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Working Across Disciplines to Understand Sex Differences in Concussion

Working Across Disciplines to Understand Sex Differences in Concussion

Researchers speculate that for a given force to the head, women may be more likely to sustain a concussion and slower to report it, experience more severe symptoms, and are slower to recover. However, current findings are based on a handful of small clinical studies. Investigators who use a population-based, epidemiologic perspective have studied this “sex difference” only to a limited extent—mostly because large, comprehensive concussion datasets are very uncommon.

Enter the team led by Douglas Wiebe, PhD, which is researching the matter as part of the large-scale Ivy League-Big Ten Epidemiology of Concussion Study. “Finding evidence of whether and why these differences exist could considerably advance our potential to identify targeted, tailored ways to make participation in sports safer within the varsity-athlete population,” says Dr. Wiebe. “The large scale of this concussion surveillance study provides a rare opportunity to explore the circumstances and consequences of concussions in women and men and potential sex differences.”

He and colleagues in our Epidemiology Division have reached out to colleagues in our Informatics Division, hoping to apply machine-learning approaches that may detect differences that have not emerged through traditional epidemiologic analyses. After determining a set of variables and the methods to apply, they expect the explorations into the data to start in the fall of 2019.

“In the past, our straightforward survival-analyses methods have suggested that female and male athletes do not differ in terms of how soon their concussion symptoms resolve and they proceed through the return-to-play protocol,” comments Dr. Wiebe. “However when we explore the conventional 22 symptoms on each concussed athlete with factor analysis, we see that the women and men do report symptoms differently: Different profiles and domains of symptom types occur in women compared to men. Perhaps only certain profiles lead to delayed recovery.

“We expect that machine-learning methods, which integrate information on the particular sport that each participant played and the patient’s concussion history, may lead us to discover new and more nuanced differences in how patients recover,” Wiebe concluded.

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