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Female Athletes More Prone to Recurrent Concussion

— Reason unclear, study leader calls for more research

MedpageToday

BOSTON -- Female collegiate athletes were more likely than males to experience concussions both overall and in gender-comparable sports, a researcher reported.

Analysis of more than 1,000 athletes found that females were significantly more likely to have sports-related concussion (SRC) than male athletes (OR 1.5, 95% CI 1.1-2.0), reported , of Columbia University Medical Center in New York City.

Both female and male athletes who had suffered a previous concussion were three times more likely to have another concussion compared with those who never had a concussion (OR 3.0, 95% CI 2.2-4.0), added Noble. The study will be presented in April at the here.

"Concussion research has been heavily focused on male sports including football. In our study, both male and female athletes with a history of concussion were more likely to get another concussion, and female athletes particularly appeared to be more prone to recurrent concussion," said Noble, the study's senior author, in an interview with ľֱ.

"This finding, if it can be further corroborated, may help in patient-centered discussions regarding risk of future concussions," he continued.

Asked to comment, , of Penn State Hershey Medical Center, said that he was not surprised by the findings: "It has been known for some time that when student athletes compete in the same sport girls and young women have a higher rate of concussion than boys and young men," he told ľֱ.

Noble and his team examined concussion data on 1,203 athletes (68.3% male) from Columbia University Athletics who played sports including soccer, basketball, and football during 2000-2014. All athletes participated in the school's concussion care plan which applied a standard concussion protocol to high-risk athletes, including pre- and post-computerized neuropsychological testing and post-concussion symptom assessments.

The researchers also tracked symptoms once athletes returned to play after a concussion.

Noble and colleagues found that 228 athletes -- 23.1% of females (n=88) and 17.0% of males (n=140, P=0.01 for the difference) -- experienced at least one concussion during their college careers.

Both males and females experienced similar symptoms following a concussion, with the exception of amnesia (43.6% in males versus 30.7% in females, P=0.052) and insomnia (29.3% in males versus 42.0% in females, P=0.048).

There was no significant difference between genders in post-concussion neuropsychological test performance when compared with their pre-injury baseline.

Median return to play (RTP) duration was 10 days for both genders and total number of symptoms, particularly in females, remained the only significant predictor of prolonged RTP length in fully adjusted models (β=0.04, P=0.005).

The researchers concluded that it is unclear why females appear to be at higher risk for sports-related concussions than males, but that more research should be done on gender differences in concussion.

There are currently several intercollegiate research programs to help further study these and other epidemiologic research questions about sports-related concussion, Noble told ľֱ.

Harbaugh noted that while the reasoning is not certain, it is likely "due to the fact that boys and men have stronger neck muscles than girls and women."

"Angular acceleration of the head is more likely to cause concussive symptoms than linear acceleration of the head and strong neck muscles help to stabilize the head and limit angular acceleration," he explained.

Primary Source

American Academy of Neurology

Davis-Hayes C, et al "Gender specific outcomes and predictors of concussion recovery: a single site 15-year Ivy League experience" AAN 2017.