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Concussion symptoms last longer in women, say researchers

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Women have a more difficult time recovering from concussion than men, suggest researchers.

In most cases, patients who experience concussion – or mild traumatic brain injury (MTBI) – will recover fully, typically within three months, note the authors of a study in the journal Radiology.

However, they added that 10-15% of patients will continue to experience persistent disabling problems beyond three months.

“In clinical practice, more women than men seek medical attention due to persistent symptoms after MTBI at a ratio of almost 2:1,” said lead study author Dr Chi-Jen Chen, from Taipei Medical University in Taiwan.

“We started to wonder whether there might be differences in MTBI outcomes between men and women,” he said.

The researchers evaluated gender differences in MTBI by using functional magnetic resonance imaging (fMRI) to analyze brain activation patterns during working memory tasks – a commonly reported impairment after concussion.

“Female gender may be a risk factor for working memory impairment after mild traumatic brain injury”

Chi-Jen Chen

The researchers studied 30 patients with MTBI and 30 control patients. Both groups contained an equal number of men and women.

Patients underwent an fMRI exam within one month after injury and a follow-up fMRI exam at six weeks after first scan. All participants underwent neuropsychological tests, including digit span and continuous performance test.

Initial fMRI results of the MTBI patients showed increased activation in working memory brain circuits in the men and decreased activation in the women, compared to the controls.

At follow-up, men with MTBI returned to a normal activation pattern similar to the controls, whereas the women showed persistent hypoactivation – suggesting ongoing working memory problems.

Neuropsychological results showed that among the women, the total digit span score was lower in the MTBI group, compared to the control group.

Dr Chen said: “These findings provide evidence that female gender may be a risk factor for working memory impairment after MTBI. If so, more aggressive management should be initiated once MTBI is diagnosed in female patients.”

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