Moran Ryan N, Guin J Russell, Roehmer Christian, Murray Nicholas G
Department of Health Science, Athletic Training Research Laboratory, The University of Alabama, Tuscaloosa, Alabama, USA.
Family, Internal, and Rural Medicine, College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama, USA.
Orthop J Sports Med. 2024 Aug 16;12(8):23259671241259735. doi: 10.1177/23259671241259735. eCollection 2024 Aug.
Hormonal contraceptives (HCs) and the menstrual cycle have been suggested to affect symptom severity and postconcussion recovery. Additionally, hormones have been a suggested rationale for sex differences between female and male athletes on concussion assessment. Researchers have yet to explore the effects of HC use on baseline symptomatology, including symptom reporting and provocation.
To examine the influence of HC use on a baseline symptom reporting and vestibular/ocular provocation battery.
Cross-sectional study; Level of evidence, 3.
A total of 61 college-aged individuals (21 HC-using women, 21 non-HC-using women, 19 men) were administered a baseline symptom battery consisting of the Post-Concussion Symptom Scale (PCSS), Headache Impact Test-6 (HIT-6), Pediatric Vestibular Symptom Questionnaire (PVSQ), and Vestibular/Ocular Motor Screening (VOMS). The main outcome measures consisted of PCSS symptom reporting (total symptoms, symptom severity score, and symptom factors), HIT-6 and PVSQ total scores, and VOMS item (ie, saccades, convergence, or vestibular/ocular reflex) symptom provocation scores.
Significant differences were reported on HIT-6, with the highest headache reporting in the HC group ( = .026). On the PVSQ, the HC group also reported greater dizziness and unsteadiness symptoms than the non-HC group ( = .023). Similar findings existed on the PCSS, with the HC group reporting greater total symptoms ( < .001), symptom severity ( < .001), and vestibular-somatic ( = .024), cognitive-sensory ( = .004), sleep-arousal ( = .001), and affective ( < .001) factors compared with the non-HC group. Smooth pursuit (ie, following finger smoothly with eyes) was the only VOMS items with differences between groups ( = .003), with the HC group having greater provocation compared with non-HC users ( = .020).
HC use was associated with overall symptomatology and worse self-reported symptoms on vestibular-related inventories and concussion symptom scales and factors when compared with non-HC users and male controls. Additionally, HC users reported higher VOMS provocation scores on the smooth pursuit item than non-HC users and male controls.
激素避孕药（HCs）和月经周期被认为会影响症状严重程度和脑震荡后的恢复。此外，激素一直被认为是女性和男性运动员在脑震荡评估中存在性别差异的一个原因。研究人员尚未探讨使用HCs对基线症状学的影响，包括症状报告和激发试验。
研究使用HCs对基线症状报告和前庭/眼动激发试验的影响。
横断面研究；证据等级，3级。
共有61名大学生（21名使用HCs的女性、21名未使用HCs的女性、19名男性）接受了由脑震荡后症状量表（PCSS）、头痛影响测试-6（HIT-6）、小儿前庭症状问卷（PVSQ）和前庭/眼动筛查（VOMS）组成的基线症状测试。主要结局指标包括PCSS症状报告（总症状数、症状严重程度评分和症状因子）、HIT-6和PVSQ总分，以及VOMS项目（即扫视、集合或前庭/眼反射）症状激发评分。
HIT-6报告存在显著差异，HC组头痛报告率最高（P = 0.026）。在PVSQ上，HC组报告的头晕和不稳定症状也比未使用HCs组更多（P = 0.023）。PCSS也有类似的发现，与未使用HCs组相比，HC组报告的总症状数更多（P < 0.001）、症状严重程度更高（P < 0.001），以及前庭-躯体（P = 0.024）、认知-感觉（P = 0.004）、睡眠-觉醒（P = 0.001）和情感（P < 0.001）因子更高。平稳跟踪（即眼睛平稳跟随手指）是两组之间唯一存在差异的VOMS项目（P = 0.003），与未使用HCs者相比，HC组激发试验结果更明显（P = 0.020）。
与未使用HCs者和男性对照组相比，使用HCs与总体症状学以及前庭相关量表和脑震荡症状量表及因子上自我报告的更差症状相关。此外，HC使用者在平稳跟踪项目上的VOMS激发评分高于未使用HCs者和男性对照组。
