Gray Max, Adamson Maheen M, Thompson Ryan C, Kapphahn Kristopher I, Han Summer, Chung Joyce S, Harris Odette A
Defense and Veterans Brain Injury Center (DVBIC), VA Palo Alto Health Care System (VAPAHCS), Palo Alto, CA, USA.
Department of Neurosurgery, Stanford School of Medicine, Palo Alto, CA, USA.
Brain Inj. 2020 Mar 20;34(4):535-547. doi: 10.1080/02699052.2020.1725979. Epub 2020 Feb 17.
: Research focused on mild traumatic brain injury in active military and veteran populations details the psychological, neurological and functional outcomes of mTBI, in a primarily male (~95%) cohort. This may misrepresent female symptoms and outcomes. Here we assess for genuine sex differences in symptom presentation and functional outcomes.: We used matched pairs to preclude potential sex bias in outcome data.: We matched 49 female/male pairs on; 1) mechanism of injury, 2) time from injury to assessment and 3) age at assessment. Statistics were t-tests, chi-square, correlations and post hoc linear regression.: Outcome assessment revealed four significant ( < .05) sex differences; Living situation, Marital status, Vocation and Branch of service. Only the Neurobehavioral Symptom Inventory (NSI) composite cognitive domain factor was significantly different between females (mean: 10.26) and males (mean: 7.58). Linear regression confirmed a significant effect of sex for the cognitive composite ( = .002).: We conclude that sex has a moderate effect on mTBI post-concussive symptom presentation. The significant sex difference in the NSI cognitive domain characterizes sex-related symptomology profiles providers can focus on for better rehabilitation management. Replication in the larger cohort would improve generalizability. TBI: Traumatic Brain Injuries; mTBI: mild Traumatic Brain Injuries; OIF: Operation Iraqi Freedom; OEF: Operation Enduring Freedom; VA: Veterans Affairs Health Care System; PSC: Polytrauma System of Care; PRC: Polytrauma Rehabilitation Center; PTRP: Polytrauma Transitional Rehabilitation Program; PNS: Polytrauma Network Site; PTSD: Post Traumatic Stress Disorder; DoD: Department of Defense; NSI: Neurobehavioral Symptom Inventory; LOC: loss of consciousness; AOC: alteration of consciousness; PTA: posttraumatic amnesia; CPRS: computerized patient record system; CTBIE: Comprehensive TBI Evaluation; OCD: obsessive compulsive disorder; ETOH: alcohol abuse.
针对现役军人和退伍军人中的轻度创伤性脑损伤开展的研究详细阐述了轻度创伤性脑损伤在心理、神经和功能方面的结果，研究对象主要是男性（约占95%）群体。这可能无法准确反映女性的症状和结果。在此，我们评估症状表现和功能结果中真正的性别差异。
我们使用配对样本以排除结果数据中潜在的性别偏差。
我们对49对女性/男性样本进行配对，配对依据为：1）损伤机制；2）从受伤到评估的时间；3）评估时的年龄。统计方法包括t检验、卡方检验以及相关性分析和事后线性回归分析。
结果评估显示出四个显著的（p < 0.05）性别差异；生活状况、婚姻状况、职业和服役分支。仅神经行为症状量表（NSI）综合认知领域因子在女性（均值：10.26）和男性（均值：7.58）之间存在显著差异。线性回归分析证实性别对认知综合指标具有显著影响（p = 0.002）。
我们得出结论，性别对轻度创伤性脑损伤的脑震荡后症状表现具有中等程度的影响。NSI认知领域的显著性别差异刻画了与性别相关的症状学特征，医疗服务提供者可据此重点关注以实现更好的康复管理。在更大规模的队列中进行重复研究将提高研究结果的普遍性。TBI：创伤性脑损伤；mTBI：轻度创伤性脑损伤；OIF：伊拉克自由行动；OEF：持久自由行动；VA：退伍军人事务医疗保健系统；PSC：多创伤护理系统；PRC：多创伤康复中心；PTRP：多创伤过渡康复项目；PNS：多创伤网络站点；PTSD：创伤后应激障碍；DoD：国防部；NSI：神经行为症状量表；LOC：意识丧失；AOC：意识改变；PTA：创伤后遗忘；CPRS：计算机化患者记录系统；CTBIE：综合脑损伤评估；OCD：强迫症；ETOH：酒精滥用
