Sex Differences in Cognitive and Mental Health Functioning Following Mild Traumatic Brain Injury
Abstract
Objectives and Rationale: The proportion of females in high-risk settings for concussion (e.g., military and sports) has steadily increased, as has the corresponding rate of concussion in females. Research examining sex differences in humans following concussion has not kept pace with this demographic shift. To date, the vast majority of concussion research has been conducted on males; subsequently, concussion management is based almost exclusively on evidence from studies conducted on males. Given differing hormones, musculature, and/or social environments in which recovery occurs, there is reason to suspect sex differences in concussion outcome. Emerging research suggests increased prevalence of concussion and potentially higher symptom reporting among females, but the work has been plagued by small samples of females, leaving it unclear as to the extent to which sex influences the nature and course of recovery following concussion. Thus, research incorporating much larger female samples is needed to better understand the role of biological sex on outcome following concussion and “big data” sources become optimal ways to amass a sufficient number of females to study. Harnessing the volume of data from both sport/civilian and military TBI available in the Federal Interagency Traumatic Brain Injury Research (FITBIR) database, the proposed project will result in one of the largest known examinations to date of sex differences in post-concussive/mental health symptoms and cognitive outcomes following concussion. The overall objective of the proposed study is to examine sex differences in symptom reporting and cognitive functioning following concussion in a large sample of Service members and civilians from available FITBIR data, with supplemental data from the Chronic Effects of Neurotrauma Consortium (CENC). Our proposal responds to the following FY19 FITBIR Analysis Award Topic(s) of Interest: (1) identification of unique clinical outcomes for civilians and Service members and (2) utilization of FITBIR data to inform clinical practice guidelines for TBI. Given its extensive sample size, in combination with the availability of comprehensive data on post-concussive/mental health symptoms and cognitive functioning, FITBIR is an ideal resource for carrying out the proposed project. With that in mind, we propose a retrospective, cross-sectional data analysis to examine sex differences in concussion outcome by determining the extent to which males and females differ with respect to post-concussive and mental health symptoms and cognitive functioning following injury. As part of our project, we will also examine interactions between sex and injury setting/population (i.e., civilians vs. military) and sex and number of concussions on symptom reporting and cognitive functioning following injury. Clinical Applications, Benefits, and Risks: In line with the award mechanism’s goal, the proposed study will address the need to better understand concussion in females and study results will identify unique clinical outcomes in concussed females in both civilian and military settings. Developing a better understanding of how sex influences recovery and outcome following mTBI has important implications for assessment, management, and treatment of concussion as concussed individuals may benefit from a more individualized approach to care. Data from this large-scale investigation of sex differences in concussion outcomes can be used to better tailor treatments to the individual, potentially alter the recovery process following concussion, and mitigate negative health consequences following injury. This would result in both health care cost savings and improved quality of life for active duty Service members, Veterans, and civilians. Results from this study also have great potential to inform clinical practice guidelines for concussion, with particular sensitivity to whether current guidelines would benefit from revision whe
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010862
Entities
People
- Amy J. Jak
Organizations
- United States Army
- Veterans Medical Research Foundation of San Diego