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However, it is presently unclear whether there are sex differences in acute and long\u2010term brain recovery. In this study, magnetic resonance imaging (MRI) was used to scan 61 participants with sport\u2010related concussion (30 male, 31 female) longitudinally at acute injury, medical clearance to return to play (RTP), and 1\u2010year post\u2010RTP. A large cohort of 167 controls (80 male, 87 female) was also imaged. Each MRI session assessed cerebral blood flow (CBF), along with white matter fractional anisotropy (FA) and mean diffusivity (MD). For concussed athletes, the parameters were converted to difference scores relative to matched control subgroups, and partial least squares modeled the main and sex\u2010specific effects of concussion. Although male and female athletes did not differ in acute symptoms or time to RTP , all MRI measures showed significant sex differences during recovery. Males had greater reductions in occipital\u2010parietal CBF (mean difference and 95%CI: 9.97\u2009ml\/100\u2009g\/min, [4.84, 15.12] ml\/100\u2009g\/min,\n                    <jats:italic>z<\/jats:italic>\n                    \u00a0=\u00a03.73) and increases in callosal MD (9.07\u2009\u00d7\u200910\n                    <jats:sup>\u22125<\/jats:sup>\n                    , [\u221214.14, \u22123.60]\u2009\u00d7\u200910\n                    <jats:sup>\u22125<\/jats:sup>\n                    ,\n                    <jats:italic>z<\/jats:italic>\n                    \u00a0=\u00a0\u22123.46), with greatest effects at 1\u2010year post\u2010RTP. In contrast, females had greater reductions in FA of the corona radiata (16.50\u2009\u00d7\u200910\n                    <jats:sup>\u22123<\/jats:sup>\n                    , [\u221222.38, \u221211.08]\u2009\u00d7\u200910\n                    <jats:sup>\u22123<\/jats:sup>\n                    ,\n                    <jats:italic>z<\/jats:italic>\n                    \u00a0=\u00a0\u22125.60), with greatest effects at RTP. These findings provide new insights into how the brain recovers after a concussion, showing sex differences in both the acute and chronic phases of injury.\n                  <\/jats:p>","DOI":"10.1002\/hbm.25591","type":"journal-article","created":{"date-parts":[[2021,10,16]],"date-time":"2021-10-16T12:49:09Z","timestamp":1634388549000},"page":"5814-5826","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Sex differences in acute and long\u2010term brain recovery after concussion"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8481-2505","authenticated-orcid":false,"given":"Nathan W.","family":"Churchill","sequence":"first","affiliation":[{"name":"Keenan Research Centre for Biomedical Science of St. Michael's Hospital  Toronto ON Canada"},{"name":"Neuroscience Research Program St. Michael's Hospital  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Hutchison","sequence":"additional","affiliation":[{"name":"Keenan Research Centre for Biomedical Science of St. Michael's Hospital  Toronto ON Canada"},{"name":"Faculty of Kinesiology and Physical Education, University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Medical Biophysics University of Toronto  Toronto ON Canada"},{"name":"Physical Sciences Platform Sunnybrook Research Institute, Sunnybrook Health Sciences Centre  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom A.","family":"Schweizer","sequence":"additional","affiliation":[{"name":"Keenan Research Centre for Biomedical Science of St. Michael's Hospital  Toronto ON Canada"},{"name":"Neuroscience Research Program St. Michael's Hospital  Toronto ON Canada"},{"name":"Faculty of Medicine (Neurosurgery), University of Toronto  Toronto ON Canada"},{"name":"The Institute of Biomaterials and Biomedical Engineering (IBBME) at the University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092734"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2007.0241"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","unstructured":"Benarroch E. 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