Anto-Ocrah Martina, Bazarian Jeff, Lewis Vivian, Jones Courtney Marie, Jusko Todd A, Van Wijngaarden Edwin
a Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry , Rochester , NY , USA.
b Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry , Rochester , NY , USA.
Brain Inj. 2019;33(11):1449-1459. doi: 10.1080/02699052.2019.1644377. Epub 2019 Jul 19.
: Traumatic Brain Injury (TBI) has frequently been associated with changes in sexual functioning. The TBI and sexuality literature, however, has limited generalizability to concussed females, who often use the emergency department (ED) as their first line of care after head injury. : The primary objective of this study was to evaluate the impact of concussions on female sexual functioning. : Secondarily, we evaluated if concussed women with sexual dysfunction also report more post-concussion symptoms (PCS) and/or mood changes. : This was a prospective cohort, with outcomes assessed at 6-10 weeks after ED enrollment. : Sexual dysfunction was defined as ≤ 45 on the Brain Injury Questionnaire on Sexuality (BIQS). The Rivermead Post-concussion Symptoms Questionnaire (RPQ) and the Hospital Anxiety and Depression Scale (HADS) assessed PCS and post-injury mood, respectively. : Eighty-nine eumenorrheic females (8-14 menstrual cycles/year) completed the study; 31(36%) had concussions, and 55(64%) were extremity injured. Concussed women had 70% increased risk of sexual dysfunction (adj.RR:1.70, 95% CI: 1.04,2.76; = .03) versus extremity injured. Of clinical relevance, concussed women with sexual dysfunction also reported more PCS symptoms (adj.β = 5.5, 95% CI: -6.7,18.2; = .37) and mood scores (adj.β = 8.0; 95% CI: -0.4, 16.4; = .06). : This study highlights the need for more research and interventions for one of the fastest growing subgroups within the TBI population.
创伤性脑损伤（TBI）常与性功能变化相关。然而，TBI与性方面的文献对脑震荡女性的普遍适用性有限，这些女性在头部受伤后常将急诊科（ED）作为她们的首选治疗途径。本研究的主要目的是评估脑震荡对女性性功能的影响。其次，我们评估了存在性功能障碍的脑震荡女性是否也报告了更多的脑震荡后症状（PCS）和/或情绪变化。这是一项前瞻性队列研究，在急诊科登记后6 - 10周评估结果。性功能障碍定义为在《脑损伤性取向问卷》（BIQS）上得分≤45。分别使用Rivermead脑震荡后症状问卷（RPQ）和医院焦虑抑郁量表（HADS）评估PCS和受伤后的情绪。89名月经周期正常的女性（每年8 - 14个月经周期）完成了研究；31名（36%）有脑震荡，55名（64%）有四肢损伤。与四肢受伤的女性相比，脑震荡女性出现性功能障碍的风险增加了70%（调整后的相对风险：1.70，95%置信区间：1.04，2.76；P = 0.03）。具有临床相关性的是，存在性功能障碍的脑震荡女性也报告了更多的PCS症状（调整后的β = 5.5，95%置信区间： - 6.7，18.2；P = 0.37）和情绪得分（调整后的β = 8.0；95%置信区间： - 0.4，16.4；P = 0.06）。本研究强调了对TBI人群中增长最快亚组之一进行更多研究和干预的必要性。
