Sex differences in the impact of concussion on complex visuomotor skill performance in working-aged adults with persisting post-concussion symptoms.

Background: Everyday tasks, such as driving, often require cognitive-motor integration (CMI), whereby guiding visual information and motor action are decoupled. Concussion can disrupt the neural networks underlying CMI, resulting in impaired motor performance. Previously, our group has found sex-related differences in the pattern of brain activity controlling CMI in healthy adults, as well as in the pattern of visuomotor skill recovery following concussion. Purpose: Here we examine possible sex differences in concussion symptom impact on rule-based visuomotor performance, accounting for factors such as age and time since injury. Methods: 41 adults (24 female; 29-64 years old, mean 47.2±9.8) having persistent post-concussion symptoms completed symptom questionnaires (RPQ,DHI) and two visuomotor tasks. One direct task involved sliding a cursor into a target on a touchscreen, and one indirect/CMI task involved displacing a cursor on a monitor by moving their hand in a different plane, with reversed cursor visual feedback. Results: We observed a significant main effect of sex on early physical symptom burden (RPQ-3, p