Understanding the Impact of Traumatic Brain Injury (TBI) on Women

Traumatic brain injury (TBI) is a subject widely studied, however, there's a significant gap in our understanding - how TBI uniquely affects women. Historically, research has predominantly focused on men, from clinical trials to the use of male animal models. This leads to gaps in understanding how TBI impacts women, which has implications for prevention, treatment, and recovery. Importantly, research shows that there are differences in brain anatomy and function between male and female sexes, which emphasizes the need to study TBI in females1.

In younger age groups, boys experience a higher incidence of TBIs compared to girls, largely due to the tendency to engage in activities that carry a higher potential for injury2. Interestingly, when children who suffered from a TBI were followed into adulthood, it was found that females were significantly more likely to report problems such as depression and anxiety, while males were significantly more likely to report problems with substance abuse or criminal behavior3.?

In the context of sports-related concussions, females have been reported to have a higher incidence of concussion in certain sports such as soccer4. There is evidence that female athletes take longer to recover and experience more severe post-concussive symptoms than their male counterparts1. Understanding these differences is crucial, particularly in developing gender-sensitive approaches to sports medicine and rehabilitation.

One critical area where women are particularly vulnerable to TBI is in cases of intimate partner violence (IPV). Studies show a high prevalence of IPV-related TBI among women, yet research on the effects of these brain injuries is extremely limited5. This lack of data hinders the development of effective interventions and support systems for women experiencing IPV-related head injuries.

In terms of work-related brain injuries, men are more likely to experience fatal work-related TBIs, often due to jobs in law enforcement and construction. Women, however, face a greater risk of TBI in healthcare and social services, often because of an assault6. In the military context, female veterans with TBI report higher incidences of depression, PTSD, and non-specific symptoms such as nausea and fatigue, in contrast, male veterans report more musculoskeletal issues7,8. However, despite an increasing number of women serving in the military, most TBI research in this context focuses on male soldiers predominantly.

In the elderly populations, epidemiological data reveals that older women are at higher risk of TBI than men of the same age group, largely due to falls9. Women also reported to suffer from different co-morbidities than men, such as suffering from dementia, which may affect their recovery and functional outcomes10.

To better understand the gender-based differences on how TBI affects individuals, there is a need for more studies that account for sex differences. Understanding how TBI affects women differently will lead to better treatment, rehabilitation, and support for all those affected. Closing this gap will improve clinical care and outcomes for women, ensuring that everyone receives the best possible treatment and support after a traumatic brain injury.

This post is based on articles and information on the public domain.

References

1)????? Valera EM, Joseph AC, Snedaker K, Breiding MJ, Robertson CL, Colantonio A, Levin H, Pugh MJ, Yurgelun-Todd D, Mannix R, Bazarian JJ, Turtzo LC, Turkstra LS, Begg L, Cummings DM, Bellgowan PSF. Understanding Traumatic Brain Injury in Females: A State-of-the-Art Summary and Future Directions. J Head Trauma Rehabil. 2021 Jan 1;36(1):E1-E17. doi: 10.1097/HTR.0000000000000652.

2)????? Thurman DJ.?The epidemiology of traumatic brain injury in children and youths: a review of research since 1990.?J Child Neurol. 2016;31(1):20–27. doi: 10.1177/0883073814544363

3)????? Scott C, McKinlay A, McLellan T, Britt E, Grace R, MacFarlane M.?A comparison of adult outcomes for males compared to females following pediatric traumatic brain injury.?Neuropsychology. 2015;29(4):501–508. doi: 10.1037/neu0000074

4)????? Gessel LM, Fields SK, Collins CL, Dick RW, Comstock RD.?Concussions among United States high school and collegiate athletes.?J Athl Train. 2007;42(4):495–503.

5)????? Smith SG, Chen J, Basile KC, et al.?The National Intimate Partner and Sexual Violence Survey (NISVS): 2010–2012 State Report. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2017.

6)????? Chang VC, Ruseckaite R, Collie A, Colantonio A. Examining the epidemiology of work-related traumatic brain injury through a sex/gender lens: analysis of workers’ compensation claims in Victoria, Australia. Occup Environ Med. 2014 Oct;71(10):695-703.

7)????? Iverson KM, Hendricks AM, Kimerling R, et al.?Psychiatric diagnoses and neurobehavioral symptom severity among OEF/OIF VA patients with deployment-related traumatic brain injury: a gender comparison.?Women’s Health Issues. 2011;21(4)(suppl):S210–S217. doi: 10.1016/j.whi.2011.04.019

8)????? Brickell TA, Lippa SM, French LM, Kennedy JE, Bailie JM, Lange RT.?Female service members and symptom reporting after combat and non-combat-related mild traumatic brain injury.?J Neurotrauma. 2017;34(2):300–312. doi: 10.1089/neu.2016.4403

9)????? Saverino C, Swaine B, Jaglal S, et al.?Rehospitalization after traumatic brain injury: a population-based study.?Arch Phys Med Rehabil. 2016;97(2)(suppl):S19–S25. doi: 10.1016/j.apmr.2015.04.016?

10) ?Mollayeva T, Hurst M, Escobar M, Colantonio A.?Sex-specific incident dementia in patients with central nervous system trauma.?Alzheimers Dement (Amst). 2019;11:355–367. doi: 10.1016/j.dadm.2019.03.003