The Role of Concussion History and Gender in Recovery from Soccer-Related Concussion

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Abstract
Background: This study was designed to investigate differences in recovery in male and female soccer athletes. Hypotheses: Soccer players with a history of concussion will perform worse on neurocognitive testing than players without a history of concussion. Furthermore, female athletes will demonstrate poorer performance on neurocognitive testing than male athletes. Study Design: Cohort study (prognosis): Level of evidence, 2. Methods: Computer-based neuropsychological testing using reaction time, memory, and visual motor-speed composite scores of the ImPACT test battery was performed postconcussion in soccer players ranging in age from 8 to 24 years (N = 234; 141 females, 93 males). A multivariate analysis of variance was conducted to examine group differences in neurocognitive performance between male and female athletes with and without a history of concussion. Results: Soccer players with a history of at least 1 previous concussion performed significantly worse on ImPACT than those who had not sustained a prior concussion (F = 2.92, P = .03). In addition, female soccer players performed worse on neurocognitive testing (F = 2.72, P = .05) and also reported more symptoms (F = 20.1, P = .00001) than male soccer players. There was no significant difference in body mass index between male and female players (F = .04, P = .85). Conclusion: A history of concussion and gender may account for significant differences in postconcussive neurocognitive test scores in soccer players and may play a role in determining recovery. These differences do not appear to reflect differences in mass between genders and may be related to other gender-specific factors that deserve further study.