{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T05:10:05Z","timestamp":1751433005448,"version":"3.41.0"},"reference-count":61,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005156","name":"Brock University","doi-asserted-by":"publisher","award":["AIF\u20102021"],"award-info":[{"award-number":["AIF\u20102021"]}],"id":[{"id":"10.13039\/501100005156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Individuals with persisting post\u2010concussion symptoms with physiological subtype (PPCS\u2010P) demonstrate exercise intolerance due to exacerbation of concussion\u2010like symptoms during incremental exercise. We tested the hypothesis that individuals with PPCS\u2010P (<jats:italic>n\u00a0<\/jats:italic>=\u00a012) would have a blunted cardiac autonomic response to face cooling compared to healthy controls (CTRL, <jats:italic>n\u00a0<\/jats:italic>=\u00a012). Participants were supine and performed a 5\u00a0min baseline, then experienced a 3\u00a0min face cold pressor test followed by 5\u00a0min of recovery. A three\u2010lead electrocardiogram was used to measure heart rate and root mean square of successive differences in R\u2010R intervals (RMSSD), finger photoplethysmography was used to measure mean arterial pressure (MAP), and laser\u2010Doppler flowmetry was used to measure finger skin blood flux. The PPCS\u2010P group had a lower exercise tolerance (9.9\u00a0\u00b1\u00a03.2\u00a0min, <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001) and lower peak heart rate (170.0\u00a0\u00b1\u00a014.0\u00a0beats\u00b7min<jats:sup>\u22121<\/jats:sup>, <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001) compared to CTRL (19.6\u00a0\u00b1\u00a02.5\u00a0min; 193.0\u00a0\u00b1\u00a05.0\u00a0beats\u00b7min<jats:sup>\u22121<\/jats:sup>). PPCS\u2010P demonstrated a blunted mean heart rate (CTRL: \u2206\u22124.0\u00a0\u00b1\u00a05.0\u00a0beats\u00b7min<jats:sup>\u22121<\/jats:sup>, PPCS\u2010P: \u22062.0\u00a0\u00b1\u00a04.0\u00a0beats\u00b7min<jats:sup>\u22121<\/jats:sup>; group effect: <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001) and mean RMSSD (CTRL: \u220626.6\u00a0\u00b1\u00a034.7\u00a0ms, PPCS\u2010P: \u2206\u22121.8\u00a0\u00b1\u00a033.9\u00a0ms; group effect: <jats:italic>P<\/jats:italic>\u00a0=\u00a00.026) responses at 2\u00a0min of face cooling compared to CTRL. Both groups had a significant increase in MAP during face cooling, where at 2\u00a0min, MAP was higher in PPCS\u2010P (\u2206+13.2\u00a0\u00b1\u00a05.5\u00a0mmHg) compared to CTRL (\u2206+8.7\u00a0\u00b1\u00a06.9\u00a0mmHg, group effect: <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001). Furthermore, PPCS\u2010P had a sustained lower finger skin blood flux (group effect: <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001) during face cooling (PPCS\u2010P: \u2206\u221248.2\u00a0\u00b1\u00a027.1%, CTRL: \u2206\u221212.8\u00a0\u00b1\u00a024.7% at 2\u00a0min). These data suggest that individuals with PPCS\u2010P demonstrate altered cardiac and peripheral autonomic function during face cooling compared to healthy controls.<\/jats:p>","DOI":"10.1113\/ep092583","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T04:49:22Z","timestamp":1751431762000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Individuals with persisting post\u2010concussion symptoms with physiological subtype demonstrate altered cardiovascular and autonomic responses to face cooling"],"prefix":"10.1113","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7023-3856","authenticated-orcid":false,"given":"Phillip J.","family":"Wallace","sequence":"first","affiliation":[{"name":"Department of Kinesiology Brock University  St Catharines Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Lidstone","sequence":"additional","affiliation":[{"name":"Brock University Sports Performance &amp; Sports Medicine Brock University  St Catharines Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josh G.","family":"Nowlan","sequence":"additional","affiliation":[{"name":"Department of Kinesiology Brock University  St Catharines Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johnathan","family":"Ljubanovich","sequence":"additional","affiliation":[{"name":"Department of Kinesiology Brock University  St Catharines Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon J.","family":"McKinlay","sequence":"additional","affiliation":[{"name":"Faculty of Applied Health &amp; Community Sciences Sheridan College  Brampton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4560-8728","authenticated-orcid":false,"given":"Stephen A.","family":"Klassen","sequence":"additional","affiliation":[{"name":"Department of Kinesiology Brock University  St Catharines Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6149-4978","authenticated-orcid":false,"given":"Stephen S.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Kinesiology Brock University  St Catharines Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1995.sp021076"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/705309","article-title":"Return to full functioning after graded exercise assessment and progressive exercise treatment of postconcussion syndrome","volume":"2012","author":"Baker J. 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