variability (BPV). A total of 2714 adult patients were studied.

CONCLUSIONS: Although the nature of link between autonomic dysfunction and outcome is unclear, the objective quantification of autonomic dysfunction seems to be associated with global patient outcome and other neurophysiologic measures. Further studies are needed to validate its use and explore the underlying molecular mechanisms of the described associations.

Language: en

Keywords

ADULT BRAIN INJURY; Autonomic dysfunction; Baroreflex sensitivity Outcome.; Blood pressure variability; CBF autoregulation; Heart rate variability; Paroxysmal sympathetic hyperactivity; TRAUMATIC BRAIN INJURY; Traumatic brain injury