a VA San Diego Healthcare System , San Diego , CA , USA.
b School of Medicine (Psychology), University of Tasmania , Hobart , TAS , Australia.
Clin Neuropsychol. 2019 Aug;33(6):1016-1043. doi: 10.1080/13854046.2018.1508616. Epub 2019 Jan 8.
The purpose of this review was to examine sex differences in concussion, or mild traumatic brain injury (mTBI) outcome, updating previous critical reviews of the literature. Within adult human studies, we reviewed a wide range of concussion outcome variables: prevalence of concussion, injury characteristics, postconcussion symptom trajectories and psychiatric distress, neuropsychological performance, and neuroimaging findings. Sports-related concussion, civilian, and military samples were included in the review. Given the robust concussion literature, there is a relative paucity of research addressing sex differences following concussion. The majority of available studies focused on sports-related concussion, with fewer studies targeting other civilian causes of concussion or military-related concussion in females. Prevalence of concussion was generally reported to be higher in females than males. Although symptom reporting largely showed a pattern for females to report greater overall symptoms than males, examining individual symptoms or symptom clusters resulted in mixed findings between the sexes. Neuropsychological studies generally showed females performing more poorly than males on measures of visual memory following concussion, though this finding was not consistently reported. Research examining sex differences in humans following concussion, in general, is in its infancy, and exploration of sex differences in studies outside of the sports concussion domain is particularly nascent. Given the increased prevalence of concussion and potential higher symptom reporting among women, ongoing research is necessary to better understand the role of biological sex on outcome following concussion. Understanding sex differences has important implications for assessment, management, and treatment of concussion.
本综述旨在探讨脑震荡（轻度创伤性脑损伤，mTBI）的性别差异，更新了之前对文献的批判性综述。在成人研究中，我们综述了广泛的脑震荡结果变量：脑震荡的患病率、损伤特征、脑震荡后症状轨迹和精神困扰、神经心理学表现和神经影像学发现。本综述纳入了与运动相关的脑震荡、平民和军事样本。鉴于脑震荡的相关研究已经非常丰富，针对脑震荡后性别差异的研究相对较少。大多数现有研究都集中在与运动相关的脑震荡上，针对其他平民原因导致的脑震荡或女性军事相关脑震荡的研究较少。一般来说，女性脑震荡的患病率高于男性。尽管症状报告总体上显示女性比男性报告更多的总体症状，但检查个别症状或症状群的结果在性别之间存在混合发现。神经心理学研究一般显示女性在脑震荡后视觉记忆方面的表现比男性差，尽管这一发现并非始终如此。总体而言，关于人类脑震荡后性别差异的研究还处于起步阶段，对运动性脑震荡以外领域的研究中性别差异的探索尤其不成熟。鉴于脑震荡的患病率增加，以及女性报告的症状可能更多，需要进行持续研究，以更好地了解生物学性别对脑震荡后结果的影响。了解性别差异对脑震荡的评估、管理和治疗具有重要意义。
