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

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

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