The Influence of Hormonal Contraceptives on Baseline ImPACT Performance

Abstract

Abstract Purpose Our study examined the influence of hormonal contraceptives (HC) on pre-injury (baseline) ImPACT performance in female collegiate athletes. Methods Participants in our cross-sectional study consisted of 304 NCAA Division I female athletes who self-reported taking (HC+ [n=154]) or not taking (HC- [n=154]) HC. HC+ participants were matched to HC- participants for height, weight, sport, and position. HC+ participants had an average age of 19.0±1.33 years, height of 170.5–8.70 cm, and mass of 64.2–10.58 kg. HC- participants had an average age of 19.0±1.24 years, height of 170.3–9.19 cm, and mass of 64.2–9.75 kg. Participants completed ImPACT as part of their preseason baseline assessment. Only participants with valid ImPACT assessments were included in our analyses. Chi-squared (χ2) tests were performed to compare groups in terms of medical history variables. Independent t-tests were used to compare groups in terms of demographic variables, self-reported hours of sleep, and ImPACT (Verbal and Visual Memory, Visual Motor Speed [VMS], Reaction Time [RT], and Total Symptom Severity [TSS]) outcome scores. Analyses were performed with α=0.05. Results No differences were observed between groups for demographic variables, hours of sleep, or medical history variables (p<0.05). For VMS, the HC- group (42.9+5.63) scored significantly worse (t[304]=2.17, p=0.03; d=0.25; 95% CI [0.1, 2.7]) than the HC+ group (44.3+5.67). For RT, the HC- group (0.55+0.06) performed significantly slower (t[304]=-2.02, p=0.05; d=0.23; 95% CI [-0.03, -0.0003]) than the HC+ group (0.54+0.05). Conclusion Our results suggest HCs may influence ImPACT performance in female collegiate athletes. Clinicians must consider the role of HCs when interpreting ImPACT outcome scores.