ArticleNeurocritical care2025
Heart Rate Variability and Cerebral Autoregulation in Patients with Traumatic Brain Injury with Paroxysmal Sympathetic Hyperactivity Syndrome.
Article in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Impact of positive end-expiratory pressure on autonomic nervous system activity and its interaction with cerebrovascular reactivity - an experimental study.Journal of clinical monitoring and computing · 2026Article
- Hyperbaric oxygen for paroxysmal sympathetic hyperactivity syndrome after acute carbon monoxide poisoning.Medical gas research · 2026Article
- Early Autonomic Dysfunction Following Severe TBI and Impact on Cerebral Hemodynamics: A Narrative Review.Journal of clinical medicine · 2026Review
- The Impact of Paroxysmal Sympathetic Hyperactivity on Prognosis in Patients with Severe Intracerebral Hemorrhage.Neurocritical care · 2025Observational
- Paroxysmal sympathetic hyperactivity risk modeling based on transients in time series describing the autonomic nervous system and cerebral hemodynamics.Acta neurochirurgica · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundSevere traumatic brain injury (TBI) can lead to transient changes in autonomic nervous system (ANS) functioning and development of paroxysmal sympathetic hyperactivity (PSH) syndrome. Clinical manifestation of ANS disorders may be obscured by therapeutic interventions in TBI. This study aims to analyze ANS metrics and cerebral autoregulation in patients with PSH syndrome to determine their significance in early prognostication.
methodsThis single-center retrospective study investigated the relationship between changes in ANS metrics, cerebral autoregulation, and PSH syndrome. Arterial blood pressure and intracranial pressure signals were monitored for 5 days post TBI. ANS metrics included time and frequency domain heart rate variability (HRV) metrics. Cerebral autoregulation was assessed using the pressure reactivity index.
resultsSixty-six patients with severe TBI (median age 33 [interquartile range 26-50] years) were analyzed, and PSH was confirmed in nine cases. Impairment of cerebral autoregulation was observed in 67% of patients with PSH and 72% without the syndrome. Patients with PSH had higher HRV in the low-frequency range (LF; 253 ± 178 vs. 176 ± 227 ms
conclusionsElevated HRV in the LF and decreased HR may serve as early predictors of PSH syndrome development, particularly in patients with diffuse axonal trauma. Further research is needed to investigate the utility of the cerebral autoregulation-ANS relationship in PSH prognostication.
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