{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T18:40:55Z","timestamp":1783795255461,"version":"3.55.0"},"reference-count":39,"publisher":"National Athletic Trainers' Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:sec><jats:title>Context<\/jats:title><jats:p>Cardiovascular responses to the cold pressor test (CPT) provide information regarding sympathetic function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine if recently concussed collegiate athletes had blunted cardiovascular responses during the CPT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross-sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients or Other Participants<\/jats:title><jats:p>A total of 10 symptomatic concussed collegiate athletes (5 men, 5 women; age = 20 \u00b1 2 years) who were within 7 days of diagnosis and 10 healthy control individuals (5 men, 5 women; age = 24 \u00b1 4 years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention(s)<\/jats:title><jats:p>The participants' right hands were submerged in agitated ice water for 120 seconds (CPT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure(s)<\/jats:title><jats:p>Heart rate and blood pressure were continuously measured and averaged at baseline and every 30 seconds during the CPT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline heart rate and mean arterial pressure were not different between groups. Heart rate increased throughout 90 seconds of the CPT (peak increase at 60 seconds = 16 \u00b1 13 beats\/min; P &amp;lt; .001) in healthy control participants but remained unchanged in concussed athletes (peak increase at 60 seconds = 7 \u00b1 10 beats\/min; P = .08). We observed no differences between groups for the heart rate response (P &amp;gt; .28). Mean arterial pressure was elevated throughout the CPT starting at 30 seconds (5 \u00b1 7 mm Hg; P = .048) in healthy control individuals (peak increase at 120 seconds = 26 \u00b1 9 mm Hg; P &amp;lt; .001). Mean arterial pressure increased in concussed athletes at 90 seconds (8 \u00b1 8 mm Hg; P = .003) and 120 seconds (12 \u00b1 8 mm Hg; P &amp;lt; .001). Healthy control participants had a greater increase in mean arterial pressure starting at 60 seconds (P &amp;lt; .001) and throughout the CPT than concussed athletes (peak difference at 90 seconds = 25 \u00b1 10 mm Hg and 8 \u00b1 8 mm Hg, respectively; P &amp;lt; .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Recently concussed athletes had blunted cardiovascular responses to the CPT, which indicated sympathetic dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.4085\/1062-6050-573-18","type":"journal-article","created":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T14:41:25Z","timestamp":1578408085000},"page":"124-131","source":"Crossref","is-referenced-by-count":24,"title":["Attenuated Cardiovascular Responses to the Cold Pressor Test in Concussed Collegiate Athletes"],"prefix":"10.4085","volume":"55","author":[{"given":"Blair D.","family":"Johnson","sequence":"first","affiliation":[{"name":"Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Sackett","sequence":"first","affiliation":[{"name":"Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary J.","family":"Schlader","sequence":"first","affiliation":[{"name":"Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Leddy","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Sports Medicine, University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"4","key":"2020060414132882800_i1062-6050-55-2-124-b01","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s11682-013-9288-2","article-title":"Diffusion tensor imaging and magnetic resonance spectroscopy in traumatic brain injury: a review of recent literature","volume":"8","author":"Xiong","year":"2014","journal-title":"Brain Imaging Behav"},{"key":"2020060414132882800_i1062-6050-55-2-124-b02","doi-asserted-by":"crossref","first-page":"301","DOI":"10.3389\/fphys.2017.00301","article-title":"Cardiac autonomic responses during exercise and post-exercise recovery using heart rate variability and systolic time intervals: a review","volume":"8","author":"Michael","year":"2017","journal-title":"Front Physiol"},{"issue":"9","key":"2020060414132882800_i1062-6050-55-2-124-b03","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1089\/neu.2010.1497","article-title":"Frequency analysis unveils cardiac autonomic dysfunction after mild traumatic brain injury","volume":"28","author":"Hilz","year":"2011","journal-title":"J Neurotrauma"},{"issue":"2","key":"2020060414132882800_i1062-6050-55-2-124-b04","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1016\/j.clinph.2015.08.006","article-title":"Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury","volume":"127","author":"Sung","year":"2016","journal-title":"Clin Neurophysiol"},{"issue":"5","key":"2020060414132882800_i1062-6050-55-2-124-b05","doi-asserted-by":"crossref","first-page":"627","DOI":"10.4085\/1062-6050-48.5.02","article-title":"Exercise intolerance in individuals with postconcussion syndrome","volume":"48","author":"Kozlowski","year":"2013","journal-title":"J Athl Train"},{"issue":"9","key":"2020060414132882800_i1062-6050-55-2-124-b06","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1089\/neu.2015.3989","article-title":"Persisting effects of concussion on heart rate variability during physical exertion","volume":"33","author":"Abaji","year":"2016","journal-title":"J Neurotrauma"},{"issue":"8","key":"2020060414132882800_i1062-6050-55-2-124-b07","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1249\/01.MSS.0000135787.73757.4D","article-title":"Heart rate variability of recently concussed athletes at rest and exercise","volume":"36","author":"Gall","year":"2004","journal-title":"Med Sci Sports Exerc"},{"issue":"1\u20132","key":"2020060414132882800_i1062-6050-55-2-124-b08","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.autneu.2009.03.001","article-title":"Transient suppression of heart rate complexity in concussed athletes","volume":"148","author":"La Fountaine","year":"2009","journal-title":"Auton Neurosci"},{"issue":"4","key":"2020060414132882800_i1062-6050-55-2-124-b09","doi-asserted-by":"crossref","first-page":"R575","DOI":"10.1152\/ajpregu.00499.2016","article-title":"Sport-related concussion induces transient cardiovascular autonomic dysfunction","volume":"312","author":"Dobson","year":"2017","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"issue":"1","key":"2020060414132882800_i1062-6050-55-2-124-b10","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1152\/japplphysiol.00089.2013","article-title":"Effect of healthy aging on renal vascular responses to local cooling and apnea","volume":"115","author":"Patel","year":"2013","journal-title":"J Appl Physiol (1985)"},{"issue":"5","key":"2020060414132882800_i1062-6050-55-2-124-b11","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1161\/HYPERTENSIONAHA.115.06700","article-title":"Sympathetic neural and hemodynamic responses during cold pressor test in elderly blacks and whites","volume":"67","author":"Okada","year":"2016","journal-title":"Hypertension"},{"key":"2020060414132882800_i1062-6050-55-2-124-b12","doi-asserted-by":"crossref","DOI":"10.7860\/JCDR\/2016\/18780.7923","article-title":"Evaluation of autonomic dysfunction in obese and non-obese hypertensive subjects","author":"Ali","year":"2016","journal-title":"J Clin Diagn Res"},{"issue":"2","key":"2020060414132882800_i1062-6050-55-2-124-b13","doi-asserted-by":"crossref","first-page":"H300","DOI":"10.1152\/ajpheart.00636.2015","article-title":"Augmented pressor and sympathetic responses to skeletal muscle metaboreflex activation in type 2 diabetes patients","volume":"310","author":"Holwerda","year":"2016","journal-title":"Am J Physiol Heart Circ Physiol"},{"issue":"4","key":"2020060414132882800_i1062-6050-55-2-124-b14","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1161\/HYPERTENSIONAHA.115.05964","article-title":"Regulation of sympathetic nerve activity during the cold pressor test in normotensive pregnant and nonpregnant women","volume":"66","author":"Usselman","year":"2015","journal-title":"Hypertension"},{"issue":"7","key":"2020060414132882800_i1062-6050-55-2-124-b15","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1038\/jhh.2014.106","article-title":"Rapid onset pressor and sympathetic responses to static handgrip in older hypertensive adults","volume":"29","author":"Greaney","year":"2015","journal-title":"J Hum Hypertens"},{"issue":"8","key":"2020060414132882800_i1062-6050-55-2-124-b16","doi-asserted-by":"crossref","first-page":"H816","DOI":"10.1152\/ajpheart.00867.2014","article-title":"Sympathetic reactivity in young women with a family history of hypertension","volume":"308","author":"Greaney","year":"2015","journal-title":"Am J Physiol Heart Circ Physiol"},{"issue":"5","key":"2020060414132882800_i1062-6050-55-2-124-b17","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1161\/01.HYP.9.5.429","article-title":"Effects of the cold pressor test on muscle sympathetic nerve activity in humans","volume":"9","author":"Victor","year":"1987","journal-title":"Hypertension"},{"key":"2020060414132882800_i1062-6050-55-2-124-b18","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ijpsycho.2016.11.011","article-title":"The independent influence of concussive and sub-concussive impacts on soccer players' neurophysiological and neuropsychological function","volume":"112","author":"Moore","year":"2017","journal-title":"Int J Psychophysiol"},{"key":"2020060414132882800_i1062-6050-55-2-124-b19","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ebiom.2016.10.029","article-title":"Evidence for acute electrophysiological and cognitive changes following routine soccer heading","volume":"13","author":"Di Virgilio","year":"2016","journal-title":"EBioMedicine"},{"issue":"5","key":"2020060414132882800_i1062-6050-55-2-124-b20","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1055\/s-2004-819941","article-title":"Effect of an acute bout of soccer heading on postural control and self-reported concussion symptoms","volume":"25","author":"Schmitt","year":"2004","journal-title":"Int J Sports Med"},{"issue":"12","key":"2020060414132882800_i1062-6050-55-2-124-b21","doi-asserted-by":"crossref","first-page":"3679","DOI":"10.1007\/s10439-016-1680-9","article-title":"Novel method of weighting cumulative helmet impacts improves correlation with brain white matter changes after one football season of sub-concussive head blows","volume":"44","author":"Merchant-Borna","year":"2016","journal-title":"Ann Biomed Eng"},{"issue":"4","key":"2020060414132882800_i1062-6050-55-2-124-b22","doi-asserted-by":"crossref","first-page":"e94734","DOI":"10.1371\/journal.pone.0094734","article-title":"Persistent, long-term cerebral white matter changes after sports-related repetitive head impacts","volume":"9","author":"Bazarian","year":"2014","journal-title":"PLoS One"},{"issue":"23","key":"2020060414132882800_i1062-6050-55-2-124-b23","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1089\/neu.2015.4267","article-title":"Abnormalities in diffusional kurtosis metrics related to head impact exposure in a season of high school varsity football","volume":"33","author":"Davenport","year":"2016","journal-title":"J Neurotrauma"},{"key":"2020060414132882800_i1062-6050-55-2-124-b24","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.nbd.2018.07.020","article-title":"Microstructural alterations of cortical and deep gray matter over a season of high school football revealed by diffusion kurtosis imaging","volume":"119","author":"Gong","year":"2018","journal-title":"Neurobiol Dis"},{"issue":"3","key":"2020060414132882800_i1062-6050-55-2-124-b25","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1148\/radiol.2016160564","article-title":"Subconcussive head impact exposure and white matter tract changes over a single season of youth football","volume":"281","author":"Bahrami","year":"2016","journal-title":"Radiology"},{"issue":"11","key":"2020060414132882800_i1062-6050-55-2-124-b26","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1136\/bjsports-2017-097506","article-title":"The Sport Concussion Assessment Tool 5th edition (SCAT5): background and rationale","volume":"51","author":"Echemendia","year":"2017","journal-title":"Br J Sports Med"},{"issue":"11","key":"2020060414132882800_i1062-6050-55-2-124-b27","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","article-title":"Consensus statement on concussion in sport: the 5th International Conference on Concussion in Sport held in Berlin, October 2016","volume":"51","author":"McCrory","year":"2017","journal-title":"Br J Sports Med"},{"issue":"9","key":"2020060414132882800_i1062-6050-55-2-124-b28","doi-asserted-by":"crossref","first-page":"e13694","DOI":"10.14814\/phy2.13694","article-title":"Face cooling exposes cardiac parasympathetic and sympathetic dysfunction in recently concussed college athletes","volume":"6","author":"Johnson","year":"2018","journal-title":"Physiol Rep"},{"issue":"5","key":"2020060414132882800_i1062-6050-55-2-124-b29","doi-asserted-by":"crossref","first-page":"2566","DOI":"10.1152\/jappl.1993.74.5.2566","article-title":"Computation of aortic flow from pressure in humans using a nonlinear, three-element model","volume":"74","author":"Wesseling","year":"1993","journal-title":"J Appl Physiol (1985)"},{"issue":"11","key":"2020060414132882800_i1062-6050-55-2-124-b30","doi-asserted-by":"crossref","first-page":"2937","DOI":"10.1113\/jphysiol.2013.251298","article-title":"Contribution of sympathetic activation to coronary vasodilatation during the cold pressor test in healthy men: effect of ageing","volume":"591","author":"Monahan","year":"2013","journal-title":"J Physiol"},{"key":"2020060414132882800_i1062-6050-55-2-124-b31","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s12883-016-0584-5","article-title":"Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury","volume":"16","author":"Hilz","year":"2016","journal-title":"BMC Neurol"},{"issue":"14","key":"2020060414132882800_i1062-6050-55-2-124-b32","doi-asserted-by":"crossref","first-page":"4009","DOI":"10.1113\/JP271875","article-title":"Preclinical and clinical evaluation of autonomic function in humans","volume":"594","author":"Joyner","year":"2016","journal-title":"J Physiol"},{"issue":"1","key":"2020060414132882800_i1062-6050-55-2-124-b33","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1161\/01.HYP.17.1.36","article-title":"Sympathetic neural adjustments to stress in physically trained and untrained humans","volume":"17","author":"Seals","year":"1991","journal-title":"Hypertension"},{"issue":"5","key":"2020060414132882800_i1062-6050-55-2-124-b34","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/1469-8986.3950568","article-title":"Influence of fitness and gender on blood pressure responses during active or passive stress","volume":"39","author":"Dishman","year":"2002","journal-title":"Psychophysiology"},{"issue":"6","key":"2020060414132882800_i1062-6050-55-2-124-b35","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1016\/j.pain.2012.03.005","article-title":"Pain perception in athletes compared to normally active controls: a systematic review with meta-analysis","volume":"153","author":"Tesarz","year":"2012","journal-title":"Pain"},{"issue":"2","key":"2020060414132882800_i1062-6050-55-2-124-b36","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1227\/01.NEU.0000255525.34956.3F","article-title":"Temporal window of metabolic brain vulnerability to concussions: oxidative and nitrosative stresses, part II","volume":"61","author":"Tavazzi","year":"2007","journal-title":"Neurosurgery"},{"issue":"6","key":"2020060414132882800_i1062-6050-55-2-124-b37","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1227\/01.NEU.0000316421.58568.AD","article-title":"Temporal window of metabolic brain vulnerability to concussion: a pilot 1H-magnetic resonance spectroscopic study in concussed athletes, part III","volume":"62","author":"Vagnozzi","year":"2008","journal-title":"Neurosurgery"},{"issue":"11","key":"2020060414132882800_i1062-6050-55-2-124-b38","doi-asserted-by":"crossref","first-page":"3232","DOI":"10.1093\/brain\/awq200","article-title":"Assessment of metabolic brain damage and recovery following mild traumatic brain injury: a multicentre, proton magnetic resonance spectroscopic study in concussed patients","volume":"133","author":"Vagnozzi","year":"2010","journal-title":"Brain"},{"issue":"8","key":"2020060414132882800_i1062-6050-55-2-124-b39","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1089\/neu.2012.2439","article-title":"Biomarkers for the diagnosis and prognosis of mild traumatic brain injury\/concussion","volume":"30","author":"Jeter","year":"2013","journal-title":"J Neurotrauma"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/55\/2\/124\/2468679\/1062-6050-573-18.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/55\/2\/124\/2468679\/1062-6050-573-18.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T18:49:49Z","timestamp":1749667789000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/55\/2\/article-p124.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,1]]},"references-count":39,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2,1]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-573-18","relation":{},"ISSN":["1062-6050"],"issn-type":[{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2020,2,1]]}}}