Macleod Harry, Smith Clare L, Laycock Robin
Royal Melbourne Institute of Technology, 124 La Trobe Street, Melbourne, VIC, 3000, Australia.
Brain Imaging Behav. 2025 Apr;19(2):594-608. doi: 10.1007/s11682-025-00970-6. Epub 2025 Jan 24.
Concussion is a common injury in sports that causes neurological damage, leading to memory loss and difficulty concentrating. Insufficient recovery time may result in significant long-term harm to individuals. Several neuroimaging techniques have been used to understand the pathophysiological changes following concussion, and how long individuals need to recover before returning to play. Despite the progress in neuroimaging concussion research, few studies have considered whether females sustain different effects on the brain and how recovery from concussion might differ from males. Thus, we conducted a systematic review of the existing literature to highlight sex differences in concussion with neuroimaging techniques. By searching four different databases, studies were selected if they used a neuroimaging technique to examine sex differences following concussion in athletes over the age of 18. After screening 2295 studies from an initial search, 15 were found to match the selection criteria. Nine papers established some difference between males and females, however many of these studies were not designed to specifically examine sex differences, and hence conclusions in this regard are somewhat limited. A further common limitation among these papers was a lack of whole brain scans, instead relying on regions of interest analyses, which reduces the ability to compare studies effectively. The current systematic review has highlighted the need for future studies to specifically consider whether, and how sex influences the impact and trajectory of brain recovery from concussion. This can then help to inform suitable amendments to current concussion return-to-play protocols for male and female athletes.
脑震荡是体育运动中常见的损伤，会导致神经损伤，进而引起记忆丧失和注意力难以集中。恢复时间不足可能会给个人带来严重的长期伤害。几种神经成像技术已被用于了解脑震荡后的病理生理变化，以及个体在恢复比赛前需要多长时间恢复。尽管神经成像脑震荡研究取得了进展，但很少有研究考虑女性是否会对大脑产生不同影响，以及脑震荡后的恢复与男性有何不同。因此，我们对现有文献进行了系统综述，以突出神经成像技术在脑震荡方面的性别差异。通过搜索四个不同的数据库，筛选出使用神经成像技术检查18岁以上运动员脑震荡后性别差异的研究。在对初步搜索得到的2295项研究进行筛选后，发现有15项符合选择标准。九篇论文确定了男性和女性之间的一些差异，然而这些研究中有许多并非专门设计用于检查性别差异，因此在这方面的结论有些有限。这些论文中另一个常见的局限性是缺乏全脑扫描，而是依赖于感兴趣区域分析，这降低了有效比较研究的能力。当前的系统综述强调了未来研究需要特别考虑性别是否以及如何影响脑震荡后脑恢复的影响和轨迹。这进而有助于为当前男女运动员脑震荡重返比赛协议提供适当的修正依据。
