Abstract

Objective: To examine differences in concussion symptom reporting between female and male adults considering current psychological symptoms such as anxiety and depression and pre-injury factors in order to identify sex differences which may guide treatment efforts. Method: This prospective study is part of the North Texas Concussion Registry (ConTex). Subjects (N = 132) age 19 to 78 years had sustained a concussion within 30 days of clinic visit. The independent variable was sex and covariates included age, ethnicity, current anxiety and depression ratings, history of attention deficit disorder, history of headache/migraine, and time to clinic. The dependent variables were 22 post-concussion symptoms as measured by the Sport Concussion Assessment Tool-5 Post-Concussion Symptom Scale. Results: Analysis of covariance and ordinal logistic regression results both revealed that females had a greater likelihood of reporting increased symptom severity for 15/22 concussion symptoms. The largest risk ratios (effect size) in symptom reporting between sexes (higher symptoms in females) included: feeling more emotional 4.05 (0.72), fatigue or low energy 4.05 (0.72), sensitivity to light 3.74 (0.69), headache 3.65 (0.57), balance problems 3.31 (0.53), pressure in head 3.06 (0.51), and neck pain 2.97 (0.60). Conclusions: Adult females in our sample reported higher levels of many concussion symptoms than males and showed an increased risk of developing these same symptoms following concussion. Examination of the magnitude of sex difference in concussion symptom reporting will better inform medical staff to anticipate and address symptoms that may present greater challenges for adult females.

摘要

目的：考虑当前的心理症状，如焦虑和抑郁以及受伤前因素，检查女性和男性成年人之间脑震荡症状报告的差异，以确定可能指导治疗工作的性别差异。方法：这项前瞻性研究是北德克萨斯脑震荡登记处 (ConTex) 的一部分。19 至 78 岁的受试者 (N = 132) 在就诊后 30 天内发生脑震荡。自变量是性别，协变量包括年龄、种族、当前焦虑和抑郁等级、注意力缺陷障碍病史、头痛/偏头痛病史和就诊时间。因变量是由运动脑震荡评估工具 5 脑震荡后症状量表测量的 22 种脑震荡后症状。结果：协方差分析和有序逻辑回归结果均显示，女性更有可能报告 15/22 脑震荡症状的症状严重程度增加。两性之间症状报告的最大风险比（效应大小）（女性症状较高）包括：感觉更情绪化 4.05 (0.72)、疲劳或低能量 4.05 (0.72)、对光敏感 3.74 (0.69)、头痛 3.65 (0.57) )，平衡问题 3.31 (0.53)，头部压力 3.06 (0.51)，颈部疼痛 2.97 (0.60)。结论：我们样本中的成年女性报告的许多脑震荡症状水平高于男性，并且在脑震荡后出现这些相同症状的风险增加。检查脑震荡症状报告中的性别差异幅度将更好地告知医务人员预测和解决可能对成年女性构成更大挑战的症状。