Abstract
Mild traumatic brain injury (TBI) is considered to induce abnormal intrinsic functional connectivity within resting-state networks (RSNs). The objective of this study was to estimate the role of sex in intrinsic functional connectivity after acute mild TBI. We recruited a cohort of 54 patients (27 males and 27 females with mild TBI within 7 days post-injury) from the emergency department (ED) and 34 age-, education-matched healthy controls (HCs; 17 males and 17 females). On the clinical scales, there were no statistically significant differences between males and females in either control group or mild TBI group. To detect whether there was abnormal sex difference on functional connectivity in RSNs, we performed independent component analysis (ICA) and a dual regression approach to investigate the between-subject voxel-wise comparisons of functional connectivity within seven selected RSNs. Compared to female patients, male patients showed increased intrinsic functional connectivity in motor network, ventral stream network, executive function network, cerebellum network and decreased connectivity in visual network. Further analysis demonstrated a positive correlation between the functional connectivity in executive function network and insomnia severity index (ISI) scores in male patients (r = 0.515, P = 0.006). The abnormality of the functional connectivity of RSNs in acute mild TBI showed the possibility of brain recombination after trauma, mainly concerning male-specific.
Highlights
Traumatic brain injury (TBI) is a substantial public health problem, and can accelerate the ageing process, leading to long-term structural and functional alterations to the brain (Benedictus et al, 2010; Cole et al, 2015)
We employed 54 patients with mild traumatic brain injury (TBI), all of which were recruited from the emergency department (ED) of the local Level-1 emergency center
None of patients were with visible contusion lesions using conventional neuroimaging techniques and exhibited cerebral microbleeds on susceptibility weighted imaging (SWI)
Summary
Traumatic brain injury (TBI) is a substantial public health problem, and can accelerate the ageing process, leading to long-term structural and functional alterations to the brain (Benedictus et al, 2010; Cole et al, 2015). About 90% of TBI is classified as mild (Vos et al, 2002). It is worthy of attentions that one-quarter of mild TBI patients have post-concussive symptoms or other cognitive disorders (Bazarian et al, 2010). The heterogeneity of the injuries and the variability of cognitive symptoms make it problematic for management (Jenkins et al, 2016). Sex steroids have been tested to demonstrate neuroprotective effects in severe TBI (Fakhran et al, 2014). The effect of sex on outcome is still unclear after mild TBI. Understanding sex differences of brain injury mechanism after mild TBI may enhance the future diagnostic work-up in patients and lead to separate management strategies for patients with different sexes
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