One emerging school of thought amidst rapidly advancing concussion research says that females may be generally more vulnerable to head injuries than their male counterparts. However, a new study shows that regardless of the severity of a patient’s initial concussion symptoms, females of most age groups who’ve sustained a mild traumatic brain injury (TBI) recover faster than males.
Researchers tracked a group of 47 men with concussions. The team administered a variety of tests and brain-scans immediately after the men received concussion diagnoses and followed them until they had fully recovered. Researchers found that the average “time to symptom resolution” was 66.9 days. A total of 22 female patients with concussions were also tracked and evaluated with the same tests and scans. The average recovery time for females was 26.3 days.
While subjects in the study ranged from 10 to 50 years old, the average age of male and female subjects did not differ significantly, and neither did the severity of their earliest post-injury symptoms. The most noteworthy difference between the genders was the speed with which they were able to recover from such lingering symptoms as headaches, dizziness, irritability or cognitive and memory difficulties.
The primary gender difference that the researchers feel plays a crucial role in concussion recovery lies at the heart of the brain, a part known as the uncinate fasciculus. The fasciculus is a hook-shaped bundle of neural ties that connect the brain’s primitive end of the limbic system with the area responsible for higher reasoning, the frontal lobes. In concussed female subjects, diffusion tensor imaging brain scans show that the uncinate fasciculus was far less likely to be strained, torn, or frayed than in male counterparts with similar concussions.
Male or female, a subject whose uncinate fasciculus showed clear signs of shearing required a significantly longer recovery period, the researchers found. Yet, even with severe concussion symptoms, brain-injured females were less likely than males to display imaging evidence of such damage. The researchers also compared the integrity of the concussion victims’ uncinate fasciculi with that of a control group of healthy, non-concussed subjects. According to the study, the bundle of connective tissue was dramatically more torn and frayed in male subjects than it was in the healthy controls. In comparison, that same tissue’s integrity in healthy female control subjects showed very little difference from women who had sustained a concussion.
More Evidence Suggests Progesterone may Insulate against Tissue Damage during TBI
Previous studies have suggested that when women suffer concussions, they initially report more symptoms than do men. However, researchers have long suspected that progesterone, a female reproductive hormone believed to help protect the brain during stroke or injury, may make women more resilient after concussions than men. Recent, unrelated studies have also been conducted to better identify the potential effectiveness of progesterone to treat head injuries in both sexes.
This latest study appears to be one of the first to offer a truly objective measure of concussion injury that bypasses social expectations and subjective reports. It focuses in on present-day’s most effective means of gauging such injury — using diffusion tensor imaging. This research also provides physicians trying with a specific place in the brain — the uncinate fasciculus — to look for injury. While researchers have been focusing increasingly on white matter as a measure of concussion injury, there are many such tracts to assess.
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