Assessment of Sex Differences in Recovery of Motor and Sensory Impairments Poststroke

Abstract

Background. Understanding potential sex differences in stroke recovery is important for prognosis, ensuring appropriate allocation of health care resources, and for stratification in research studies. Previously, functional measures have shown poorer outcomes for females, however, little is known about sex differences that may exist in specific motor and sensory impairments. Objective. The aim of this study was to utilize robotic assessments of motor and sensory impairments to determine if there are sex differences at the impairment level in stroke recovery over the first 6 months poststroke. Methods. We used robotic and clinical assessments of motor and sensory impairments at 1, 6, 12, and 26 weeks poststroke in 108 males and 52 females. Linear mixed models were used to examine the effect of sex on recovery poststroke, controlling for age and lesion volume. Results. In general, we did not find significant sex differences across a range of assessments. The exception to this was a sex × age interaction for the Purdue Pegboard Assessment, where we found that females had better performance than males at younger ages (<62 years), but males had better performance at older ages. Conclusions. While recruitment biases need to be acknowledged when generalizing our results to stroke recovery at-large, our results suggest that sex differences do not exist at the impairment level poststroke.

Relationship between sex and age characteristics, comorbid status, and dynamics of recovery in the acute period of stroke in patients living in the Arkhangelsk region

“…Возраст влияет не только на увеличение частоты возникновения инсульта и заболеваний сосудистого риска, но и ухудшает функциональные исходы после инсульта, что связано с патофизиологическими изменениями в нервной системе у пожилых пациентов, которые лежат в основе повышенной восприимчивости головного мозга к повреждению [16]. Сведения по половым различиям и результатам восстановления после инсульта не так однозначны: одни исследования сообщают о худших функциональных исходах у женщин, причём только в более старшей возрастной группе [17][18][19], другие, наоборот, описывают лучшие результаты у пожилых женщин [20,21], третьи представляют более значимое восстановление у женщин младше, а у мужчин старше 62 лет [22], также имеются данные об отсутствии половых различий в достижении хорошего функционального результата [23,24].…”

Chronic stroke sensorimotor impairment is related to smaller hippocampal volumes: An ENIGMA analysis

“…Estrogen levels may play a mediating role in these trends 24 and have been associated with stroke severity and mortality 25 . Stroke-related outcomes including disability and quality of life are generally poorer in women than men 1,26,27 , although conclusive sex differences have not been reported in terms of post-stroke sensorimotor impairment 28 . As such, sex could moderate the relationship between sensorimotor impairment and hippocampal volume following a stroke.…”

Chronic Stroke Sensorimotor Impairment Is Related to Smaller Hippocampal Volumes: An ENIGMA Analysis

“… 20 Stroke‐related outcomes including disability and quality of life are generally poorer in women than men, 1 , 21 although conclusive sex differences have not been reported in terms of poststroke sensorimotor impairment. 22 As such, sex could moderate the relationship between sensorimotor impairment and hippocampal volume following a stroke. In particular, women may have smaller hippocampal volumes and worse sensorimotor impairment, potentially leading to stronger effect sizes compared with men.…”