Preliminary Report: Cerebral blood flow mediates the relationship between progesterone and perceived stress symptoms among female club athletes after mild traumatic brain injury
Female athletes are severely understudied in the field of concussion
research, despite higher prevalence for injuries and tendency to have longer
recovery time. Hormonal fluctuations due to normal menstrual cycle (MC) or
hormonal contraceptive (HC) use have been shown to impact both post-injury
symptoms and neuroimaging measures, but have not been accounted for in
concussion studies. In this preliminary study, we compared arterial spin
labeling measured cerebral blood flow (CBF) between concussed female club
athletes 3-10 days post injury (mTBI) and demographic, HC/MC matched controls
(CON). We test whether CBF mediates the relationship between progesterone
levels in blood and post-injury symptoms, which may be evidence for
progesterones role in neuroprotection. We found a significant three-way
relationship between progesterone, CBF and perceived stress score (PSS) in the
left middle temporal gyrus. 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 (Sobels p-value=0.017). These
findings suggest progesterone may have a neuroprotective role after concussion
and highlight the importance of controlling for the effects of sex hormones in
future concussion studies.
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