Preliminary Evidence of Sex Differences in Cortical Thickness Following Acute Mild Traumatic Brain Injury

Abstract

The main objective of this study was to evaluate sex differences in cortical thickness after acute mild traumatic brain injury (mTBI) and its associations with clinical outcomes. Thirty-two patients with mTBI at acute phase (2.4 ± 1.3 days post-injury) and 30 healthy controls were enrolled. All the participants underwent comprehensive neurocognitive assessments and MRI to assess cortical thickness. Significant sex differences were determined by using variance analysis of factorial design. Relations between the cortical thickness and clinical assessments were measured with the Spearman Correlation. Results revealed that patients with mTBI had significantly reduced cortical thickness in the left entorhinal cortex while increased cortical thickness in the left precuneus cortex and right lateral occipital cortex, compared with healthy controls. The interaction effect of the group × sex on cortical thickness was significant. Female patients had significant thicker cortical thickness in the left caudal anterior cingulate cortex (ACC) than male patients and had higher scores on Posttraumatic stress disorder Checklist—Civilian Version (PCL-C). Spearman correlational analysis showed a significantly positive correlations between the cortical thickness of the left caudal ACC and PCL-C ratings in female patients. Sex differences in cortical thickness support its potential as a neuroimaging phenotype for investigating the differences in clinical profiles of mild TBI between women and men.

Sex-Related Differences in the Incidence, Severity, and Recovery of Concussion in Adolescent Student-Athletes Between 2009 and 2019

“…Specifically, one study showed that after mTBI, male (compared with female) patients had significantly increased connectivity in the ventral stream network known to play an integral role in visual processing; another study linked increased thickness of the left caudal anterior cingulate cortex to increased Symptom scores in female patients compared with male patients after mTBI. 43,48…”

“…Specifically, one study showed that after mTBI, male (compared with female) patients had significantly increased connectivity in the ventral stream network known to play an integral role in visual processing; another study linked increased thickness of the left caudal anterior cingulate cortex to increased Symptom scores in female patients compared with male patients after mTBI. 43,48 Previous studies have examined symptom cluster discrepancies between the sexes in amateur athletes both at baseline and after concussion. 12,13,16,39,50 Although these studies agree that female athletes experience more symptoms than male athletes, the specific clusters that differ between the sexes has been inconsistent, due in part to inconsistent methods.…”

Morphometric changes in the cortex following acute mild traumatic brain injury

“…All of the mTBI patients in this cohort study were enrolled from the Department of Radiology of the Second Xiangya Hospital between September and December 2019. The sample size calculation was based on previous studies (Zhou et al, 2013;Shao et al, 2018;Ofoghi et al, 2020). The mTBI patients were pre-screened prior to scanning to rule out any contraindications to MRI.…”

“…The inclusion criteria for the mTBI patients were based on the World Health Organization's Collaborating Center for Neurotrauma Task Force (Holm et al, 2005): (1) Glasgow Coma Scale (Teasdale et al, 2014) score ranging from 13-15; (2) one or more of any of the following: (a) existence of confusion or disorientation, (b) loss of consciousness of less than 30 minutes, (c) post-traumatic amnesia of less than 24 hours, (d) existence of transient neurologic abnormalities (focal signs or seizure), (e) existence of an intracranial lesion not requiring surgery; (3) mTBI onset within 7 days of trauma. The exclusion criteria for mTBI patients followed those used in the study of Shao et al (2018):…”

“…These aforementioned studies explored CT, CSA, and CV alterations over the entire cortex and their correlations with physical, emotional, and cognitive symptoms after mTBI. However, most of the studies investigated the CT, CSA, and CV of mTBI patients in the sub-acute or chronic stage, and only a few studies focused on CT, CSA, and CV changes in the acute stage (Wang et al, 2015;Dall'Acqua et al, 2016;Govindarajan et al, 2016;Shao et al, 2018). Furthermore, the published studies performing structural MRI evaluations on mTBI patients have not reached a consensus regarding CT, CSA, and CV alterations in the acute stage.…”