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CONCUSSION MAY AFFECT WOMEN MORE SEVERELY THAN MEN

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A new study suggests that the effects of concussion may differ between men and women, with women experiencing more persistent working memory impairment 10 weeks after injury.

The researchers in Taiwan say their findings may indicate that a more aggressive treatment protocol is needed for women after concussion.

Concussion, also known as mild traumatic brain injury (MTBI), is defined as a temporary loss of normal brain function caused by a head injury. It is a particular risk in fast-paced team sports like rugby, as well as winter sports like skiing and snowboarding.

According to the NHS, symptoms of concussion can include brief loss of consciousness after the injury; periods of memory loss; problems with vision, such as “seeing stars” or blurry vision; periods of confusion; drowsiness; and persistent headaches.

In most cases, patients who experience concussion make a full recovery, typically within three months. But according to the researchers, 10-15% of patients continue to experience persistent disabling problems beyond three months. These problems may include post-traumatic headache; sleep disturbance; loss of balance, memory and other cognitive impairments; fatigue; and mood or affective disorders.

Several recent reports have indicated that female athletes suffer concussions at a higher rate than male athletes playing similar sports.

“In clinical practice, more women than men seek medical attention due to persistent symptoms after MTBI at a ratio of almost 2:1,” said the study´s lead author, Dr. Chi-Jen Chen. “We started to wonder whether there might be differences in MTBI outcomes between men and women.”

Dr. Chen and colleagues studied 30 patients with MTBI and 30 control patients in order to evaluate gender differences in symptoms. They used functional magnetic resonance imaging (fMRI) to analyse brain activation patterns during working memory tasks.

Results from the group of MTBI patients showed increased activation in working memory brain circuits in the men and decreased activation in the women, compared to the controls. At follow-up, men with MTBI returned to a normal activation pattern similar to the controls, whereas the women showed persistent hypoactivation, suggesting ongoing working memory problems, the researchers reported.

“These findings provide evidence that female gender may be a risk factor for working memory impairment after MTBI,” Dr. Chen commented.

He said that it may be worth incorporating fMRI into the treatment protocol for MTBI in the future, because it has the potential to detect working memory impairment, predict outcome and monitor treatment effect. However, further studies are needed to validate these preliminary findings.

http://www2.rsna.org/timssnet/media/pressreleases/14_pr_target.cfm?ID=809

http://pubs.rsna.org/doi/10.1148/radiol.2015142549

http://www.nhs.uk/conditions/concussion/pages/introduction.aspx