Curry School faculty find females may have higher concussion rates

Researchers investigated sex differences and concussion management in a comprehensive review of literature

hs-Concussion-CourtesyWikimediaCommons

Concussions can lead to the release of excess excitatory signals in the brain, creating an imbalance of ions like potassium and calcium.

Courtesy Wikimedia Commons

In a comprehensive review of literature published in the journal Clinics in Sports Medicine, researchers in the Curry School of Education found that females may have a higher rate of concussions compared to their male counterparts.

Concussions are a moderate form of traumatic brain injury that temporarily affects brain chemistry. These brain injuries are commonly caused by blows to the head in motor vehicle collisions, falls, sports, injuries and bicycle accidents. In the last decade, concussions have risen about 200 percent among teenagers aged 14 to 19 and in 2013 resulted in approximately 2.8 million emergency department visits, hospitalizations and deaths in the United States. 

The effects of such a brain injury can be significant, altering the brain’s physiology for hours or even years. Concussions can lead to the release of excess excitatory signals in the brain, creating an imbalance of ions like potassium and calcium.

Through these physiological effects emerge symptoms such as headaches, nausea, amnesia, sensitivity to light and weakness. However, symptoms vary among people and, at times, can go unnoticed. As a result, providers may fail to diagnose patients who do not express symptoms, since diagnosis is based on patient report of symptoms rather than a definitive test.

“Because we diagnose concussion based on symptoms, they wouldn’t be diagnosed with a concussion if they didn’t have any symptoms,” Kinesiology Prof. Susan Saliba said.

Over the past several years, there has also been research published on the correlation between sex differences and incidence and severity of concussions.

Assist. Kinesiology Prof. Jacob Resch and his team in the Curry School sought to coalesce the approximately 157 different studies on concussions in order to provide an overview of this research, looking at predisposing and potential hormonal factors associated with concussions and differences in performance size between males and females. 

“There were inconsistencies in the literature and our team wanted to take an unbiased evidence-based approach to address common factors that people associate with concussions as well,” Resch said. “We wanted to see okay what does the literature say about males and females in response to injury.”

The review found that females have a higher rate of concussions compared to their male counterparts partaking in the same sport. At the same time, females also have a higher symptom burden, in that they report more severe symptoms, and they may take longer to recover from the head injury as well. 

These higher incidences may be due to the increased likelihood that females are more likely to report their injuries. In addition, Resch said females may not actually take significantly longer to recover from concussion related injuries.

“One of the things I found interesting was the idea that women take longer than males to recover,” Resch said. “In some cases that was absolutely true but if you look at the data in aggregate form, you can see that women do take longer than males to recover [but] it was not substantially longer — maybe it was a few more days.”

In light of these results, Resch suggests that, rather than focusing on sex differences, providers who treat, diagnose and manage concussions should take a more individualized approach. In that, providers should track symptoms and provide a treatment plan that caters to the individual patient and the severity of his or her symptoms, instead of basing treatment heavily on the sex of the patient.

“The idea is that we are going to track your symptoms — and yes there is evidence out there saying that women take longer to recover — however, we are going to take a very individualized approach,” Resch said.

Resch and his team plan to continue reviewing literature on concussions, especially looking at hormones related to sport concussion injuries as well as looking at the presence of the brain injury in different populations. With the continued research, Resch hopes to provide a clearer picture for parents and patients about concussion injuries.

“One of the nice things about this review is that even though the media will portray concussions as an extremely negative thing, a majority of injuries are set to recover within a relatively short period of time,” Resch said. “There are good outcomes for a majority of patients who have a concussion.”

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