Zuckerman Scott L, Solomon Gary S, Forbes Jonathan A, Haase Richard F, Sills Allen K, Lovell Mark R
Vanderbilt University School of Medicine, Department of Neurological Surgery, T-4224 Medical Center North, Nashville, Tennessee 37232-2380, USA.
J Neurosurg Pediatr. 2012 Dec;10(6):504-10. doi: 10.3171/2012.8.PEDS12139. Epub 2012 Oct 2.
Several studies have suggested a gender difference in response to sports-related concussion (SRC). The Concussion in Sport group did not include gender as a modifying factor in SRC, concluding that the evidence at that point was equivocal. In the present study the authors endeavored to assess acute neurocognitive and symptom responses to an SRC in equivalent cohorts of male and female soccer players. The authors hypothesized that female athletes would experience greater levels of acute symptoms and neurocognitive impairment than males.
Baseline symptom and neurocognitive scores were determined in 40 male and 40 female soccer players by using the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) scale prior to any SRC. After sustaining an SRC, each athlete completed postconcussion ImPACT tests and was carefully matched on a wide array of biopsychosocial variables. Baseline symptom and neurocognitive test scores were compared, and their acute symptoms and neurocognitive responses to concussive injury were assessed.
Specific a priori hypotheses about differences between males and females at baseline and at postconcussion measurements of verbal and visual memory ImPACT scores were evaluated according to simple main effects of the gender variable and according to baseline-to-postconcussion main effect and interaction of 2 × 2 split-plot ANOVA. Neither the interaction nor the main effects nor the simple main effects for either ImPACT variable were found to be statistically significant. Exploratory ANOVAs applied to the remaining ImPACT variables of visualmotor speed, reaction time, impulse control, and symptom total scores revealed only a single statistically significant baseline-to-postconcussion main effect for the symptom total.
The results failed to replicate prior findings of gender-specific baseline neurocognitive differences in verbal and visual memory. The findings also indicated no differential gender-based acute response to concussion (symptoms or neurocognitive scores) among high school soccer players. The implications of these findings for the inclusion of gender as a modifying factor in this tightly matched cohort are addressed. Potential explanations for the null findings are discussed.
多项研究表明，在与运动相关的脑震荡（SRC）反应方面存在性别差异。运动脑震荡小组未将性别作为SRC的一个调节因素，得出的结论是当时的证据并不明确。在本研究中，作者试图评估男女足球运动员同等队列中对SRC的急性神经认知和症状反应。作者假设女性运动员比男性会经历更严重的急性症状和神经认知障碍。
在40名男性和40名女性足球运动员遭受任何SRC之前，通过使用脑震荡后即刻评估和认知测试（ImPACT）量表确定其基线症状和神经认知分数。遭受SRC后，每位运动员完成脑震荡后ImPACT测试，并在一系列生物心理社会变量上进行仔细匹配。比较基线症状和神经认知测试分数，并评估他们对脑震荡损伤的急性症状和神经认知反应。
根据性别变量的简单主效应以及根据基线到脑震荡后的主效应和2×2裂区方差分析的交互作用，评估了关于男性和女性在基线以及脑震荡后言语和视觉记忆ImPACT分数测量方面差异的特定先验假设。未发现ImPACT变量的交互作用、主效应或简单主效应具有统计学意义。对视觉运动速度、反应时间、冲动控制和症状总分等其余ImPACT变量进行的探索性方差分析仅显示症状总分在基线到脑震荡后有一个统计学上显著的主效应。
结果未能重复先前关于言语和视觉记忆中性别特异性基线神经认知差异的研究结果。研究结果还表明，高中足球运动员中在脑震荡方面不存在基于性别的急性反应差异（症状或神经认知分数）。讨论了这些研究结果对于在这个紧密匹配的队列中将性别作为一个调节因素的意义。讨论了结果为阴性的潜在解释。
