Dataset Information

Sex-Based Differences in the Incidence of Sports-Related Concussion: Systematic Review and Meta-analysis.

ABSTRACT: CONTEXT:The incidence of sports-related concussion in females has been increasing in recent years. OBJECTIVE:To conduct a meta-analysis on sex-based differences in concussion incidence in various sports and to determine the effects of study design (retrospective vs prospective), setting (competition vs practice), and population (university and above vs high school and below) via a meta-regression. DATA SOURCES:PubMed (Medline), EMBASE, and Cochrane Library databases were searched from January 2000 to January 2018. STUDY SELECTION:Studies reporting sports-related concussion incidence data for both males and females (age ?10 years) were included. STUDY DESIGN:Systematic review with meta-analysis and meta-regression. LEVEL OF EVIDENCE:Level 4. METHODS:The rate ratio was calculated as the concussion rate in females/males. Data were pooled using the DerSimonian-Laird random-effects model. RESULTS:Thirty-eight studies met the eligibility criteria and were included in the meta-analysis. Soccer and basketball demonstrated significantly higher incidence of concussions in females compared with males (rate ratio [95% CI], 1.76 [1.43-2.16] and 1.99 [1.56-2.54], respectively; P < 0.01). Sex-based differences in concussion incidence rates for baseball/softball, ice hockey, lacrosse, swimming/diving, and track and field were not statistically significant. In the meta-regression analysis, there were no significant effects on the rate ratio when evaluating study design, setting, and population. CONCLUSION:Concussion incidence rates were significantly higher in females than in males for soccer and basketball.

SUBMITTER: Cheng J

PROVIDER: S-EPMC6822209 | biostudies-literature | 2019 Nov/Dec

REPOSITORIES: biostudies-literature

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Sex-Based Differences in the Incidence of Sports-Related Concussion: Systematic Review and Meta-analysis.

Cheng Jennifer J Ammerman Brittany B Santiago Kristen K Jivanelli Bridget B Lin Emerald E Casey Ellen E Ling Daphne D

Sports health 20190930 6

<h4>Context</h4>The incidence of sports-related concussion in females has been increasing in recent years.<h4>Objective</h4>To conduct a meta-analysis on sex-based differences in concussion incidence in various sports and to determine the effects of study design (retrospective vs prospective), setting (competition vs practice), and population (university and above vs high school and below) via a meta-regression.<h4>Data sources</h4>PubMed (Medline), EMBASE, and Cochrane Library databases were se ...[more]

PMID: 31567052

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Project description:Sex differences in molecular biomarkers after sports-related concussion (SRC) could steadily advance our understanding of injury heterogeneity and complexity, and help capture phenotypic characteristics, by unveiling sex-dependent pathobiological processes and disease mechanisms. Such knowledge will help improve diagnosis, clinical management, and prognosis. Total-tau (t-tau) has recently emerged as a promising blood marker showing sex-associated differences in neurodegenerative diseases. Nonetheless, to date, little is known about the potential influence of sex on its injury-related concentration and dynamics after SRC. We hypothesized that measurements of circulating levels of t-tau over time would reflect a differential vulnerability signature, providing insights into the sex-related phenotypes and their relationship with clinical outcomes. To test this hypothesis, plasma levels of t-tau were measured using an ultrasensitive immunoassay up to 7 days after injury, in 46 concussed athletes (20 males, 26 females). We used trajectory analysis to generate two distinct temporal profiles of t-tau, which were then compared with gender and return to play (RTP). The majority of subjects (~63%) started with low t-tau concentrations that further declined within the first 48 h; while the remaining ("maximal decliners") started with concentrations comparable to the baseline levels that also fell over time, but persisting markedly higher compared with the first profile. The maximal decliner group was primarily composed of female subjects (p = 0.007) and was significantly associated with poor outcome (RTP ≥ 10 days after concussion) (p = 0.011). Taken together, our data provide evidence for the existence of sex-related biosignatures following sports-related concussions, possibly indicating a differential effect as a result of distinct brain vulnerability and inherent injury response. Future studies will be required to further elucidate underlying sex-based biological and pathophysiological mechanisms, and determine the value of t-tau signatures for management and therapeutic decision-making in sports-related concussions.

Project description:Background and purposeQuantitative susceptibility mapping using MR imaging can assess changes in brain tissue structure and composition. This report presents preliminary results demonstrating changes in tissue magnetic susceptibility after sports-related concussion.Materials and methodsLongitudinal quantitative susceptibility mapping metrics were produced from imaging data acquired from cohorts of concussed and control football athletes. One hundred thirty-six quantitative susceptibility mapping datasets were analyzed across 3 separate visits (24 hours after injury, 8 days postinjury, and 6 months postinjury). Longitudinal quantitative susceptibility mapping group analyses were performed on stability-thresholded brain tissue compartments and selected subregions. Clinical concussion metrics were also measured longitudinally in both cohorts and compared with the measured quantitative susceptibility mapping.ResultsStatistically significant increases in white matter susceptibility were identified in the concussed athlete group during the acute (24 hour) and subacute (day 8) period. These effects were most prominent at the 8-day visit but recovered and showed no significant difference from controls at the 6-month visit. The subcortical gray matter showed no statistically significant group differences. Observed susceptibility changes after concussion appeared to outlast self-reported clinical recovery metrics at a group level. At an individual subject level, susceptibility increases within the white matter showed statistically significant correlations with return-to-play durations.ConclusionsThe results of this preliminary investigation suggest that sports-related concussion can induce physiologic changes to brain tissue that can be detected using MR imaging-based magnetic susceptibility estimates. In group analyses, the observed tissue changes appear to persist beyond those detected on clinical outcome assessments and were associated with return-to-play duration after sports-related concussion.

Project description:BackgroundGaelic games are some of the most popular sports played by Irish adolescents, and the Gaelic Athletic Association has undertaken educational initiatives to improve awareness of a sports-related concussion (SRC). However, SRC underreporting is common among adolescent athletes internationally, potentially due to poor knowledge or attitudes toward SRC. This study aimed to examine previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future education in adolescent Gaelic games players and their parents.HypothesesThe hypotheses were as follows: (1) A significant number of adolescent Gaelic games players will have experienced an SRC, (2) nondisclosure of SRCs will be common, and (3) adolescents will display poorer attitudes toward reporting than parents.Study designCross-sectional study.Level of evidenceLevel 3.MethodsAdolescent male and female Gaelic games players (n = 113) and parents (n = 151) completed an anonymous questionnaire examining previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future SRC education initiatives.ResultsOverall, 57.5% of adolescent Gaelic games players suspected they had suffered an SRC previously, and a greater number of suspected SRCs were reported than were medically diagnosed. Adolescent players (mean score, 11.4/14) and their parents (mean score, 11.8) displayed good knowledge of SRC signs and symptoms. However, adolescents were less likely to report an SRC during an important game or if an important game was coming up. Both adolescents and their parents would like more SRC education, particularly in the format of online videos or medical professional-led workshops.ConclusionUnderreporting of SRC occurs in adolescent players, despite good knowledge of SRC signs and symptoms. Education is required to highlight the importance of completing a return-to-play program after an SRC regardless of match importance.Clinical relevanceA multifaceted educational strategy that targets the wider Gaelic games community in the preferred formats identified by key stakeholders is required.

Project description:BackgroundRecognizing sport-related concussion (SRC) is challenging and relies heavily on subjective symptom reports. An objective, biological marker could improve recognition and understanding of SRC. There is emerging evidence that salivary micro-ribonucleic acids (miRNAs) may serve as biomarkers of concussion; however, it remains unclear whether concussion-related miRNAs are impacted by exercise. We sought to determine whether 40 miRNAs previously implicated in concussion pathophysiology were affected by participation in a variety of contact and non-contact sports. Our goal was to refine a miRNA-based tool capable of identifying athletes with SRC without the confounding effects of exercise.MethodsThis case-control study harmonized data from concussed and non-concussed athletes recruited across 10 sites. Levels of salivary miRNAs within 455 samples from 314 individuals were measured with RNA sequencing. Within-subjects testing was used to identify and exclude miRNAs that changed with either (a) a single episode of exercise (166 samples from 83 individuals) or (b) season-long participation in contact sports (212 samples from 106 individuals). The miRNAs that were not impacted by exercise were interrogated for SRC diagnostic utility using logistic regression (172 samples from 75 concussed and 97 non-concussed individuals).ResultsTwo miRNAs (miR-532-5p and miR-182-5p) decreased (adjusted p < 0.05) after a single episode of exercise, and 1 miRNA (miR-4510) increased only after contact sports participation. Twenty-three miRNAs changed at the end of a contact sports season. Two of these miRNAs (miR-26b-3p and miR-29c-3p) were associated (R > 0.50; adjusted p < 0.05) with the number of head impacts sustained in a single football practice. Among the 15 miRNAs not confounded by exercise or season-long contact sports participation, 11 demonstrated a significant difference (adjusted p < 0.05) between concussed and non-concussed participants, and 6 displayed moderate ability (area under curve > 0.70) to identify concussion. A single ratio (miR-27a-5p/miR-30a-3p) displayed the highest accuracy (AUC = 0.810, sensitivity = 82.4%, specificity = 73.3%) for differentiating concussed and non-concussed participants. Accuracy did not differ between participants with SRC and non-SRC (z = 0.5, p = 0.60).ConclusionSalivary miRNA levels may accurately identify SRC when not confounded by exercise. Refinement of this approach in a large cohort of athletes could eventually lead to a non-invasive, sideline adjunct for SRC assessment.

Dataset Information

Sex-Based Differences in the Incidence of Sports-Related Concussion: Systematic Review and Meta-analysis.

Publications

Sex-Based Differences in the Incidence of Sports-Related Concussion: Systematic Review and Meta-analysis.

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