Cited by 83Traumatic Brain Injury ResearchAdvanced Neuroimaging Techniques and ApplicationsAutomotive and Human Injury Biomechanics

Sex Differences in White Matter Abnormalities after Mild Traumatic Brain Injury: Localization and Correlation with Outcome

Fakhran, Saeed, Yaeger, Karl, Collins, Michael, Alhilali, Lea·2014·Radiology

Abstract

PURPOSE: To evaluate sex differences in diffusion-tensor imaging (DTI) white matter abnormalities after mild traumatic brain injury (mTBI) using tract-based spatial statistics (TBSS) and to compare associated clinical outcomes. MATERIALS AND METHODS: The institutional review board approved this study, with waiver of informed consent. DTI in 69 patients with mTBI (47 male and 22 female patients) and 21 control subjects (10 male and 11 female subjects) with normal conventional magnetic resonance (MR) images were retrospectively reviewed. Fractional anisotropy (FA) maps were generated as a measure of white matter integrity. Patients with mTBI underwent serial neurocognitive testing with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Correlation between sex, white matter FA values, ImPACT scores, and time to symptom resolution (TSR) were analyzed with multivariate analysis and TBSS. RESULTS: No significant difference in age was seen between males and females (control subjects, P = .3; patients with mTBI, P = .34). No significant difference was seen in initial ImPACT symptom scores (P = .33) between male and female patients with mTBI. Male patients with mTBI had significantly decreased FA values in the uncinate fasciculus (UF) bilaterally (mean FA, 0.425; 95% confidence interval: 0.375, 0.476) compared with female patients with mTBI and control subjects (P < .05), with a significantly longer TSR (P = .04). Multivariate analysis showed sex and UF FA values independently correlated with TSR longer than 3 months (adjusted odds ratios, 2.27 and 2.38; P = .04 and P < .001, respectively), but initial symptom severity did not (adjusted odds ratio, 1.15; P = .35). CONCLUSION: Relative sparing of the UF is seen in female compared with male patients after mTBI, with sex and UF FA values as stronger predictors of TSR than initial symptom severity.

Integrity signals

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Crossref · 10.1148/radiol.14132512

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  • Greater preservation of white matter integrity is associated with shorter duration of post-TBI symptoms in women compared with men.

    “Another study reported that greater preservation of white matter integrity was associated with shorter duration of post-TBI symptoms in women compared with men. 26”

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Authors
Fakhran, S., Yaeger, K., Collins, M., & Alhilali, L.
Affiliations
University of Pittsburgh (US)
Venue
Radiology
Published
2014-09
Volume
272
Issue
3
Pages
815-823
ISSN
  • 0033-8419 (ISSN-L)
  • 1527-1315
OpenAlex
W2122431232
Cited by
83
References
36
Citations by year
2026: 4 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 12 · 2021: 15 · 2020: 10 · 2019: 9 · 2018: 4 · 2017: 6 · 2016: 5 · 2015: 7 · 2014: 1
FWCI
4.79
Type
journal article
Language
en
Open access
closed
Locations
  • Radiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
Keywords
mild traumatic brain injury, sex differences, white matter abnormalities, uncinate fasciculus, fractional anisotropy, diffusion tensor imaging, tract-based spatial statistics, symptom resolution time, impact, concussion, white matter integrity
MeSH terms
Adolescent, Adult, Brain, Brain Injuries, Child, Female, Humans, Male, Nerve Fibers, Myelinated, Prognosis, Sex Characteristics, Trauma Severity Indices, Young Adult

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