Women May Recover More Slowly From Concussions

A new study finds that women have more difficulty than men in recovering from concussions.

A team led by Chi-Jen Chen, MD, a superintendent at Chia-Yi Hospital in Taiwan, sought to evaluate gender differences in mild traumatic brain injury (MTBI) by using functional magnetic resonance imaging (fMRI) to analyze brain activation patterns during working memory tasks. Chen and colleagues studied 30 patients with MTBI along with 30 control patients, with both groups including equal numbers of men and women. Each patient underwent an fMRI exam within 1 month of incurring their brain injury, and had a follow-up fMRI exam at 6 weeks after the first scan. In addition, all participants underwent neuropsychological tests, including digit span and continuous performance test.
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According to the initial results, the male MTBI patients demonstrated increased activation in working memory brain circuits, while women showed decreased activation, in comparison to the control group. At the time of follow-up, the male patients with MTBI returned to a normal activation pattern similar to that of those in the control group. Meanwhile, the female patients demonstrated persistent hypoactivation, which suggests ongoing working memory problems, according to the authors. In addition, neuropsychological results revealed that women in the MTBI group registered a lower total digit span score in comparison to the control group.

In mild traumatic brain injury, “MRI and CT scans are often normal, and these injuries are commonly overlooked,” says Chen. “Even though [these injuries] are called ‘mild’ traumatic brain injuries, the effect on the family and the injured person can be devastating.”

As such, “we think more aggressive management should be applied for female patients who have suffered a concussion, including close monitoring of symptoms, complete neuropsychological and imaging evaluation, more aggressive pharmacological and psychological treatments, rehabilitation, as well as longer follow-up,” he says.

The results also suggest that fMRI may have the potential to detect working memory impairment, predict outcome, and provide a sensitive measure to monitor treatment effect, adds Chen.

“Thus,” he says, “incorporation of fMRI study to treatment protocol may be necessary in the future.”

However, “a lot more work needs to be done in order to validate the usage of fMRI in MTBI treatment,” notes Chen, adding that future clinical trials on therapeutic drugs for MTBI may use fMRI for assessing treatment effect, “since there is still no specific pharmacological treatment for MTBI up to now.”

—Mark McGraw

Reference

Chen CJ, Hsu HL, et al. Sex Differences in Working Memory after Mild Traumatic Brain Injury: A Functional MR Imaging study. Radiology. 2015.