La Fountaine Michael F, Hill-Lombardi Vicci, Hohn Asante N, Leahy Caroline L, Testa Anthony J
Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ, United States.
The Institute for Advanced Study of Rehabilitation and Sports Science, Seton Hall University, Nutley, NJ, United States.
Front Neurol. 2019 Jul 9;10:691. doi: 10.3389/fneur.2019.00691. eCollection 2019.
A difference exists between sexes for the incidence of concussion injuries and severity of post-injury outcomes with females having a higher incidence rate (in comparable sports) and experience more robust symptoms than males. The basis for this disparity has remained largely unresolved. Recent findings point to a potential biological mechanism that may be related to the menstrual cycle as an arbiter of post-injury outcomes. What has not been addressed, is whether the phase of menstrual cycle (inferred fluctuations of ovarian hormones) contributes to an increased vulnerability to sustain a concussion injury. This prospective, observational study sought to determine if concussions occurred at different frequencies throughout the phase of the menstrual cycle. Female athletes who sustained a concussion injury were queried three times over the 7-day study (e.g., within 48 h of injury, and 4 and 7 days after injury) to recall the number of days that have elapsed since the beginning of their most recent menstruation. Twenty female athletes enrolled after sustaining a concussion; 18 were eumenorrheic and 2 amenorrheic. Among eumenorrheic participants at the time of injury, 2 were in the follicular phase, 4 were in the early luteal phase and 9 were in the late luteal phase. Two athletes were injured on the first and 1 was injured on the second day of menstruation. The greatest number of concussions were sustained during the late luteal phase and during the first 2 days of menstruation. This 9-day window accounted for 2/3rd of the sustained concussions in our study.
在脑震荡损伤的发生率和伤后结果的严重程度方面，性别之间存在差异，女性的发生率更高（在类似运动中），并且比男性经历更强烈的症状。这种差异的原因在很大程度上仍未得到解决。最近的研究结果指出了一种潜在的生物学机制，该机制可能与月经周期有关，是伤后结果的一个决定因素。尚未解决的问题是，月经周期的阶段（推断的卵巢激素波动）是否会导致更容易遭受脑震荡损伤。这项前瞻性观察研究旨在确定在月经周期的不同阶段脑震荡的发生频率是否不同。对遭受脑震荡损伤的女运动员在为期7天的研究中进行了三次询问（例如，在受伤后48小时内，以及受伤后4天和7天），以回忆自她们最近一次月经开始以来已经过去的天数。20名女运动员在遭受脑震荡后入组；18名月经周期正常，2名闭经。在受伤时月经周期正常的参与者中，2名处于卵泡期，4名处于黄体早期，9名处于黄体晚期。2名运动员在月经第一天受伤，1名在月经第二天受伤。脑震荡发生最多的时期是黄体晚期和月经的前两天。在我们的研究中，这9天的时间段占所有脑震荡的三分之二。
