Concussion and gender: A difference?


New University of Michigan research shows that concussion does not hurt women athletes more than men.

Does concussion affect women differently from men? A new study from the University of Michigan sheds some light on the subject.

We talked with lead author Kathryn O’Connor, a Ph.D. student at University of Michigan’s NeuroSport Research Laboratory, to learn more about the study and her thoughts on gender differences in concussion. O’Connor recently presented the study results at the American Academy of Neurology’s Sports Concussion Conference.

Tell us briefly about your study.

Our work is part of the National Sport Concussion Outcomes Study (NSCOS) funded by the NCAA.

The research involved 148 Division I college athletes from 11 sports at the University of Michigan during a single season. Of the participants, 51 percent played a contact sport, 24 percent had experienced a concussion and 45 percent were female.

All participants had taken learning and processing tests along with other measures of the brain’s abilities, such as attention and working memory speed. 

They had as few as zero to as many as four concussions—for an average of 0.3 concussions. Men and women were equally likely to have had a history of concussion, even after we adjusted for the percentage who played contact sports.

How did the women athletes fare?

While the women experienced greater baseline symptoms and scored worse on cognitive skills at preseason testing, women were not affected more by concussion than men.

There is some fundamental difference (we don’t know what) between the genders that cause women to perform worse. The reassuring piece of this is that concussion does not hurt women worse than men. Women, for some reason, have lower scores on certain tests to begin with. Think of ice hockey, for example—both men and women play, but on average male players have a harder slap shot.

Even women athletes who had a history of at least one concussion did not score lower than the other female athletes on computerized baseline testing. However, all women, regardless of concussion history, had greater concussion-like symptoms, symptom severity and poorer cognitive performance than men. Why is that?

The symptom scale asks about headache, fatigue, sluggishness—the kinds of symptoms people experience day to day. We don’t expect symptoms to ever be zero, but we ask to see if the number and severity of symptoms increase after a concussion. There is considerable evidence that females score higher on symptom scales; unfortunately we are not sure why. Some possibilities are that they may be more honest with reporting, headaches/migraines are more common in females, other biological factors, etc.

What prompted you to conduct this particular study?

As a researcher and female athlete, I saw that much of the research about concussion has been done on male athletes. Thus, I’ve been interested in figuring out whether gender differences exist and how they are expressed in terms of concussive injury.

I grew up playing ice hockey and later entered clinical research in college. I worked for the VA hospital and a Neuro ICU for a few years before coming to the University of Michigan.

Seeing the spectrum of brain injury and the incredible resilience of the brain propelled me to focus on concussion. Studying concussion enables me to work with athletes and the Armed Forces to improve their safety and help them have long healthy careers and retirement.

Take the next steps

Kathryn_OConnorKathryn O’Connor is working on her Doctorate of Philosophy in Movement Science in the University of Michigan School of Kinesiology. Since 2014 she has been a Ph.D. student and graduate research assistant in U-M Neurosport’s NeuroTrauma Research Laboratory and is a member of the American Academy of Neurology.



University of Michigan NeuroSport is one of only a handful of comprehensive programs in the country dedicated to the neurological concerns of athletes. By drawing on the resources in the health system as well as the rich athletic tradition of a historic NCAA program, we specialize in the treatment and prevention of neurological sports injuries, as well as the management of primary neurological diseases that affect athletic performance. www.uofmhealth.org/neurosport