{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:03:02Z","timestamp":1787025782333,"version":"build-2736575974"},"reference-count":92,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Prior studies have investigated associations between gender, symptom resolution, and time to return to play following sport-related concussion (SRC). However, there is a notable gap in research regarding the association between gender and return to learn (RTL) in adolescents. Therefore, this study 1) compared the patterns of RTL between boys and girls who are high school student athletes, and 2) evaluated the possible association between gender and time to RTL after adjusting for covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective cohort study of a prospective surveillance program that monitored concussion recovery of athletes in high schools throughout the state of Maine between February 2015 and January 2023 was performed. The primary independent variable was gender, dichotomized as boys and girls. The primary outcome was time to RTL, defined by the number of days for an athlete to return to school without accommodations. Mann-Whitney U-tests were used to compare RTL between the boys and girls. Each athlete\u2019s RTL status was dichotomized (i.e., returned vs had not returned) at several time points following injury (i.e., 1, 2, 3, and 4 weeks), and chi-square tests were performed to compare the proportions who achieved RTL between groups. Multivariable linear regression analyses were performed to evaluate the predictive value of gender on RTL. Covariates included age, number of previous concussions, history of learning disability or attention-deficit disorder or attention-deficit\/hyperactivity disorder, history of a psychological condition, history of headaches or migraines, initial Sport Concussion Assessment Tool (SCAT3\/SCAT5) score, and days to evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Of 895 high school athletes, 488 (54.5%) were boys and 407 (45.5%) were girls. There was no statistically significant difference in median [IQR] days to RTL between genders (6.0 [3.0\u201311.0] vs 6.0 [3.0\u201312.0] days; U = 84,365.00, p &lt; 0.375). A greater proportion of boys successfully returned to learn without accommodations by 3 weeks following concussion (93.5% vs 89.4%; \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      = 4.68, p = 0.030), but no differences were found at 1, 2, or 4 weeks. A multivariable model predicting days to RTL showed that gender was not a significant predictor of RTL (p &gt; 0.05). Longer days to evaluation (\u03b2 = 0.10, p = 0.021) and higher initial SCAT3\/SCAT5 scores (\u03b2 = 0.15, p &lt; 0.001) predicted longer RTL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In a cohort of high school athletes, RTL did not differ between boys and girls following SRC. Gender was not a significant predictor of RTL. Longer days to evaluation and higher initial symptom scores were associated with longer RTL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.4.focus24130","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T14:52:00Z","timestamp":1720018320000},"page":"E9","source":"Crossref","is-referenced-by-count":2,"title":["Examining for gender differences in return to learn following sport-related concussion in high school student athletes"],"prefix":"10.3171","volume":"57","author":[{"given":"Jacob","family":"Jo","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee;"},{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Dugan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee;"},{"name":"University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant H.","family":"Rigney","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee;"},{"name":"Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen L.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"Berkner","sequence":"additional","affiliation":[{"name":"University of New England, College of Osteopathic Medicine, Biddeford, Maine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant L.","family":"Iverson","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts;"},{"name":"Mass General for Children Sports Concussion Program, Boston, Massachusetts; and"},{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and the Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee;"},{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas P.","family":"Terry","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee;"},{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Clin Spine Surg","first-page":"191","article-title":"Sports-related concussion in children and adolescents","volume":"30","author":"Refakis CA","year":"2017","unstructured":"Refakis CA, Turner CD, Cahill PJ. Sports-related concussion in children and adolescents. Clin Spine Surg. 2017;30(5):191\u2013196."},{"issue":"4","key":"b2","series-title":"JAMA Pediatr","first-page":"399","article-title":"Variation in national survey estimates and youth traumatic brain injury-where does the truth lie?","volume":"173","author":"Veliz P","year":"2019","unstructured":"Veliz P. Variation in national survey estimates and youth traumatic brain injury-where does the truth lie?. JAMA Pediatr. 2019;173(4):399."},{"issue":"11","key":"b3","series-title":"JAMA Pediatr","first-page":"1078","article-title":"Prevalence of parent-reported traumatic brain injury in children and associated health conditions","volume":"172","author":"Haarbauer-Krupa J","year":"2018","unstructured":"Haarbauer-Krupa J, Lee AH, Bitsko RH, Zhang X, Kresnow-Sedacca MJ. Prevalence of parent-reported traumatic brain injury in children and associated health conditions. 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J Clin Med. 2023;12(15):4883."},{"key":"b23","series-title":"Front Neurol","first-page":"1152504","article-title":"The Toronto Concussion Study: a prospective investigation of characteristics in a cohort of adults from the general population seeking care following acute concussion, 2016-2020","volume":"14","author":"Comper P","year":"2023","unstructured":"Comper P, Foster E, Chandra T,  The Toronto Concussion Study: a prospective investigation of characteristics in a cohort of adults from the general population seeking care following acute concussion, 2016-2020. Front Neurol. 2023;14:1152504."},{"issue":"6","key":"b24","series-title":"Brain Inj","first-page":"698","article-title":"Do male and female adolescents report symptoms differently after concussion?","volume":"35","author":"Alsalaheen B","year":"2021","unstructured":"Alsalaheen B, Almeida A, Eckner J,  Do male and female adolescents report symptoms differently after concussion?. 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Validity of the ImPACT Post-Concussion Symptom Scale (PCSS) affective symptom cluster as a screener for depression in collegiate athletes. Arch Clin Neuropsychol. 2019;34(4):563\u2013574."},{"issue":"10","key":"b37","series-title":"Am J Sports Med","first-page":"2375","article-title":"A revised factor structure for the Post-Concussion Symptom Scale: baseline and postconcussion factors","volume":"40","author":"Kontos AP","year":"2012","unstructured":"Kontos AP, Elbin RJ, Schatz P. A revised factor structure for the Post-Concussion Symptom Scale: baseline and postconcussion factors. Am J Sports Med. 2012;40(10):2375\u20132384."},{"issue":"11","key":"b38","series-title":"Brain Inj","first-page":"1345","article-title":"Determining sensitivity and specificity of the Sport Concussion Assessment Tool 3 (SCAT3) components in university athletes","volume":"32","author":"Downey RI","year":"2018","unstructured":"Downey RI, Hutchison MG, Comper P. 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J Child Neurol. 2022;37(12-14):970\u2013978."},{"issue":"2","key":"b43","series-title":"J Neurosurg Pediatr","first-page":"165","article-title":"Association of time to initial clinic visit with prolonged recovery in pediatric patients with concussion","volume":"26","author":"Eagle SR","year":"2020","unstructured":"Eagle SR, Puligilla A, Fazio-Sumrok V, Kegel N, Collins MW, Kontos AP. Association of time to initial clinic visit with prolonged recovery in pediatric patients with concussion. J Neurosurg Pediatr. 2020;26(2):165\u2013170."},{"issue":"7","key":"b44","series-title":"Sports Med","first-page":"1491","article-title":"The influence of timing of reporting and clinic presentation on concussion recovery outcomes: a systematic review and meta-analysis","volume":"51","author":"Barnhart M","year":"2021","unstructured":"Barnhart M, Bay RC, Valovich McLeod TC. The influence of timing of reporting and clinic presentation on concussion recovery outcomes: a systematic review and meta-analysis. Sports Med. 2021;51(7):1491\u20131508."},{"issue":"3","key":"b45","series-title":"Can Fam Physician","first-page":"e87","article-title":"Relapse of concussion symptoms in the context of premature return to learn and return to play: comparative analysis of 2006 to 2011 and 2011 to 2016","volume":"68","author":"Carson JD","year":"2022","unstructured":"Carson JD, Diep D, Baker C,  Relapse of concussion symptoms in the context of premature return to learn and return to play: comparative analysis of 2006 to 2011 and 2011 to 2016. Can Fam Physician. 2022;68(3):e87\u2013e91."},{"issue":"17-18","key":"b46","series-title":"J Neurotrauma","first-page":"1146","article-title":"Clinical outcome following sport-related concussion among children and adolescents with a history of prior concussion: a systematic review","volume":"39","author":"Cook NE","year":"2022","unstructured":"Cook NE, Gaudet CE, Van Patten R, Kissinger-Knox A, Iverson GL. Clinical outcome following sport-related concussion among children and adolescents with a history of prior concussion: a systematic review. J Neurotrauma. 2022;39(17-18):1146\u20131158."},{"issue":"5","key":"b1","series-title":"Clin Spine Surg","first-page":"191","article-title":"Sports-related concussion in children and adolescents","volume":"30","author":"Refakis CA","year":"2017","unstructured":"Refakis CA, Turner CD, Cahill PJ. Sports-related concussion in children and adolescents. 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