Department of Defense (DoD)   /   TBI

TBI Symptoms, Severity Differ for Women Veterans But Cause Remains A Mystery

USM By U.S. Medicine
April 12, 2011

WASHINGTON, DC—As more data is emerging on the short and long-term effects of traumatic brain injury (TBI), researchers are discovering that the injury affects women differently than it does men. Most notably, there seems to be a differential pattern of post-concussive symptoms among female compared to male OEF/OIF veterans with deployment–related TBI.

This new information may lead to differences in how post-concussive symptoms are diagnosed in women, and in how they are treated.

More Severe Symptoms

Current estimates are that 12% to 20% of OEF/OIF veterans have TBI—usually blast-related—with most of those cases being mild (mTBI). A significant number of those (65%) experience comorbid PTSD. To date, 13% of U.S. personnel serving in theater are women and, despite having a limited combat role, 10.5% of women OEF/OIF veterans receiving care at VA have screened positive for TBI post-deployment. Sports medicine research has shown that women react differently to TBI than men, explained Katherine Iverson, PhD, clinical psychologist in the Boston VA Healthcare System. “Persistent post-concussive symptoms may be worse for women than men. [We] wanted to see if this remained true for veterans,” said Iverson who was speaking at the annual VA Health Services R&D conference.While differences in how the genders react to combat trauma has been recognized for some time, there has been little study on TBI specifically. Iverson and her colleagues examined gender differences in post-concussive symptoms severity. They looked at each of the four types of cognitive symptoms—affective, somatosensory, cognitive, and vestibular.

“Women reported significantly more severe symptoms in all four domains,” Iverson said. “But we also looked at symptom severity stratified by PTSD status.”

Men with PTSD reported significantly more affective symptoms than those without. Women who had no additional injury at the time of their blast experience reported nearly equivalent symptom severity, regardless of PTSD status.

However, women reported significantly more affective symptoms than their male counterparts across the board, whether they experienced blast only or had additional injuries (“blast-plus”). There was also evidence of a complex interaction between gender, PTSD, and the etiology of the injury when it came to vestibular and somatosensory symptoms.

Causes Unknown

The implications of the data are that women deployed to OEF/OIF experience concussions of all etiologies in meaningful numbers and have returned with more severe post-concussive symptoms than their male counterparts, Iverson said. And the effects of blast trauma are more pronounced in women than men.

The root cause remains a mystery, however. “We can describe gender differences, but we cannot comment on the causes,” Iverson said. “There may be gender-related biases in reporting of symptoms by veterans, or in the diagnosing of TBI by evaluators.”

What the data does prove is that more attention needs to be paid to the post-concussive symptoms of women, and that education is needed for health care providers, veterans, and the general public, Iverson said.

“Although women make up a smaller percentage of men that have mild TBI, the post-concussive symptoms that they experience are more severe. It’s important that we get women connected to services, not only for physical problems, but for their cognitive problems, such as difficulty sleeping and pain problems.”

back to April articles


Related Articles

Fibromyalgia Presents Differently in Male, Female Veterans

Research on fibromyalgia, a poorly understood, chronically disabling pain syndrome, generally has focused on its clinical presentation and treatment.

How Veterans Feel About Remote Management of Their Care

The VA is expanding remote management of patients to improve disease prevention and care.


U.S. Medicine Recommends


More From department of defense dod

Department of Defense (DoD)

High Rate of Pectoralis Tears Among Deployed Servicemembers Lifting Weights

Lifting weights is one way servicemembers keep in peak physical condition during deployment.

Department of Defense (DoD)

DoD Study Finds That Type 2 Diabetes Increases Breast Cancer Mortality

Having Type 2 diabetes mellitus (DM-2) increases mortality risk in breast cancer patients, regardless of whether diabetes was diagnosed before or after breast cancer, according to a recent study.

Department of Defense (DoD)

Now Hear This: Otolaryngologist Leads Effort to Prevent Auditory Issues

Among those who are exposed to combat, it’s the weapons fire that does it. In the Navy, it’s the noise levels in engine rooms and on the decks of carriers.

Department of Defense (DoD)

GAO: ‘Gaps’ in MHS Physician Specialties Could Affect Wartime Readiness

WASHINGTON — The military services need to develop “targeted and coordinated strategies” to alleviate military physician gaps, a recent report recommended.

Department of Veterans Affairs (VA)

VA Vows to Meet Deadline for Revamp of Veteran Claims Appeal Process

WASHINGTON—VA has told legislators that the agency is on track with a new law that will give veterans more options to have their claims appeals reviewed.

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up