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October 28, 2014; 83 (18) Views & Reviews

Cerebrovascular regulation, exercise, and mild traumatic brain injury

Can Ozan Tan, William P. Meehan, Grant L. Iverson, J. Andrew Taylor
First published October 1, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000944
Can Ozan Tan
From the Cardiovascular Research Laboratory, Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School (C.O.T., J.A.T.); The Micheli Center for Sports Injury Prevention, Division of Sports Medicine, Boston Children's Hospital, Department of Pediatrics and Orthopedics, Harvard Medical School (W.P.M.); and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Massachusetts General Hospital Sport Concussion Clinic, Red Sox Foundation and Massachusetts General Hospital Home Base Program (G.L.I.).
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William P. Meehan III
From the Cardiovascular Research Laboratory, Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School (C.O.T., J.A.T.); The Micheli Center for Sports Injury Prevention, Division of Sports Medicine, Boston Children's Hospital, Department of Pediatrics and Orthopedics, Harvard Medical School (W.P.M.); and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Massachusetts General Hospital Sport Concussion Clinic, Red Sox Foundation and Massachusetts General Hospital Home Base Program (G.L.I.).
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Grant L. Iverson
From the Cardiovascular Research Laboratory, Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School (C.O.T., J.A.T.); The Micheli Center for Sports Injury Prevention, Division of Sports Medicine, Boston Children's Hospital, Department of Pediatrics and Orthopedics, Harvard Medical School (W.P.M.); and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Massachusetts General Hospital Sport Concussion Clinic, Red Sox Foundation and Massachusetts General Hospital Home Base Program (G.L.I.).
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J. Andrew Taylor
From the Cardiovascular Research Laboratory, Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School (C.O.T., J.A.T.); The Micheli Center for Sports Injury Prevention, Division of Sports Medicine, Boston Children's Hospital, Department of Pediatrics and Orthopedics, Harvard Medical School (W.P.M.); and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Massachusetts General Hospital Sport Concussion Clinic, Red Sox Foundation and Massachusetts General Hospital Home Base Program (G.L.I.).
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Citation
Cerebrovascular regulation, exercise, and mild traumatic brain injury
Can Ozan Tan, William P. Meehan, Grant L. Iverson, J. Andrew Taylor
Neurology Oct 2014, 83 (18) 1665-1672; DOI: 10.1212/WNL.0000000000000944

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Abstract

A substantial number of people who sustain a mild traumatic brain injury report persistent symptoms. Most common among these symptoms are headache, dizziness, and cognitive difficulties. One possible contributor to sustained symptoms may be compromised cerebrovascular regulation. In addition to injury-related cerebrovascular dysfunction, it is possible that prolonged rest after mild traumatic brain injury leads to deconditioning that may induce physiologic changes in cerebral blood flow control that contributes to persistent symptoms in some people. There is some evidence that exercise training may reduce symptoms perhaps because it engages an array of cerebrovascular regulatory mechanisms. Unfortunately, there is very little work on the degree of impairment in cerebrovascular control that may exist in patients with mild traumatic brain injury, and there are no published studies on the subacute phase of recovery from this injury. This review aims to integrate the current knowledge of cerebrovascular mechanisms that might underlie persistent symptoms and seeks to synthesize these data in the context of exploring aerobic exercise as a feasible intervention to treat the underlying pathophysiology.

GLOSSARY

mTBI=
mild traumatic brain injury;
NO=
nitric oxide

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received April 17, 2014.
  • Accepted in final form July 29, 2014.
  • © 2014 American Academy of Neurology
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