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Diffusion Imaging Reveals Sex Differences in the White Matter Following Sports-Related Concussion.

PMID: 33860291 (view PubMed database entry)
DOI: 10.1093/cercor/bhab095 (read at publisher's website )

David K Wright, Georgia F Symons, William T O'Brien, Stuart J McDonald, Akram Zamani, Brendan Major, Zhibin Chen, Daniel Costello, Rhys D Brady, Mujun Sun, Meng Law, Terence J O'Brien, Richelle Mychasiuk, Sandy R Shultz,

Sports-related concussion (SRC) is a serious health concern. However, the temporal profile of neuropathophysiological changes after SRC and how these relate to biological sex are still poorly understood. This preliminary study investigated whether diffusion-weighted magnetic resonance imaging (dMRI) was sensitive to neuropathophysiological changes following SRC; whether these changes were sex-specific; and whether they persisted beyond the resolution of self-reported symptoms. Recently concussed athletes (nā€‰=ā€‰14), and age- and education-matched nonconcussed control athletes (nā€‰=ā€‰16), underwent MRI 24-48-h postinjury and again at 2-week postinjury (i.e., when cleared to return-to-play). Male athletes reported more symptoms and greater symptom severity compared with females. dMRI revealed white matter differences between athletes with SRC and their nonconcussed counterparts at 48-h postinjury. These differences were still present at 2-week postinjury, despite SRC athletes being cleared to return to play and may indicate increased cerebral vulnerability beyond the resolution of subjective symptoms. Furthermore, we identified sex-specific differences, with male SRC athletes having significantly greater white matter disruption compared with female SRC athletes. These results have important implications for the management of concussion, including guiding return-to-play decisions, and further improve our understanding regarding the role of sex in SRC outcomes.

Cereb Cortex (Cerebral cortex (New York, N.Y. : 1991))
[2021, 31(10):4411-4419]

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