A-31 Examining Interactions between Concussion Population and Biological Sex on Post-Concussive Symptom Reporting in FITBIR

Abstract

Abstract Purpose: The purpose of this study was to examine interactions between population (sport/civilian vs. military) and biological sex (females vs. males) on post-concussive symptom reporting using Federal Interagency Traumatic Brain Injury Research (FITBIR) data. Methods: Data were obtained from the national FITBIR informatics system. Studies released as of 04/07/21 that included both males and females with a history of concussion were included. In total, 6 studies with 9957 participants (8918 sport/civilian, 1039 military; 3209 females, 6748 males) were evaluated. Symptom measures included the Sport Concussion Assessment Tool-3rd Edition, Neurobehavioral Symptom Inventory, and Rivermead Post Concussion Symptoms Questionnaire. These measures were harmonized to generate an overall composite score and three symptom domains (somatic, affective, and cognitive). Data were analyzed using linear mixed-effects models. Symptom scores were regressed onto population, sex, and the population-by-sex interaction. Results: We found significant main effects of population (military>sport/civilian; beta(β) = 0.30, p = 0.003) and sex (females>males; β = 0.06, p < 0.001) on the overall composite, as well as a significant population-by-sex interaction such that female service members/veterans endorsed the highest rates of symptoms (β = 0.27, p < 0.001). Similar patterns of significance and effect sizes were observed for the somatic and affective composites. Cognitive symptom composites showed a similar pattern, but with smaller effect sizes overall. Conclusions: Findings increase our understanding of population and sex-specific experiences following concussion, suggesting a need for individually-tailored treatments and interventions for these groups. Future studies are planned using FITBIR data to further explore the population-by-sex interaction on post-injury outcomes.