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The present study aimed to explore the use of heart rate variability (HRV) in the follow-up of concussions among college athletes and to investigate the relationships between biological sex, symptomatology, and HRV values at baseline and after a concussion. Correlations between measures were also analyzed. A total of 169 (55 females) athletes aged 16 to 22 years old completed baseline testing, and 30 (8 females) concussion cases were followed. Baseline assessment (T1) included psychosocial and psychological questionnaires, symptoms report, and four minutes of HRV recording. In the event of a concussion, athletes underwent re-testing within 72 h (T2) and before returning to play (T3). Baseline findings revealed that girls had higher %VLF while sitting than boys, and a small negligible correlation was identified between %HF and total symptoms score as well as %HF and affective sx. Post-concussion analyses demonstrated a significant effect of time \u00d7 position \u00d7 biological sex for %HF, where girls exhibited higher %HF at T3. These findings suggest disruptions in HRV following a concussion and underscore biological sex as an important factor in the analysis of HRV variation in concussion recovery trajectory.<\/jats:p>","DOI":"10.3390\/brainsci13121669","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T08:36:59Z","timestamp":1701419819000},"page":"1669","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Heart Rate Variability in Concussed College Athletes: Follow-Up Study and Biological Sex Differences"],"prefix":"10.3390","volume":"13","author":[{"given":"Mariane","family":"Doucet","sequence":"first","affiliation":[{"name":"Departement of Psychology, Universit\u00e9 de Montr\u00e9al, Montreal, QC H3C 3J7, Canada"},{"name":"Centre for Interdisciplinary Research in Rehabilitation (CRIR), Institut Universitaire sur la R\u00e9adaptation en D\u00e9ficience Physique de Montr\u00e9al (IURDPM), CIUSSS du Centre-Sud-de-l\u2019\u00cele-de-Montr\u00e9al, Montreal, QC H3S 2J4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Brisebois","sequence":"additional","affiliation":[{"name":"Departement of Psychology, Coll\u00e8ge Montmorency, Laval, QC H7N 5H9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8887-2393","authenticated-orcid":false,"given":"Michelle","family":"McKerral","sequence":"additional","affiliation":[{"name":"Departement of Psychology, Universit\u00e9 de Montr\u00e9al, Montreal, QC H3C 3J7, Canada"},{"name":"Centre for Interdisciplinary Research in Rehabilitation (CRIR), Institut Universitaire sur la R\u00e9adaptation en D\u00e9ficience Physique de Montr\u00e9al (IURDPM), CIUSSS du Centre-Sud-de-l\u2019\u00cele-de-Montr\u00e9al, Montreal, QC H3S 2J4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/S1474-4422(17)30371-X","article-title":"Traumatic Brain Injury: Integrated Approaches to Improve Prevention, Clinical Care, and Research","volume":"16","author":"Maas","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2325967116662458","DOI":"10.1177\/2325967116662458","article-title":"The Rise of Concussions in the Adolescent Population","volume":"4","author":"Zhang","year":"2016","journal-title":"Orthop. 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