Imaging Shows Females May Have Lower Recovery Time After Concussions

Diffusion tensor imaging shows differences in the brain between males and females who sustain concussions.

Diffusion tensor images (DTI) detected lower fractional anisotropy (FA) values in males who sustained mild traumatic brain injuries than in females, according to a study published in the journal Radiology.

Researchers from the University of Pittsburgh School of Medicine sought to evaluate the sex differences in DTI white matter abnormalities following mild TBI. They assessed computerized neurocognitive tests and DTIs of the brains from 47 males (median age 17) and 22 females (median age 16) who sustained mild TBIs, and 10 male and 11 female control subjects. Thirty-two of the 47 males with mild TBI (68 percent) were injured while playing sports, as were 10 of the 22 females (45 percent).

“MRI and CT brain images of concussion patients are often normal,” Saeed Fakhran, MD, coauthor and assistant professor of neuroradiology at the University of Pittsburgh School of Medicine, said in a release. “Diffusion tensor imaging is the first imaging technique that shows abnormalities associated with concussion, because it is able to see white matter tracts at a microscopic level.”

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The DTI scans of the patients who had sustained mild TBIs revealed abnormalities within the uncinate fasciculi (UF), a white matter tract that connects the frontal and temporal lobes of the brain. Although its exact role is controversial, the UF tract is believed to allow temporal lobe-based memory associations to modify behavior though interactions with another area of the brain.

The researchers also found that the male patients with TBIs had significantly decreased UF FA values compared to the females with mild TBIs, while there was no difference between the males and females in the control group.

“In the future, we would like to look at the issue of gender and concussions more in depth to determine who does better and why,” Fakhran said.

While the average time for recovery for all patients with mild TBI was 54 days, recovery time longer than three months was associated with decreased UF FA, as was being male. Female patients recovered on average in 26.3 days, but males took an average of 66.9 days, irrespective of initial symptom severity.

The researchers feel that the study findings indicate a potential role for UF FA values in triaging concussion patients in the future.

“There’s prognostic value in DTI for both children participating in sports as well as for professional athletes,” Fakhran said. “Lower FA values in the uncinate fasciculi could offer a metric for evaluating the severity of mild traumatic brain injuries and predicting clinical outcome. We’re not at the point where DTI can provide individual prognoses yet, but that’s the hope and goal.”