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 journalArticlepeer-review

1 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 languageEnglish (US)
Pages (from-to)1809-1820
Number of pages12
JournalJournal of neurotrauma
Volume38
Issue number13
DOIs
StatePublished - Jun 1 2021
Externally publishedYes

Keywords

  • brain perfusion
  • concussion
  • female
  • mild traumatic injury
  • progesterone
  • sport injury

ASJC Scopus subject areas

  • Clinical Neurology

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