Sex Differences in Concussion Symptoms of High School Athletes

Abstract

Context: More than 1.6 million sport-related concussions occur every year in the United States, affecting greater than 5% of all high school athletes who participate in contact sports. As more females participate in sports, understanding possible differences in concussion symptoms between sexes becomes more important.Objective: To compare symptoms, symptom resolution time, and time to return to sport between males and females with sport-related concussions.Design: Descriptive epidemiology study. Setting: Data were collected from 100 high schools via High School RIO (Reporting Information Online).Patients or Other Participants: Athletes from participating schools who sustained concussions while involved in interscholastic sports practice or competition in 9 sports (boys' football, soccer, basketball, wrestling, and baseball and girls ' soccer, volleyball, basketball, and softball) Main Outcome Measure(s): Reported symptoms, symptom resolution time, and return-to-play time.Results: No difference was found between the number of symptoms reported (P 5 .30). However, a difference was seen in the types of symptoms reported. In year 1, males reported amnesia (exact P 5 .03) and confusion/disorientation (exact P 5 .04) more frequently than did females. In year 2, males reported more amnesia (exact P 5 .002) and confusion/ disorientation (exact P 5 .002) than did females, whereas females reported more drowsiness (exact P 5 .02) and sensitivity to noise (exact P 5 .002) than did males. No differences were observed for symptom resolution time (P 5 .40) or return-to-play time (P 5 .43) between sexes.Conclusions: The types of symptoms reported differed between sexes after sport-related concussion, but symptom resolution time and return-to-play timelines were similar.

Sex matters: repetitive mild traumatic brain injury in adolescent rats

“…Another study found that juvenile males and females did not differ on a range of sensorimotor outcomes, which is consistent with our findings of motor‐related deficits in both male and female rats given RmTBI 67. Clinical studies of sex differences following mTBI in high school and collegiate students are currently conflicted; some have reported females are more likely to be cognitively impaired and experience more subjective and objective symptoms,11 while others have reported no differences in the number of symptoms, but sex differences in the type of symptoms experienced 64. Given the significant degree of brain maturation occurring during this critical period of development, sex‐dependent variations, and the differences in symptomology associated with single versus repetitive mTBI, it is not surprising that clinical studies have failed to produce reliable results regarding symptom presentation.…”

“…Consistent with epidemiological findings, postinjury symptomology differed between males and females 12, 64. Males given mTBIs exhibited greater impairment on the cognitive task (i.e., NCM), whereas females given mTBIs exhibited increased impairments on the forced swim task.…”

Acute Concussion Symptom Severity and Delayed Symptom Resolution

“…After sensitivity analysis, the best cut-point score was used for multiple logistic regression, adjusting for gender and age, as symptom report may vary by both age and gender. [32][33][34] The same methods were used substituting our clinical definition of DSR with the PCS criteria. Results of x 2 analysis were considered significant if P , .05.…”

Social norms theory and concussion education

“…In that intervening period, athletes may experience a combination of cognitive, somatic and emotional symptoms [9,10] that can impair their ability to complete school or work obligations [11]. Athletes who sustain more concussions are more likely to experience prolonged symptoms [12][13][14].…”