Athletes are known to under-report concussion symptoms due to competitive disincentives to report and conflation of concussion symptoms with other conditions associated with rigorous participation in sports. A quantitative biomarker for concussion has the potential to decrease the reliance on inconsistent patient-reported symptoms for the diagnosis of concussion. The objective of this project was to monitor heart rate variability (HRV) patterns of in-season athletes as a potential biomarker for concussion.Twenty in-season National Collegiate Athletic Association (NCAA) Division 2 collegiate soccer players were given a wristband heart rate sensor with instructions to wear the band full time (24/7) for the entire fall season (approximately 3 months). The athletes were prompted by email to complete a weekly survey on the severity and frequency of any concussion symptoms. The survey and HRV data were de-identified for confidentiality, and to increase the likelihood of accurate reporting the athletes were told their responses would not be used to disqualify them from athletics. Our hypothesis was that HRV would be diminished in those with recent concussion.One athlete (5% of the cohort) sustained a concussion during the study period. A marked decrease in HRV was identified 7 days following the concussion, which eventually returned to baseline. This normalization of HRV followed the timing of resolution of concussion symptoms. Participants who did not sustain a concussion exhibited minimal variance in HRV over time.This preliminary study shows that HRV has potential as a biomarker for symptom resolution after clinically apparent concussion. HRV is unlikely to serve as a concussion diagnostic due to the 7-day lag in HRV change after concussion.
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