Gender Response To Accumulative Effects of Multiple mTBI

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General Subject Classification:

Special Topics



  • To present clinicians, researchers and consumers with new directions for improving attention in the inpatient TBI population.
  • To report results on how well can severe TBI survivors in the early stages of recovery tolerate attention exercises using advanced technology.


Objective: Recent studies indicate accumulative effects associated to repeated mild traumatic brain injury (mTBI). The project aimed to characterize gender response to multiple mTBI.

Design: Case-controlled group comparison design.

Methods: 51 participants (M/F = 23/28) aged 18 - 40 years were grouped as with (MHI group: n = 23) or without (NMHI group: n = 28).a mTBI history over the past 12 months. The ImPACT® protocol documented symptoms profile, verbal/ visual memory and cognitive reaction times. The Trail-Making A/B Test accessed motor processing speed and accuracy while the NeuroCom EquiTest® system assessed standing balance using the Sensory Organization Test and Motor Control Test graded platform perturbations. The NeuroCom InVision® system documented vestibular ocular reflexes for gaze stability in vertical and horizontal planes.

Data Analysis: Descriptive statistics and MANOVA were used to address Group vs. Gender vs. Number of Concussions interactions (0, 1, 2,>2). Post Hoc analysis included Bonferroni corrections. Alpha level = 0.05.

Preliminary Results: Results indicate significant group differences in headache, sleep, vision and balance scores. The MHI group had significantly higher Symptom Profile scores than the NMHI group (20.59 ± 18.56 vs. 9.96 ± 11.00, p=0.023) and significant differences in Dynamic Visual Acuity symmetry scores (4.11± 10.53 vs. -1.83 ±8.57) and acuity scores indicating deficits in gaze stability. There was a significant negative relationship between SOT_Conditon06 and Headache scores (-0.356, p=0.028), and balance symptom and visual memory scores (-0.384, p=0.009). A noted significant interaction was found between Gender x Group x Number of Concussions for Vision (F1,1,3 = 4.713, p = 0.011) and Headache (F1,1,3 = 7.022, p = 0.015).

Clinical Relevance: Preliminary results suggest significant differences in cognitive, oculomotor and balance function after mTBI and that females may not recover similar to males after experiencing multiple head injuries. Further investigation is warranted to provide comprehensive rehabilitation protocols.