Feasibility of Mild Traumatic Brain Injury Assessment Based on Cardiovascular Response to Postural Change

Objective: To determine the feasibility of short-term cardiovascular responses to postural change as a screening tool for mild traumatic brain injury (mTBI), using heart rate metrics that can be measured with a wearable electrocardiogram sensor. Setting: Military TBI clinic. Design: Data collected from active-duty service members who had sustained a medically diagnosed mTBI within the prior 72 hours and from age- and sex-matched controls. Cardiac data collected while participants performed a sequence of postural changes. Main Measures: Model classification compared with clinical mTBI diagnosis. Results: Cardiac biomarkers of mTBI were identified and logistic regression classifiers for mTBI were developed from different subsets of biomarkers. The best model achieved 90% sensitivity and 69% specificity using data from 2 different postural changes. Conclusion: Noninvasive measurement of cardiovascular response to postural change is a promising approach for field-deployable post-mTBI screening.