Preliminary Report: Localized Cerebral Blood Flow Mediates the Relationship between Progesterone and Perceived Stress Symptoms among Female Collegiate Club Athletes after Mild Traumatic Brain Injury

Yufen Chen; Amy A. Herrold; Virginia Gallagher; Zoran Martinovich; Sumra Bari; Nicole L. Vike; Brian Vesci; Jeffrey Mjaanes; Leanne R. McCloskey; James L. Reilly; Hans C. Breiter

doi:10.1089/neu.2020.7217

Preliminary Report: Localized Cerebral Blood Flow Mediates the Relationship between Progesterone and Perceived Stress Symptoms among Female Collegiate Club Athletes after Mild Traumatic Brain Injury

Yufen Chen^*, Amy A. Herrold, Virginia Gallagher, Zoran Martinovich, Sumra Bari, Nicole L. Vike, Brian Vesci, Jeffrey Mjaanes, Leanne R. McCloskey, James L. Reilly, Hans C. Breiter

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Female athletes are under-studied in the field of concussion research, despite evidence of higher injury prevalence and longer recovery time. Hormonal fluctuations caused by the natural menstrual cycle (MC) or hormonal contraceptive (HC) use impact both post-injury symptoms and neuroimaging findings, but the relationships among hormone, symptoms, and brain-based measures have not been jointly considered in concussion studies. In this preliminary study, we compared cerebral blood flow (CBF) measured with arterial spin labeling between concussed female club athletes 3-10 days after mild traumatic brain injury (mTBI) and demographic, HC/MC matched controls (CON). We tested whether CBF statistically mediates the relationship between progesterone serum levels and post-injury symptoms, which may support a hypothesis for progesterone's role in neuroprotection. We found a significant three-way relationship among progesterone, CBF, and perceived stress score (PSS) in the left middle temporal gyrus for the mTBI group. Higher progesterone was associated with lower (more normative) PSS, as well as higher (more normative) CBF. CBF mediates 100% of the relationship between progesterone and PSS (Sobel p value = 0.017). These findings support a hypothesis for progesterone having a neuroprotective role after concussion and highlight the importance of controlling for the effects of sex hormones in future concussion studies.

Original language	English (US)
Pages (from-to)	1809-1820
Number of pages	12
Journal	Journal of neurotrauma
Volume	38
Issue number	13
DOIs	https://doi.org/10.1089/neu.2020.7217
State	Published - Jun 1 2021

Funding

Funding was provided in part by the Eleanor Wood-Prince Grant Initiative: A Project of the Woman’s Board of North-western Memorial Hospital, the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (NIH) under Award Number F31NS106840, and data collection via REDCap was supported in part by a Clinical and Translational Science Award (CTSA) grant from the NIH under Award Number UL1TR001422. Funding for scanning was supplied by the Warren Wright Adolescent Center (WWAC), Northwestern Memorial Hospital, and the WWAC provided space and/or salary for V.G., S.B., N.L.V., J.L.R., and H.C.B. A.A.H. was supported by VA RR&D Career Development Award RX000949. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Keywords

brain perfusion
concussion
female
mild traumatic injury
progesterone
sport injury

ASJC Scopus subject areas

Clinical Neurology

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10.1089/neu.2020.7217

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Chen, Y., Herrold, A. A., Gallagher, V., Martinovich, Z., Bari, S., Vike, N. L., Vesci, B., Mjaanes, J., McCloskey, L. R., Reilly, J. L., & Breiter, H. C. (2021). Preliminary Report: Localized Cerebral Blood Flow Mediates the Relationship between Progesterone and Perceived Stress Symptoms among Female Collegiate Club Athletes after Mild Traumatic Brain Injury. Journal of neurotrauma, 38(13), 1809-1820. https://doi.org/10.1089/neu.2020.7217

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title = "Preliminary Report: Localized Cerebral Blood Flow Mediates the Relationship between Progesterone and Perceived Stress Symptoms among Female Collegiate Club Athletes after Mild Traumatic Brain Injury",

abstract = "Female athletes are under-studied in the field of concussion research, despite evidence of higher injury prevalence and longer recovery time. Hormonal fluctuations caused by the natural menstrual cycle (MC) or hormonal contraceptive (HC) use impact both post-injury symptoms and neuroimaging findings, but the relationships among hormone, symptoms, and brain-based measures have not been jointly considered in concussion studies. In this preliminary study, we compared cerebral blood flow (CBF) measured with arterial spin labeling between concussed female club athletes 3-10 days after mild traumatic brain injury (mTBI) and demographic, HC/MC matched controls (CON). We tested whether CBF statistically mediates the relationship between progesterone serum levels and post-injury symptoms, which may support a hypothesis for progesterone's role in neuroprotection. We found a significant three-way relationship among progesterone, CBF, and perceived stress score (PSS) in the left middle temporal gyrus for the mTBI group. Higher progesterone was associated with lower (more normative) PSS, as well as higher (more normative) CBF. CBF mediates 100% of the relationship between progesterone and PSS (Sobel p value = 0.017). These findings support a hypothesis for progesterone having a neuroprotective role after concussion and highlight the importance of controlling for the effects of sex hormones in future concussion studies.",

keywords = "brain perfusion, concussion, female, mild traumatic injury, progesterone, sport injury",

author = "Yufen Chen and Herrold, {Amy A.} and Virginia Gallagher and Zoran Martinovich and Sumra Bari and Vike, {Nicole L.} and Brian Vesci and Jeffrey Mjaanes and McCloskey, {Leanne R.} and Reilly, {James L.} and Breiter, {Hans C.}",

note = "Funding Information: Funding was provided in part by the Eleanor Wood-Prince Grant Initiative: A Project of the Woman{\textquoteright}s Board of North-western Memorial Hospital, the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (NIH) under Award Number F31NS106840, and data collection via REDCap was supported in part by a Clinical and Translational Science Award (CTSA) grant from the NIH under Award Number UL1TR001422. Funding for scanning was supplied by the Warren Wright Adolescent Center (WWAC), Northwestern Memorial Hospital, and the WWAC provided space and/or salary for V.G., S.B., N.L.V., J.L.R., and H.C.B. A.A.H. was supported by VA RR&D Career Development Award RX000949. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Publisher Copyright: {\textcopyright} Copyright 2021, Mary Ann Liebert, Inc., publishers 2021.",

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doi = "10.1089/neu.2020.7217",

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Chen, Y, Herrold, AA, Gallagher, V, Martinovich, Z, Bari, S, Vike, NL, Vesci, B, Mjaanes, J, McCloskey, LR, Reilly, JL & Breiter, HC 2021, 'Preliminary Report: Localized Cerebral Blood Flow Mediates the Relationship between Progesterone and Perceived Stress Symptoms among Female Collegiate Club Athletes after Mild Traumatic Brain Injury', Journal of neurotrauma, vol. 38, no. 13, pp. 1809-1820. https://doi.org/10.1089/neu.2020.7217

Preliminary Report: Localized Cerebral Blood Flow Mediates the Relationship between Progesterone and Perceived Stress Symptoms among Female Collegiate Club Athletes after Mild Traumatic Brain Injury. / Chen, Yufen; Herrold, Amy A.; Gallagher, Virginia et al.
In: Journal of neurotrauma, Vol. 38, No. 13, 01.06.2021, p. 1809-1820.

Research output: Contribution to journal › Article › peer-review

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Preliminary Report: Localized Cerebral Blood Flow Mediates the Relationship between Progesterone and Perceived Stress Symptoms among Female Collegiate Club Athletes after Mild Traumatic Brain Injury

Abstract

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Keywords

ASJC Scopus subject areas

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