Sex-related differences exist in resting-state quantitative EEG parameters and symptom profiles both before and after sport-related concussion, underscoring the importance of considering biological sex when interpreting rs-QEEG metrics and evaluating post-concussion symptomatology.
Key Findings
Results
At baseline, women college athletes exhibited higher beta1 power (absolute and relative) and higher beta2 power (absolute) compared to men, primarily in the eyes-open condition.
Baseline sample included 115 student-athletes (31 women) aged 16-22 years old
Differences were observed after Benjamini-Hochberg corrections were applied for multiple comparisons
Differences were primarily observed in the eyes-open condition rather than eyes-closed
rs-QEEG was recorded as 10 minutes of resting-state EEG (5 minutes eyes-closed, 5 minutes eyes-open)
Primary outcomes included absolute and relative power across standard frequency bands
Results
At baseline, women athletes reported significantly greater scores than men for anxiety, sleep-arousal, affective, and total post-concussion symptoms.
Self-reported measures of psychological health and post-concussion symptoms were collected at baseline
Symptom differences covered multiple domains: anxiety, sleep-arousal, affective, and total symptoms
The sample included 31 women and 84 men at baseline
Differences remained after Benjamini-Hochberg corrections were applied
Results
No significant associations between rs-QEEG power and symptoms were observed at baseline after adjustment for multiple comparisons.
Associations were tested between rs-QEEG power measures and self-reported symptom scores
Results did not survive Benjamini-Hochberg correction for multiple comparisons
This was assessed in a sample of 115 student-athletes at the baseline visit
Results
Following concussion, no statistically significant main effect of time on rs-QEEG measures was observed after correction for multiple comparisons.
30 athletes (8 women) sustained a sport-related concussion during the 2019-2020 season and were reassessed within 72 hours
Post-concussion assessment used the same 10-minute rs-QEEG protocol and post-concussion symptoms scale as baseline
Theta absolute power showed a decrease across regions in the eyes-open condition at the unadjusted level, but did not survive multiple comparison correction
Concussions occurred during training or competition
Results
After concussion, women continued to show higher beta2 power (absolute and relative) than men.
The post-concussion subsample included 8 women and 22 men
The sex difference in beta2 power persisted from baseline into the post-concussion period
Assessment was conducted within 72 hours following sport-related concussion
Results
An association between alpha absolute power and affective symptoms was observed in women at post-concussion assessment, but did not remain significant in sensitivity analyses.
This association was specific to women in the post-concussion assessment
The finding did not survive sensitivity analyses, limiting its interpretability
The post-concussion women subsample consisted of only 8 athletes, limiting statistical power
Conclusions
The study found that sex-related differences in rs-QEEG parameters and symptom profiles exist both before and after sport-related concussion.
Study included a prospective design with baseline and within-72-hour post-concussion assessments
Sample comprised college athletes aged 16-22 across the 2019-2020 season
Authors conclude that biological sex should be considered when interpreting rs-QEEG metrics and evaluating post-concussion symptomatology
Authors note the clinical utility of rs-QEEG has not yet been established
What This Means
This research suggests that male and female college athletes show measurable differences in brain activity patterns as measured by EEG (electroencephalography) even before they experience a concussion. Specifically, women showed stronger high-frequency brain signals (called beta power) compared to men when measured at rest with their eyes open. Women also reported more symptoms related to anxiety, sleep disturbance, and mood at baseline, before any injury had occurred. These findings imply that what counts as a 'normal' brain activity reading may differ between male and female athletes.
When 30 of these athletes went on to sustain a sports concussion during the season, they were re-tested within 72 hours of injury. The study found no clear, statistically reliable change in overall brain activity patterns from before to after concussion once the researchers accounted for the large number of comparisons being made. However, there was a suggestive decrease in slower brain wave activity (theta power) after concussion that did not meet the strict statistical threshold. Women continued to show higher beta brain activity than men after concussion as well, reinforcing that sex-based differences in brain signals persist through injury.
This research suggests that concussion assessment tools relying on EEG brain signals should not use a single standard for all athletes regardless of sex. Because women showed higher baseline beta activity and more pre-existing symptoms even without a concussion, comparing a female athlete's post-concussion readings to male-based norms could be misleading. The study highlights the need for sex-specific reference values in EEG-based concussion research, though it also cautions that the clinical usefulness of resting-state EEG in concussion management has not yet been firmly established.
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Mariane Doucet, Hélène Brisebois, Anne-Catherine Gauthier-Lamer, Michelle McKerral. (2026). Resting-state quantitative electroencephalography in men and women college athletes before and after sport-related concussion.. Neuroscience. https://doi.org/10.1016/j.neuroscience.2026.03.044