Description
- Abstract:
- Moderate to severe traumatic brain injury (msTBI) is a major cause of long-term disability, cognitive impairment, and increased dementia risk. The CAPCOG-TBI study investigates whether cerebrovascular dysfunction predicts cognitive and functional outcomes up to one year. Sex and hormonal status are also emerging as important modifiers of recovery. This sub-analysis examines whether menopausal status modifies early neurocognitive recovery. Participants with msTBI were recruited within one-week post-injury from Texas Health Resources and Parkland Hospital and stratified into premenopausal women (n=9), postmenopausal women (n=4), and men (n=20), with menopause inferred by age. Cognitive outcomes were assessed at 3 months using the NIH Toolbox battery. Admission Glasgow Coma Scale (GCS) scores indexed injury severity. Group comparisons were conducted via ANCOVA in R, controlling for GCS at admission. The Dimensional Change Card Sort (DCCS) percentile was significantly lower, 20 points lower on average, in the pre-menopausal group after adjusting for GCS (p ≈ 0.027), suggesting a robust difference in executive-switching performance. Other cognitive domains were nonsignificant after controlling for GCS, implying unadjusted differences reflected baseline severity rather than true group effects. While counterintuitive, these results reveal that pre-menopausal women may have a more challenging recovery post-TBI, potentially due to their increased reliance on estradiol for neuroprotection and the acute disruption of the HPG axis impairing cognitive recovery. Additionally, higher baseline cognitive function in pre-menopausal women may make subtle post-TBI deficits more detectable, and the timing of injury relative to hormonal and circulatory fluctuations can modulate neuro-inflammatory responses and recovery trajectories.
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Citation
Celine Wei, Danilo Cardim, and Kan Ding,
"Cognitive Outcomes Post-TBI Recovery: Increased Vulnerability in Pre-menopausal Women"
(2025).
Student Neurosurgery/Neurology Research Conference.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/77cx-3d02
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Student Neurosurgery/Neurology Research Conference
Brown University Department of Neurosurgery and Department of Neurology and Warren Alpert Medical School annually hosts the Student Neurosurgery/Neurology Research Conference, a national conference for medical students conducting research in neurosurgery/neurology or related neuroscience fields....