Measuring Autonomic Nervous System in Warfighters Following Exertion and Resting Stressors (Measuring ANSWERS)
Abstract
Measuring Autonomic Nervous System in Warfighters following Exertion and Resting Stressors (Measuring ANSWERS) seeks to build on a promising area of traumatic brain injury research. Specifically, there is emerging evidence that the autonomic nervous system (ANS), our fight or flight control system, is disrupted after mild traumatic brain injury (mTBI). This disruption to ANS functioning potentially contributes to common post-mTBI symptoms, such as slowed thinking, balance issues, cognitive disruptions, sleep problems, and mood disturbances. However, research has not yet clearly linked measures of ANS functioning and those symptom or functional measures commonly used in mTBI clinical care. Such links would have important implications for post-mTBI care. Measures of ANS functioning, such as heart rate variability and pupillary light reflex, are objective and cannot be exaggerated or minimized by patients. Currently, many clinical recommendations for returning someone to activity after mTBI rely on self-reported symptoms which are prone to misrepresentations. Additionally, ANS functioning would serve as a marker of physiologic recovery, which may be a more accurate indicator than currently used assessments of whether and when an individual is ready to return to unrestricted activity. There are two key Aims in Measuring ANSWERS. First, we will connect measures of ANS functioning (heart rate variability and pupillary light reflex) to common post-mTBI clinical and symptom measures, including cognition (i.e., reaction time), balance, ocular functioning, physical symptoms (e.g., headaches, sleep), and mood. Our test battery is adapted from other studies with Warfighters we are conducting, as our goal is to adapt findings to best serve military populations. A group of 50 active-duty military Service Members and 100 student sports club level athletes will be enrolled. Within these groups, individuals with a history of mTBI will be compared to those with no history of mTBI. For Aim 2, we seek to understand the trajectory of ANS functioning from immediately after mTBI through recovery. We will assess 50 sports club athletes who sustained a recent mTBI 3 times: within 3 days of injury, at self-reported symptom recovery, and within a week of being medically cleared to return to unrestricted activity. We will use the same battery of tests from Aim 1. Age- and sex-matched controls will also be assessed at similar time points to serve as a comparison. For both Aims, participants will also engage in a virtual reality-based assessment that mimics real-world activities. This will allow us to determine if recovery on ANS measures and current mTBI measures translates to successful real-world performance. Measuring ANSWERS synergizes our collective expertise and leverages our military and sports mild traumatic brain injury (mTBI) experience to execute a project that will expand our understanding of the biological underpinnings of mTBI and how our current assessments and clinical decision-making tools can be improved for the benefit of the Warfighter. The Measuring ANSWERS project will occur at The Matthew Gfeller Center on the campus of UNC-Chapel Hill. The Matthew Gfeller Center has a long history of collaboration with partners who have lived experience and insights into the dynamic and complex issues surrounding civilian and military mTBI. We have been committed to engaging military community partners and stakeholders in our work as a result. This extends beyond community members serving in an advisory capacity as we have created true partnerships between our scientific clinical researchers and military community members. These relationships guide and shape our research goals and study design, and our projects have the ultimate goal of translating research findings to benefit and better serve military populations. Findings from Measuring ANSWERS will further our understanding of the role of the ANS in mTBI sympt
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310642
Entities
People
- Wesley Cole
Organizations
- United States Army
- University of North Carolina at Chapel Hill