Study: Concussion recovery longer for men than women

Suffering a concussion can be a different experience for everyone and now, new imaging research has revealed that the recovery process may actually be more difficult for one gender than the other.

In a new study published online in the journal Radiology, researchers from the University of Pittsburgh utilized diffusion tensor imaging (DTI) on concussion patients to determine how males and females recover from injury. Their scans revealed that males may take longer to overcome a concussion also known as a mild traumatic brain injury (mTBI) than females with similar injuries.

According to the researchers, these findings indicate that DTI could be used to provide more tailored treatment for concussions in the future. Currently, its difficult to determine which patients will have a smoother recovery from concussion, as opposed to those who will struggle.

The thing that got us curious is you see differences [in concussion recovery] between males and females all the time, Dr. Saeed Fakhran, assistant professor of neuroradiology at the University of Pittsburgh School of Medicine. We wanted to know: Is it a gender difference or something else? No one had really looked at the imaging, so we didnt even know there would be a difference.

Approximately 1.7 million Americans suffer a traumatic brain injury each year, and of these cases, 75 to 90 percent are considered mTBIs, according to the Brain Injury Association of America. In order to determine the severity of these head injuries, physicians will typically conduct a magnetic resonance imaging (MRI) or computed tomography (CT) scan but Fakhran said these types of imaging dont detail the abnormalities associated with concussion.

Traditionally, the definition of a concussion is a normal MRI or CT, which is still true to this day, Fakhran said, noting that abnormal MRIs or CTs indicate more severe brain injuries. But if you meet people who have a concussion, sometimes theyll turn from A students to C students struggling to concentrate; clearly something is still wrong. DTI looks even more closely at the microscopic level ofbrain changes in these patients.

A more advanced form of MRI, DTI allows physicians to look very closely at the brains white matter tracts tissues comprised of nerve fibers, or axons, that connect various parts of the brain. Typically, water flows along these tracts in a uniform, directional way. But for patients who have suffered a concussion, their white matter is damaged, and the waters directional flow is lost.

To indicate this disruption in the brain, DTI provides a measurement called fractional anisotropy (FA), which qualifies water movement along the brains white matter. A high FA score is associated with a more directional flow while an abnormally low FA score indicates an erratic flow, and thus, cognitive impairment.

The researchers tested this imaging technique on 69 patients diagnosed with mTBI between 2006 and 2013 47 of whom were males and 22 of whom were females. All patients underwent a computerized neurocognitive test and DTI of the brain.

Overall, the scans revealed the males to have much lower FA scores in the uncinate fasciculus (UF) area of the brain, compared to their female counterparts. These scores correlated with the patients recovery times, as the females took an average of 26.3 days to recover from their concussions, while the male patients took an average of 66.9 days to recover.

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Study: Concussion recovery longer for men than women