美国国家公共电台 NPR--Concussion protocols are based on research of mostly men. What about women?

Concussion¹ protocols² are based on research of mostly men. What about women?

Transcript³

Lindsay Simpson still has questions about her concussions⁴.

Her first one came when she was 16. At the time, she was playing for a club soccer team in Atlanta, as a promising⁵ high school goalkeeper with aspirations⁶ of a Division I scholarship and – in her biggest dreams – a professional playing career.

"I dove for the ball, and my body hit funny. I slammed the back of my head on the ground," Simpson said. "You train very well not to do that, but mistakes happen."

When she was injured in 2002, "concussion" was not the household word that it is today. For weeks, Simpson experienced mysterious symptoms and struggled at school, leaving her and her parents wondering what was wrong. "I had this horrible, excruciating headache. I couldn't be in the bright lights. I was just really not myself," she said.

Her parents took her to doctor after doctor, trying to understand what was wrong. She saw chiropractors, orthopedists, even an orthodontist.

Eventually, they saw a neurologist who suggested it could be a concussion. "He said, 'Have you had any knocks to your head lately?'" Simpson recalled.

The field of concussion research has come a long way since the early 2000s. Greater awareness⁷ among the American public – who watch every weekend as college and professional football players undergo concussion evaluations⁸ – could be the reason why U.S. teens are reporting concussions in growing numbers.

But many questions still abound⁹, especially when it comes to the differences between men and women. Some studies have suggested that women and girls might be more susceptible¹⁰ to concussions, and they may need longer to recover.

Those disparities are one subject researchers are planning to discuss at this week's International Conference on Concussion in Sport. Some concussion experts hope that the major meeting in Amsterdam could lead to a consensus¹¹ statement that could improve research on how concussions impact women.

Concussions took her out of the game

Outside of American football, no high school sport causes concussions at a higher rate than girls' soccer.

Nine months after her first concussion, Simpson was able to return to the soccer field. But for the rest of her career – from high school through her time as an NCAA Division I player, Simpson experienced concussion after concussion, some mild, some more serious.

Finally, in the final game of her sophomore¹² spring season at the University of Maryland, she ran out of the box to clear a ball and collided with a player on the opposing team. Simpson's head hit the other player's shoulder. The next thing she remembers is her teammate helping¹³ her up off the field.

The symptoms – nausea¹⁴, dizziness, light sensitivity, memory issues – were so intense that she had to withdraw from her courses.

Afterward¹⁵, a neurologist told her that she'd never play competitive soccer again. All these years later, she said, "it still hurts, it still stings."

Now, at age 36, Simpson still has questions about the concussions that have altered the course of her life.

"The million dollar question, to me, is why? Why did I get that impact and it affected¹⁶ me that way – and yet you watch someone take a hit every Sunday on TV, and they're fine?" she said. "That's the question I want answered in my lifetime."

Many women get concussions, but studies have historically focused on men

Every year, millions of Americans get concussions. In a 2017 CDC survey, 2.5 million high school students – 15% of all high school students nationwide – reported having experienced a concussion in the previous year. More than 40% were girls.

Yet much of the most consequential¹⁷ concussion research has focused on men and boys, according to a new analysis published in the September issue of the British Journal of Sports Medicine.

Schools, teams and medical professionals nationwide rely on the guidance of three important organizations – including the International Conference on Concussion in Sport – to help guide concussion diagnosis¹⁸ and protocols.

Researchers looked at the studies cited by those organizations' influential¹⁹ concussion statements. The participants, they found, were 80.1% male to only 19.9% female.

"The startling part was just how male it was," said Julianne Schmidt, a concussion researcher at the University of Georgia and one of the study's authors.

Worse, about 40% of the studies cited included no women or girls at all. "Putting a number to it made it very clear that this is a huge imbalance, and it's going to take a lot of work to bring it back into balance," she said.

Schmidt is in Amsterdam for the latest International Conference on Concussion in Sport, where a panel of experts will begin to draft a consensus statement that reflects the latest in concussion research to make recommendations about diagnosis and treatment.

The conference normally meets every four years. But because of pandemic delays, the latest statement now dates from the 2016 meeting – a very long time ago for a rapidly evolving field in which hundreds of studies are published each year.

Because the ICCS statement is so influential, an update that reflects the imbalance of research is needed, Schmidt said – even something as simple as an acknowledgment of the gender²⁰ gap and a call for more research funding.

"The doctor that's treating an NFL player on the sideline is using the same statements and guidelines that a pediatrician is using to treat a 14-year-old soccer player who's female," Schmidt said. "We can't just assume that women are miniature males."

What the research says about women and concussions

The gender imbalance stems from the origins of concussion research – studies of high-impact sports, namely American football and ice hockey, both of which are predominantly played by men.

Research access has been a factor, too: Professional sports teams and high-level college programs have dedicated²¹ medical teams, making it easier to track and diagnose concussions among those athletes than in other populations.

The gender balance has improved over the past decade as researchers have examined groups more diverse than just high-level male athletes, said Dr. Christina Lin Master, a pediatrician and concussion specialist at the Children's Hospital of Philadelphia and the University of Pennsylvania.

Researchers know that women report more concussion symptoms than men after a head impact. Now, Master said, studies are needed to figure out why.

"Is that because they have a more severe injury and have more symptoms, or is that something about gendered behavior where they are reporting more symptoms, or more likely to disclose, as opposed to hide, symptoms?" said Master.

The differences could also be biological, she said. The hypotheses there are many: One factor could be that men have stronger neck muscles than women. Another could be hormones²² – even menstrual cycles. It could be that women have more delicate axons, the slender fibers²³ that connect neurons to each other.

"There's probably a little bit of 'both-and' and not 'either-or,'" Master said. And some of it may not be related to women themselves, but rather the medical staff around them: A study she led suggested that recovery times disparities among male and female college athletes could be explained by access to medical training staff.

That's where influential groups – like the ICCS panel of experts – come in, she said. An updated consensus statement could help nudge the field toward answering these questions by highlighting the gaps. "If they make a statement on what research is needed, I do think that the funding bodies pay attention," she said.

1 concussion   

n.脑震荡；震动

参考例句：

• He was carried off the field with slight concussion.他因轻微脑震荡给抬离了现场。
• She suffers from brain concussion.她得了脑震荡。

2 protocols   

n.礼仪( protocol的名词复数 )；（外交条约的）草案；（数据传递的）协议；科学实验报告（或计划）

参考例句：

• There are also protocols on the testing of nuclear weapons. 也有关于核武器试验的协议。 来自辞典例句
• Hardware components and software design of network transport protocols are separately introduced. 介绍系统硬件组成及网络传输协议的软件设计。 来自互联网

3 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

4 concussions   

n.震荡( concussion的名词复数 )；脑震荡；冲击；震动

参考例句：

• People who have concussions often trouble thinking or remembering. 患脑震荡的人通常存在思考和记忆障碍。 来自互联网
• Concussions also make a person feel very tired or angry. 脑震荡也会使人感觉疲倦或愤怒。 来自互联网

5 promising   

adj.有希望的，有前途的

参考例句：

• The results of the experiments are very promising.实验的结果充满了希望。
• We're trying to bring along one or two promising young swimmers.我们正设法培养出一两名有前途的年轻游泳选手。

6 aspirations   

强烈的愿望( aspiration的名词复数 )； 志向； 发送气音； 发 h 音

参考例句：

• I didn't realize you had political aspirations. 我没有意识到你有政治上的抱负。
• The new treaty embodies the aspirations of most nonaligned countries. 新条约体现了大多数不结盟国家的愿望。

7 awareness   

n.意识，觉悟，懂事，明智

参考例句：

• There is a general awareness that smoking is harmful.人们普遍认识到吸烟有害健康。
• Environmental awareness has increased over the years.这些年来人们的环境意识增强了。

8 evaluations   

估价( evaluation的名词复数 )； 赋值； 估计价值； [医学]诊断

参考例句：

• In fact, our moral evaluations are merely expressions of our desires. 事实上，我们的道德评价只是我们欲望的表达形式。 来自哲学部分
• Properly speaking, however, these evaluations and insights are not within the concept of official notice. 但准确地讲，这些评估和深远见识并未包括在官方通知概念里。

9 abound   

vi.大量存在；(in，with)充满，富于

参考例句：

• Oranges abound here all the year round.这里一年到头都有很多橙子。
• But problems abound in the management of State-owned companies.但是在国有企业的管理中仍然存在不少问题。

10 susceptible   

adj.过敏的，敏感的；易动感情的，易受感动的

参考例句：

• Children are more susceptible than adults.孩子比成人易受感动。
• We are all susceptible to advertising.我们都易受广告的影响。

11 consensus   

n.(意见等的)一致，一致同意，共识

参考例句：

• Can we reach a consensus on this issue?我们能在这个问题上取得一致意见吗？
• What is the consensus of opinion at the afternoon meeting?下午会议上一致的意见是什么？

12 sophomore   

n.大学二年级生；adj.第二年的

参考例句：

• He is in his sophomore year.他在读二年级。
• I'm a college sophomore majoring in English.我是一名英语专业的大二学生。

13 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

14 nausea   

n.作呕，恶心；极端的憎恶(或厌恶)

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕期常有恶心的现象。
• He experienced nausea after eating octopus.吃了章鱼后他感到恶心。

15 afterward   

adv.后来；以后

参考例句：

• Let's go to the theatre first and eat afterward. 让我们先去看戏，然后吃饭。
• Afterward,the boy became a very famous artist.后来，这男孩成为一个很有名的艺术家。

16 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

17 consequential   

adj.作为结果的，间接的；重要的

参考例句：

• She was injured and suffered a consequential loss of earnings.她受了伤因而收入受损。
• This new transformation is at least as consequential as that one was.这一新的转变至少和那次一样重要。

18 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

19 influential   

adj.有影响的，有权势的

参考例句：

• He always tries to get in with the most influential people.他总是试图巴结最有影响的人物。
• He is a very influential man in the government.他在政府中是个很有影响的人物。

20 gender   

n.（生理上的）性，（名词、代词等的）性

参考例句：

• French differs from English in having gender for all nouns.法语不同于英语，所有的名词都有性。
• Women are sometimes denied opportunities solely because of their gender.妇女有时仅仅因为性别而无法获得种种机会。

21 dedicated   

adj.一心一意的；献身的；热诚的

参考例句：

• He dedicated his life to the cause of education.他献身于教育事业。
• His whole energies are dedicated to improve the design.他的全部精力都放在改进这项设计上了。

22 hormones   

n. 荷尔蒙，激素 名词hormone的复数形式

参考例句：

• This hormone interacts closely with other hormones in the body. 这种荷尔蒙与体內其他荷尔蒙紧密地相互作用。
• The adrenals produce a large per cent of a man's sex hormones. 肾上腺分泌人体的大部分性激素。

23 fibers   

光纤( fiber的名词复数 )； （织物的）质地； 纤维，纤维物质

参考例句：

• Thesolution of collagen-PVA was wet spined with the sodium sulfate as coagulant and collagen-PVA composite fibers were prepared. 在此基础上，以硫酸钠为凝固剂，对胶原-PVA共混溶液进行湿法纺丝，制备了胶原-PVA复合纤维。
• Sympathetic fibers are distributed to all regions of the heart. 交感神经纤维分布于心脏的所有部分。