{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T18:05:25Z","timestamp":1781978725383,"version":"3.54.5"},"reference-count":97,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>\n                    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\u201310 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\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    value\u2009=\u20090.017). 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.\n                  <\/jats:p>","DOI":"10.1089\/neu.2020.7217","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T06:59:46Z","timestamp":1611125986000},"page":"1809-1820","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["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"],"prefix":"10.1177","volume":"38","author":[{"given":"Yufen","family":"Chen","sequence":"first","affiliation":[{"name":"Center for Translational Imaging, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy A.","family":"Herrold","sequence":"additional","affiliation":[{"name":"Edward Hines, Jr. VA Hospital, Hines, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoran","family":"Martinovich","sequence":"additional","affiliation":[{"name":"Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumra","family":"Bari","sequence":"additional","affiliation":[{"name":"Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole L.","family":"Vike","sequence":"additional","affiliation":[{"name":"Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Vesci","sequence":"additional","affiliation":[{"name":"Northwestern Health Services Sports Medicine, Northwestern University, Evanston, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Mjaanes","sequence":"additional","affiliation":[{"name":"Northwestern Health Services Sports Medicine, Northwestern University, Evanston, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne R.","family":"McCloskey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James L.","family":"Reilly","sequence":"additional","affiliation":[{"name":"Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans C.","family":"Breiter","sequence":"additional","affiliation":[{"name":"Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA."},{"name":"Laboratory of Neuroimaging and Genetics, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"key":"e_1_3_4_2_2","first-page":"495","article-title":"Concussions among United States high school and collegiate athletes","volume":"42","author":"Gessel L.M.","year":"2007","unstructured":"Gessel L.M., , Fields S.K., , Collins C.L., , Dick R.W., , and Comstock R.D. 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