Hormone Variations on Concussion Testing in Young Females Kirsten N. Mansfield Ninth Grade

“Can the normal female hormonal changes that occur during a menstrual cycle affect concussion testing in the high school athlete?” Question

Brain injury caused by a blow or jolt to head that makes the brain move rapidly inside the skull Symptoms may be mild causing headache, nausea, confusion, sleep problems and mood changes May have serious long-term effects including memory loss A second concussion while still recovering from the first can be lethal (second impact syndrome)

Concussions In Sports 2-3 million sports related concussions occur in the U.S. each year Teens are more likely to get a concussion and take longer to recover than adults 135,900 concussion occur each year in high school sports in the U.S. It is estimated that 2 people die each year in U.S. due to second impact syndrome The lethal second impact syndrome is more common in teenagers and children

Verbal Memory Visual Memory Visual Motor Speed Reaction Time Impulse Control Symptoms

The Difference Between Boys & Girls Women are more likely than men to suffer a concussion in similar sports  Girls concussion rate in high school soccer is 68% higher than boys  Girls concussion rate in high school basketball is triple the rate of boys  Girls concussion rate for high school lacrosse is double the rate of boys  Similar differences are found in softball/baseball & Ice hockey Women suffer more symptoms from concussions and recover more slowly than men

If hormonal changes that occur in women during the normal menstrual cycle causes differences in their concussion test scores, then testing female students at different stages of their menstrual cycle should reveal varying concussion test scores.

Materials & Methods Inclusion Criteria: Female High School Students from My School Regular menstrual cycles between days No recent concussion for past 3 months No use of oral or injectable steroid-like medication

Materials & Methods ImPACT testing scored each participant in both follicular phase (day 3-9) and luteal phase (day 18-24) of the menstrual cycle Consents obtained from both students and their parents 11 students met criteria and submitted proper consent School’s Athletic Department administered the ImPACT testing

Materials & Methods Independent Variable - Students taking the ImPACT concussion test during the luteal phase of their menstrual cycle Dependent Variable - The test results from the luteal phase of the menstrual cycle Control - Students ImPACT concussion test scores during the follicular phase of their menstrual cycle Constants - The ImPACT concussion test program

Results

Conclusion Menstrual cycle had no effect on the ImPACT test scores in the high school athlete and therefore my hypothesis was not supported Clinical measures of concussion testing will not be affected by the follicular or luteal phase of the menstrual cycle.  Decreased performance on ImPACT testing following a concussion can be attributed to the injury alone and not due to menstrual cycle changes.  Improving scores during the recovering of a concussion can be attributed to actual recovery of the brain injury and not from varying phases of the menstrual cycle.

Conclusion Further improvements of this study can be made by:  Increasing the sample size  Objective measures to determine hormonal changes:  Basal Body Temperature Charting  Blood Testing to determine progesterone levels  Use men as the control Current use of ImPACT testing should be continued and encouraged in the high school female athlete.

Thank You! Any Questions? Work Cited ImPACT. N.p., n.d. Web. 25 Sept Keating, Peter. “HEADING FOR TROUBLE.” ESPN. N.p., Web. 24 Feb Laino, Charlene. “Dementia Risk for Retired Football Players?” WebMD. N.p., 19 July Web. 22 Feb Lovell, Mark. “Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)™ Background Information.” UPMC. Affiliated with the U of Pittsburgh Schools of the Health Sciences, Web. 22 Feb MCilroy, Annie. “Females More Susceptible to Concussion, Studies Suggest.” The Globe and Mail 18 Mar. 2011: n. pag. The Globe and Mail. Web. 20 Feb “Men And Women With History Of Concussion Mend Differently, Study Finds.” Science Daily. N.p., 10 July Web. 25 Feb Mendeley. N.p., n.d. Web. 22 Sept ScienceDirect. N.p., n.d. Web. 23 Sept SportsMd. N.p., n.d. Web. 23 Sept