In 24 post-mTBI-patients (35.3±2.7 years; 6 women, 32.8±5.6 months post-injury) and 26 healthy persons (30.4±2.3 years; 10 women), we monitored respiration, RR-intervals (RRIs), systolic and diastolic blood pressure (BPsys, BPdia) before and during presentation of 3-minute excerpts of “happy” music (Marriage of Figaro, Overture, K. 492) and “fearful” music (The miraculous Mandarin, Suite, Op. 19). Participants rated “happiness” and “fear” on 1 to 5 Likert-scales.

Likert-scores assigned to happy and fearful music were similar in patients and controls. “Happy” music accelerated respiration in controls (14.1±0.7 vs 16.0±0.7 bpm), increased BPsys in controls (134.0±3.5 vs 137.7±3.5 mmHg) and patients (129.6±3.0 vs 134.0±3.2 mmHg), but did not change BPdia and RRIs. “Fearful” music did not change respiration or RRIs, increased BPsys in controls (130.9±3.1 vs 135.1±3.3 mmHg) and patients (130.0±3.6 vs 134.3±3.7 mmHg), but increased BPdia only in controls (67.4±1.9 vs 68.8±2.1 mmHg).

The similar emotional ratings of the musical stimuli in patients and controls suggest that the patients’ emotional perception of “happy” and “fearful” music was not significantly compromised at the time of study, 32.8±5.6 months after the mTBI. In contrast, lack of respiration-acceleration with happy music and BPdia-increase with fearful music in the patients indicates persistence of subtle changes in sympathetic processing of musical stimuli even months to years after mild TBI. The findings suggest that central autonomic regulation might be more vulnerable to mTBI than is the perception of emotional stimuli.