MRI findings differ significantly in boys and girls who have sustained concussions

Findings from functional MRI brain scans following concussions in pediatric patients indicate that injury recovery times may differ between sexes. 

A new paper published in Scientific Reports details a “significant amount” of clusters with variations in connectivity patterns visualized on resting state functional MRI exams in girls after sustaining a concussion [1]. In comparison, these patterns were minimally present in boys.  

Experts involved in the research note that these findings are important for understanding how a child will recover from a concussion, given that each sex has unique factors influencing their neurodevelopment, such as hormonal status, that could make them more vulnerable to injury-induced pathologies. However, there is a significant lack of data comparing concussion trajectories and outcomes between sexes, authors of the new paper suggest. 

“The lack of a sex-specific understanding of rs-fMRI differences in pediatric concussion is a considerable knowledge gap, given that sex, as a biological variable, has been recognized as an understudied yet important consideration in neuroscience,” corresponding author Brian W. Timmons, with the Department of Pediatrics at McMaster University in Ontario, Canada, and colleagues explained. “Further, a growing body of research demonstrates that concussion presents differently in boys vs. girls.” 

For the study, the team compared imaging from children who had sustained a concussion one month prior versus scans from healthy controls for both boys and girls. They conducted seed-based and region-of-interest analyses to identify sex-based rs-fMRI differences, in addition to using threshold-free cluster enhancement and a family-wise error corrected p-values to visualize different clusters. 

In the group of females, experts observed several notable differences. First, the group noted reduced connectivity between the anterior cingulate cortex of the salience network and the thalamus and precuneus and the cingulate gyrus. They observed increased connectivity between the salience network seed and the cerebellum and the PCC and the thalamus, cuneal cortex and lateral occipital cortex left. 

Hyper- and hypo-connectivity was observed in 10 and five significant clusters for females with concussions, but in just one and three for males. 

“With a large evidence base suggesting that symptom presentation differs in pediatric concussion by sex, and with the current study demonstrating sex-based rs-fMRI differences in children with concussion, there is reason to hypothesize that this variable symptom presentation has an underlying functional sex-specific neuropathology,” the authors suggest. 

The team noted that their findings emphasize the need for sex-specific analyses in research and in children who have sustained a concussion

The study is available here

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.

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