October 18, 2007 / 5:38 PM / 12 years ago

Mental deficits after concussion persist in women

NEW YORK (Reuters Health) - Up to eight months after suffering a concussion, female college-level soccer players still have impairment in certain mental functions, Canadian researchers report.

“Contrary to what is typically thought, these effects are longer-lasting,” Dr. Dave Ellemberg of the University of Montreal told Reuters Health. “They’re mild, but yet they’re prolonged.”

Most research on concussions to date has been in males, Ellemberg and his team note in the Clinical Journal of Sports Medicine. And studies evaluating cognitive function after concussion have often included giving athletes the same test repeatedly, they add. Because study participants get better on the test with practice, Ellemberg noted in an interview, after the tests have been given three to four times “they’ve lost all their validity, basically.”

To better understand how concussions affect cognitive function long-term in females, Ellemberg and his colleagues gave 22 university soccer players a battery of tests. Ten had experienced a first concussion 6 to 8 months previously, while the rest had not suffered concussions.

The concussed athletes performed significantly more slowly than the non-injured athletes on tests of complex reaction time, inhibition and flexibility, and planning, the researchers found. However, their short- and long-term verbal memory, simple reaction time and attention were not impaired.

While significant, the effects are “subtle, as all these athletes are still average students and they’re succeeding relatively well in their academic program,” Ellemberg said. “They’re not people who are handicapped.”

Based on similar studies in males, he noted, the findings suggest that females may be more vulnerable to the effects of concussion, perhaps due to more fragile brain structures and weaker neck and shoulder muscles.

He hypothesizes that concussions may cause damage to the brain’s prefrontal region, which is located directly behind the forehead and is less protected from injury than deeper brain regions involved in language and memory.

Soccer players should be kept off the field after a concussion until they have gone a week without having symptoms such as dizziness, headache, nausea, and balancing problems, Ellemberg said. Continued play before healing is complete — especially if heading the ball is involved — may prevent complete recovery, he added, pointing out that many of the injured athletes in the study were still reporting symptoms months after their concussions.

SOURCE: Clinical Journal of Sports Medicine, September 2007.

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