Abstract
The main objective of this study was to evaluate sex differences in cortical thickness after acute mild traumatic brain injury (mTBI) and its associations with clinical outcomes. Thirty-two patients with mTBI at acute phase (2.4 ± 1.3 days post-injury) and 30 healthy controls were enrolled. All the participants underwent comprehensive neurocognitive assessments and MRI to assess cortical thickness. Significant sex differences were determined by using variance analysis of factorial design. Relations between the cortical thickness and clinical assessments were measured with the Spearman Correlation. Results revealed that patients with mTBI had significantly reduced cortical thickness in the left entorhinal cortex while increased cortical thickness in the left precuneus cortex and right lateral occipital cortex, compared with healthy controls. The interaction effect of the group × sex on cortical thickness was significant. Female patients had significant thicker cortical thickness in the left caudal anterior cingulate cortex (ACC) than male patients and had higher scores on Posttraumatic stress disorder Checklist—Civilian Version (PCL-C). Spearman correlational analysis showed a significantly positive correlations between the cortical thickness of the left caudal ACC and PCL-C ratings in female patients. Sex differences in cortical thickness support its potential as a neuroimaging phenotype for investigating the differences in clinical profiles of mild TBI between women and men.
Highlights
Traumatic brain injury (TBI) is an important global health issue, of which 75–90% are classified as mild TBI [1]
The interaction effect of the group × sex on cortical thickness was significant in the left caudal anterior cingulate cortex [F(1, 57) = 5.976, P = 0.018], fusiform cortex [F(1, 57) = 10.13, P = 0.002], insula cortex [F(1, 57) = 7.35, P = 0.009] and superior frontal cortex (SFC) [F(1, 57) = 5.131, P = 0.027] (Figure 2)
Simple effect testing indicated that female patients had significant increased cortical thickness than male patients in the left caudal anterior cingulate cortex (ACC) (P = 0.004)
Summary
Traumatic brain injury (TBI) is an important global health issue, of which 75–90% are classified as mild TBI (mTBI) [1]. Sex differences in outcomes after mTBI have been addressed in lots of studies, of which some found females have a poorer outcome than males [3,4,5,6,7,8]. Another study have found that females have a higher risk of developing epilepsy, suicide, and. Sex Differences in mTBI use more health care services and males have a higher risk for schizophrenia after mTBI [9]. While other studies have shown no substantial difference in outcome with regard to sex [10, 11]. Understanding sex differences of brain injury mechanism after mild TBI may change the future diagnostic work-up in patients with mTBI and lead to separate management strategies for patients of different sex
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