Sex Differences in Working Memory after Mild Traumatic Brain Injury: A Functional MR Imaging Study
Abstract
PURPOSE: To evaluate sex differences in mild traumatic brain injury (MTBI) with working memory functional magnetic resonance (MR) imaging. MATERIALS AND METHODS: Research ethics committee approval and patient written informed consent were obtained. Working memory brain activation patterns were assessed with functional MR imaging in 30 patients (15 consecutive men and 15 consecutive women) with MTBI and 30 control subjects (15 consecutive men and 15 consecutive women). Two imaging studies were performed in patients: the initial study, which was performed within 1 month after the injury, and a follow-up study, which was performed 6 weeks after the first study. For each participant, digit span and continuous performance testing were performed before functional MR imaging. Clinical data were analyzed by using Kruskal-Wallis, Mann-Whitney U, Wilcoxon signed rank, and Fisher exact tests. Within- and between-group differences of functional MR imaging data were analyzed with one- and two-sample t tests, respectively. RESULTS: Among female participants, the total digit span score was lower in the MTBI group than in the control group (P = .044). In initial working memory functional MR imaging studies, hyperactivation was found in the male MTBI group and hypoactivation was found in the female MTBI group compared with control male and female groups, respectively. At the 6-week follow-up study, the female MTBI group showed persistent hypoactivation, whereas the male MTBI group showed a regression of hyperactivation at visual comparison of activation maps. The male MTBI group was also found to have a higher initial ß value than the male control group (P = .040), and there was no significant difference between the male MTBI group and the male control group (P = .221) at follow-up evaluation, which was comparable to findings on activation maps. In the female MTBI group, average ß values at both initial and follow-up studies were lower compared with those in the female control group but were not statistically significant (P = .663 and P = .191, respectively). CONCLUSION: Female patients with MTBI had lower digit span scores than did female control subjects, and functional MR imaging depicted sex differences in working memory functional activation; hypoactivation with nonrecovery of activation change at follow-up studies may suggest a worse working memory outcome in female patients with MTBI.
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Sex-related differences in fMRI activity, heart rate variability, edema, and intracranial hypertension were reported even in the absence of differences in cognition, post-concussive symptoms, duration of recovery, and GOS.
“Indeed, sex-related differences in functional magnetic resonance imaging (fMRI) activity, heart rate variability, edema, and intracranial hypertension were reported even in the absence of differences in cognition, post-concussive symptoms, duration of recovery, and GOS. 13,55,56”
From Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know (2019) · cites this paper as [55]
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- Authors
- Hsu, H.-L., Chen, D. Y.-T., Tseng, Y.-C., Kuo, Y.-S., Huang, Y.-L., Chiu, W.-T., Yan, F.-X., Wang, W.-S., & Chen, C.-J.
- Affiliations
- Taipei Medical University-Shuang Ho Hospital (TW)
- Venue
- Radiology
- Published
- 2015-09
- Volume
- 276
- Issue
- 3
- Pages
- 828-835
- ISSN
- 0033-8419 (ISSN-L)
- 1527-1315
- OpenAlex
- W2128243949
- Cited by
- 47
- References
- 31
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 3 · 2020: 12 · 2019: 5 · 2018: 9 · 2017: 2 · 2016: 2 · 2015: 1
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Radiology (publishedVersion)
- PubMed (publishedVersion)
- Taipei Medical University Repository (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- mild traumatic brain injury, sex differences, working memory, brain activation, hypoactivation, hyperactivation, digit span, functional MRI
- MeSH terms
- Adolescent, Adult, Aged, Brain Injuries, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Memory, Short-Term, Middle Aged, Prospective Studies, Sex Factors, Young Adult
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