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Updated: Jan 29, 2026

A Mouse Model of Single and Repetitive Mild Traumatic Brain Injury
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Sex Differences in Severity and Recovery Following Mild Traumatic Brain Injury: A Systematic Review.

Shanika Arachchi1, Ed Daly1, Anushree Dwivedi2

  • 1Department of Sport, Exercise and Nutrition, Atlantic Technological University, H91 T8NW Galway, Ireland.

Brain Sciences
|January 28, 2026
PubMed
Summary

Women experience more severe symptoms and slower recovery after mild traumatic brain injury (mTBI). Understanding these sex-based differences is crucial for developing targeted diagnostic and rehabilitation strategies for mTBI patients.

Keywords:
cognitive impairmentmild traumatic brain injury (mTBI)neuroimagingrecoverysex differencessports-related concussion (SRC)symptom severity

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Area of Science:

  • Neuroscience
  • Traumatology
  • Public Health

Background:

  • Sex-based biological and neurochemical variations impact mild traumatic brain injury (mTBI) presentation and recovery.
  • Investigating sex-related differences in mTBI is essential for understanding varied patient outcomes.
  • Previous research indicates potential sex disparities in mTBI, necessitating a comprehensive review.

Purpose of the Study:

  • To systematically review and synthesize existing literature on sex-based differences in mild traumatic brain injury (mTBI) severity, symptoms, and recovery.
  • To identify specific patterns in how males and females experience and recover from mTBI.
  • To provide evidence for sex-specific diagnostic and rehabilitation approaches in mTBI management.

Main Methods:

  • Systematic review adhering to PRISMA 2020 guidelines, registered with PROSPERO.
  • Comprehensive literature search across PubMed, SPORTDiscus, Web of Science, and Scopus (2000-2024).
  • Inclusion of adult studies (≥18 years) with mTBI/concussion and quantifiable sex-specific outcome data; JBI critical appraisal tools used for quality assessment.

Main Results:

  • Forty-one studies (15,656 participants) revealed females reported greater symptom burden, pain, and longer recovery times.
  • Neuroimaging indicated more white matter alterations in females and reduced cerebral blood flow in males.
  • Females exhibited poorer cognitive performance, slower reaction times, and higher rates of vestibular-ocular and visual abnormalities compared to males.

Conclusions:

  • Sex significantly influences mTBI symptom presentation and recovery trajectories.
  • Females appear more vulnerable across multiple clinical domains post-mTBI, likely due to biological factors.
  • Recognizing sex-specific patterns is vital for tailoring mTBI diagnostics and rehabilitation strategies for improved patient outcomes.