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Huibregtse ME, Cooper JJ, Ross DA. Hieroglyphs and Head Injuries: Sex Differences in Traumatic Brain Injury. Biol Psychiatry 2024; 95:e25-e27. [PMID: 38811076 DOI: 10.1016/j.biopsych.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 05/31/2024]
Affiliation(s)
- Megan E Huibregtse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
| | - Joseph J Cooper
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - David A Ross
- Department of Psychiatry, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
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2
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Guglielmi V, Dalle Grave R, Leonetti F, Solini A. Female obesity: clinical and psychological assessment toward the best treatment. Front Endocrinol (Lausanne) 2024; 15:1349794. [PMID: 38765954 PMCID: PMC11099266 DOI: 10.3389/fendo.2024.1349794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Obesity is a heterogeneous condition which results from complex interactions among sex/gender, sociocultural, environmental, and biological factors. Obesity is more prevalent in women in most developed countries, and several clinical and psychological obesity complications show sex-specific patterns. Females differ regarding fat distribution, with males tending to store more visceral fat, which is highly correlated to increased cardiovascular risk. Although women are more likely to be diagnosed with obesity and appear more motivated to lose weight, as confirmed by their greater representation in clinical trials, males show better outcomes in terms of body weight and intra-abdominal fat loss and improvements in the metabolic risk profile. However, only a few relatively recent studies have investigated gender differences in obesity, and sex/gender is rarely considered in the assessment and management of the disease. This review summarizes the evidence of gender differences in obesity prevalence, contributing factors, clinical complications, and psychological challenges. In addition, we explored gender differences in response to obesity treatments in the specific context of new anti-obesity drugs.
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Affiliation(s)
- Valeria Guglielmi
- Unit of Internal Medicine and Obesity Center, Department of Systems Medicine, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, VR, Italy
| | - Frida Leonetti
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
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3
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Kropp DR, Rainville JR, Glover ME, Tsyglakova M, Samanta R, Hage TR, Carlson AE, Clinton SM, Hodes GE. Chronic variable stress leads to sex specific gut microbiome alterations in mice. Brain Behav Immun Health 2024; 37:100755. [PMID: 38618010 PMCID: PMC11010943 DOI: 10.1016/j.bbih.2024.100755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/17/2024] [Indexed: 04/16/2024] Open
Abstract
Stress has been implicated in the incidence and severity of psychiatric and gastrointestinal disorders. The immune system is capable of modulating the activity and composition of the gut following stress and vice versa. In this study we sought to examine the sequential relationship between immune signaling and microbiome composition occurring in male and female mice over time using a variable stress paradigm. Tissue was collected prior to, during, and after the stress paradigm from the same mice. Cytokines from plasma and brain were quantified using a multiplexed cytokine assay. Fecal samples were collected at the same timepoints and 16S rRNA amplicon sequencing was performed to determine the relative abundance of microbiota residing in the guts of stressed and control mice. We found sex differences in the response of the gut microbiota to stress following 28 days of chronic variable stress but not 6 days of sub-chronic variable stress. Immune activation was quantified in the nucleus accumbens immediately following Sub-chronic variable when alterations of gut composition had not yet occurred. In both sexes, 28 days of stress induced significant changes in the proportion of Erysipelotrichaceae and Lactobacillaceae, but in opposite directions for male and female mice. Alterations to the gut microbiome in both sexes were associated with changes in cytokines related to eosinophilic immune activity. Our use of an animal stress model reveals the immune mechanisms that may underly changes in gut microbiome composition during and after stress. This study reveals potential drug targets and microbiota of interest for the intervention of stress related conditions.
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Affiliation(s)
- Dawson R. Kropp
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Jennifer R. Rainville
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Matthew E. Glover
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Mariya Tsyglakova
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Rupabali Samanta
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Tamer R. Hage
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Audrey E. Carlson
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Sarah M. Clinton
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Georgia E. Hodes
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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4
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Gompers A, Olivier MT, Maney DL. Training in the implementation of sex and gender research policies: an evaluation of publicly available online courses. Biol Sex Differ 2024; 15:32. [PMID: 38570790 PMCID: PMC10988906 DOI: 10.1186/s13293-024-00610-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/26/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Recently implemented research policies requiring the inclusion of females and males have created an urgent need for effective training in how to account for sex, and in some cases gender, in biomedical studies. METHODS Here, we evaluated three sets of publicly available online training materials on this topic: (1) Integrating Sex & Gender in Health Research from the Canadian Institutes of Health Research (CIHR); (2) Sex as a Biological Variable: A Primer from the United States National Institutes of Health (NIH); and (3) The Sex and Gender Dimension in Biomedical Research, developed as part of "Leading Innovative measures to reach gender Balance in Research Activities" (LIBRA) from the European Commission. We reviewed each course with respect to their coverage of (1) What is required by the policy; (2) Rationale for the policy; (3) Handling of the concepts "sex" and "gender;" (4) Research design and analysis; and (5) Interpreting and reporting data. RESULTS All three courses discussed the importance of including males and females to better generalize results, discover potential sex differences, and tailor treatments to men and women. The entangled nature of sex and gender, operationalization of sex, and potential downsides of focusing on sex more than other sources of variation were minimally discussed. Notably, all three courses explicitly endorsed invalid analytical approaches that produce bias toward false positive discoveries of difference. CONCLUSIONS Our analysis suggests a need for revised or new training materials that incorporate four major topics: precise operationalization of sex, potential risks of over-emphasis on sex as a category, recognition of gender and sex as complex and entangled, and rigorous study design and data analysis.
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Affiliation(s)
- Annika Gompers
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Psychology, Emory University, Atlanta, GA, USA
| | | | - Donna L Maney
- Department of Psychology, Emory University, Atlanta, GA, USA.
- Harvard-Radcliffe Institute, Cambridge, MA, USA.
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5
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Wang X, Xia Y, Yan R, Sun H, Huang Y, Xia Q, Sheng J, You W, Hua L, Tang H, Yao Z, Lu Q. Sex differences in anhedonia in bipolar depression: a resting-state fMRI study. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01765-4. [PMID: 38558145 DOI: 10.1007/s00406-024-01765-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/13/2024] [Indexed: 04/04/2024]
Abstract
Previous studies about anhedonia symptoms in bipolar depression (BD) ignored the unique role of gender on brain function. This study aims to explore the regional brain neuroimaging features of BD with anhedonia and the sex differences in these patients. The resting-fMRI by applying fractional amplitude of low-frequency fluctuation (fALFF) method was estimated in 263 patients with BD (174 high anhedonia [HA], 89 low anhedonia [LA]) and 213 healthy controls. The effects of two different factors in patients with BD were analyzed using a 3 (group: HA, LA, HC) × 2 (sex: male, female) ANOVA. The fALFF values were higher in the HA group than in the LA group in the right medial cingulate gyrus and supplementary motor area. For the sex-by-group interaction, the fALFF values of the right hippocampus, left medial occipital gyrus, right insula, and bilateral medial cingulate gyrus were significantly higher in HA males than in LA males but not females. These results suggested that the pattern of high activation could be a marker of anhedonia symptoms in BD males, and the sex differences should be considered in future studies of BD with anhedonia symptoms.
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Affiliation(s)
- Xiaoqin Wang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Yi Xia
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Rui Yan
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Hao Sun
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
- Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, China
| | - Yinghong Huang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
- Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, China
| | - Qiudong Xia
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Junling Sheng
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Wei You
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Lingling Hua
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Hao Tang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Zhijian Yao
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China.
- Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, China.
- School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing, 210096, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing, 210096, China.
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China.
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Sanchis-Segura C, Wilcox RR. From means to meaning in the study of sex/gender differences and similarities. Front Neuroendocrinol 2024; 73:101133. [PMID: 38604552 DOI: 10.1016/j.yfrne.2024.101133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/12/2024] [Accepted: 04/07/2024] [Indexed: 04/13/2024]
Abstract
The incorporation of sex and gender (S/G) related factors is commonly acknowledged as a necessary step to advance towards more personalized diagnoses and treatments for somatic, psychiatric, and neurological diseases. Until now, most attempts to integrate S/G-related factors have been reduced to identifying average differences between females and males in behavioral/ biological variables. The present commentary questions this traditional approach by highlighting three main sets of limitations: 1) Issues stemming from the use of classic parametric methods to compare means; 2) challenges related to the ability of means to accurately represent the data within groups and differences between groups; 3) mean comparisons impose a results' binarization and a binary theoretical framework that precludes advancing towards precision medicine. Alternative methods free of these limitations are also discussed. We hope these arguments will contribute to reflecting on how research on S/G factors is conducted and could be improved.
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Affiliation(s)
- Carla Sanchis-Segura
- Departament de Psicologia bàsica, Clinica i Psicobiologia, Universitat Jaume I, Castelló, Spain.
| | - Rand R Wilcox
- Department of Psychology, University of Southern California, Los Angeles, USA
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Doucette MM, Kwan H, Premji Z, Duchesne A, Gawryluk JR, Garcia-Barrera MA. Integration of sex/gender and utilization of ecological Momentary assessment of cognition in clinical populations: a scoping review. Clin Neuropsychol 2024:1-32. [PMID: 38533627 DOI: 10.1080/13854046.2024.2333579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
Objectives: We aimed to describe the methods of smartphone-based cognitive ecological momentary assessment designs in clinical populations, with an intention to evaluate how the role of sex and/or gender has been considered in the design and analyses, particularly including female-specific physiology. Methods: This scoping review was conducted based on JBI scoping review methodology. On March 2nd, 2023, we searched for literature across four databases. Screening of the results and data extraction were conducted in duplicate according to the a priori methods in the pre-registered protocol. Results: 31 articles were included in this review. Participants ranged in age from 15-85 years old with various clinical disorders. Prompts were given between 1-7 times per day for 7-84 days. Executive function was the most frequently assessed cognitive domain. Over half the studies (n = 17, 55%) did not investigate the effects of sex and/or gender, and only one study considered the impact of hormonal therapy. Many studies (n = 14, 45%) used sex and gender interchangeably or incorrectly. Conclusions: Studies varied in design, with heterogeneity in the reporting of methodological information. The lack of attention to sex/gender on neuropsychological outcomes can lead to confusion and contradiction regarding its potential impact on cognition in clinical populations. This may hinder the identification of effective interventions for those assigned female at birth who have been overlooked or considered indistinguishable from their male counterparts. Given the well-documented impact of sex/gender on cognition, it is essential that future neuropsychological research, especially EMA-based studies, prioritize investigating sex/gender to ensure better outcomes for all.
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Affiliation(s)
| | - Heather Kwan
- Department of Psychology, University of Victoria, British Columbia, Canada
- Institute on Aging & Lifelong Health, University of Victoria, British Columbia, Canada
| | - Zahra Premji
- Libraries, University of Victoria, British Columbia, Canada
| | - Annie Duchesne
- Department of Psychology, University of Northern British Columbia, British Columbia, Canada
- Department of Psychology, Université du Québec à Trois-Rivières, Quebec, Canada
| | - Jodie R Gawryluk
- Department of Psychology, University of Victoria, British Columbia, Canada
- Institute on Aging & Lifelong Health, University of Victoria, British Columbia, Canada
- Division of Medical Sciences, University of Victoria, British Columbia, Canada
| | - Mauricio A Garcia-Barrera
- Department of Psychology, University of Victoria, British Columbia, Canada
- Institute on Aging & Lifelong Health, University of Victoria, British Columbia, Canada
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Thränhardt P, Veselaj A, Friedli C, Wagner F, Marti S, Diem L, Hammer H, Radojewski P, Wiest R, Chan A, Hoepner R, Salmen A. Sex differences in multiple sclerosis relapse presentation and outcome: a retrospective, monocentric study of 134 relapse events. Ther Adv Neurol Disord 2024; 17:17562864241237853. [PMID: 38532803 PMCID: PMC10964455 DOI: 10.1177/17562864241237853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/07/2024] [Indexed: 03/28/2024] Open
Abstract
Background Reporting of sex-specific analyses in multiple sclerosis (MS) is sparse. Disability accrual results from relapses (relapse-associated worsening) and independent thereof (progression independent of relapses). Objectives A population of MS patients during relapse treated per standard of care was analyzed for sex differences and short-term relapse outcome (3-6 months) as measured by Expanded Disability Status Scale (EDSS) change. Design Single-center retrospective study. Methods We analyzed 134 MS relapses between March 2016 and August 2020. All events required relapse treatment (steroids and/or plasma exchange). Demographic, disease, and paraclinical characteristics [cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI)] were displayed separated by sex. Multivariable linear regression was run to identify factors associated with short-term EDSS change. Results Mean age at relapse was 38.4 years (95% confidence interval: 36.3-40.4) with a proportion of 71.6% women in our cohort. Smoking was more than twice as prevalent in men (65.8%) than women (32.3%). In- and after-relapse EDSSs were higher in men [men: 3.3 (2.8-3.9), women: 2.7 (2.4-3.0); men: 3.0 (1.3-3.6); women: 1.8 (1.5-2.1)] despite similar relapse intervention. Paraclinical parameters revealed no sex differences. Our primary model identified female sex, younger age, and higher EDSS at relapse to be associated with EDSS improvement. A higher immunoglobulin G (IgG) quotient (CSF/serum) was associated with poorer short-term outcome [mean days between first relapse treatment and last EDSS assessment 130.2 (79.3-181.0)]. Conclusion Sex and gender differences are important in outcome analyses of MS relapses. Effective treatment regimens need to respect putative markers for a worse outcome to modify long-term prognosis such as clinical and demographic variables, complemented by intrathecal IgG synthesis. Prospective trials should be designed to address these differences and confirm our results.
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Affiliation(s)
- Pauline Thränhardt
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Admirim Veselaj
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Friedli
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Neurology, Waikato Hospital, Hamilton, New Zealand
| | - Franca Wagner
- University Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Translational Imaging Center, Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Stefanie Marti
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lara Diem
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Helly Hammer
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Piotr Radojewski
- University Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Translational Imaging Center, Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Roland Wiest
- University Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Translational Imaging Center, Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Andrew Chan
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Robert Hoepner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anke Salmen
- Department of Neurology, St Josef-Hospital Bochum, Ruhr-University Bochum, Gudrunstrasse 56, Bochum 44791, GermanyDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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9
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Pape M, Miyagi M, Ritz SA, Boulicault M, Richardson SS, Maney DL. Sex contextualism in laboratory research: Enhancing rigor and precision in the study of sex-related variables. Cell 2024; 187:1316-1326. [PMID: 38490173 DOI: 10.1016/j.cell.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/21/2023] [Accepted: 02/08/2024] [Indexed: 03/17/2024]
Abstract
Understanding sex-related variation in health and illness requires rigorous and precise approaches to revealing underlying mechanisms. A first step is to recognize that sex is not in and of itself a causal mechanism; rather, it is a classification system comprising a set of categories, usually assigned according to a range of varying traits. Moving beyond sex as a system of classification to working with concrete and measurable sex-related variables is necessary for precision. Whether and how these sex-related variables matter-and what patterns of difference they contribute to-will vary in context-specific ways. Second, when researchers incorporate these sex-related variables into research designs, rigorous analytical methods are needed to allow strongly supported conclusions. Third, the interpretation and reporting of sex-related variation require care to ensure that basic and preclinical research advance health equity for all.
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Affiliation(s)
- Madeleine Pape
- Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Miriam Miyagi
- Center for Computational Molecular Biology, Brown University, Providence, RI, USA
| | - Stacey A Ritz
- Department of Pathology & Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Marion Boulicault
- Department of Philosophy, University of Edinburgh, Edinburgh, Scotland
| | - Sarah S Richardson
- Department of the History of Science, Harvard University, Cambridge, MA, USA; Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA, USA
| | - Donna L Maney
- Department of Psychology, Emory University, Atlanta, GA, USA; Harvard-Radcliffe Institute, Harvard University, Cambridge, MA, USA
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10
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Raimondi GM, Eng AK, Kenny MP, Britting MA, Ostroff LE. Track-by-Day: A standardized approach to estrous cycle monitoring in biobehavioral research. Behav Brain Res 2024; 461:114860. [PMID: 38216058 DOI: 10.1016/j.bbr.2024.114860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/03/2024] [Accepted: 01/06/2024] [Indexed: 01/14/2024]
Abstract
Despite known sex differences in brain function, female subjects are underrepresented in preclinical neuroscience research. This is driven in part by concerns about variability arising from estrous cycle-related hormone fluctuations, especially in fear- and anxiety-related research where there are conflicting reports as to whether and how the cycle influences behavior. The inconsistency may arise from a lack of common standards for tracking and reporting the cycle as opposed to inherent unpredictability in the cycle itself. The rat estrous cycle is conventionally tracked by assigning vaginal cytology smears to one of four qualitatively-defined stages. Although the cytology stages are of unequal length, the stage names are often, but not always, used to refer to the four cycle days. Subjective staging criteria and inconsistent use of terminology are not necessarily a problem in research on the cycle itself, but can lead to irreproducibility in neuroscience studies that treat the stages as independent grouping factors. We propose the explicit use of cycle days as independent variables, which we term Track-by-Day to differentiate it from traditional stage-based tracking, and that days be indexed to the only cytology feature that is a direct and rapid consequence of a hormonal event: a cornified cell layer formed in response to the pre-ovulatory 17β-estradiol peak. Here we demonstrate that cycle length is robustly regular with this method, and that the method outperforms traditional staging in detecting estrous cycle effects on Pavlovian fear conditioning and on a separate proxy for hormonal changes, uterine histology.
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Affiliation(s)
- Gianna M Raimondi
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA; Connecticut Institute for the Brain and Cognitive Science, University of Connecticut, Storrs, CT, USA
| | - Ashley K Eng
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
| | - Murphy P Kenny
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
| | - Madison A Britting
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
| | - Linnaea E Ostroff
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA; Connecticut Institute for the Brain and Cognitive Science, University of Connecticut, Storrs, CT, USA; Institute of Materials Science, University of Connecticut, Storrs, CT, USA.
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11
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Kirby ED, Andrushko JW, Rinat S, D'Arcy RCN, Boyd LA. Investigating female versus male differences in white matter neuroplasticity associated with complex visuo-motor learning. Sci Rep 2024; 14:5951. [PMID: 38467763 PMCID: PMC10928090 DOI: 10.1038/s41598-024-56453-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 03/06/2024] [Indexed: 03/13/2024] Open
Abstract
Magnetic resonance imaging (MRI) has increasingly been used to characterize structure-function relationships during white matter neuroplasticity. Biological sex differences may be an important factor that affects patterns of neuroplasticity, and therefore impacts learning and rehabilitation. The current study examined a participant cohort before and after visuo-motor training to characterize sex differences in microstructural measures. The participants (N = 27) completed a 10-session (4 week) complex visuo-motor training task with their non-dominant hand. All participants significantly improved movement speed and their movement speed variability over the training period. White matter neuroplasticity in females and males was examined using fractional anisotropy (FA) and myelin water fraction (MWF) along the cortico-spinal tract (CST) and the corpus callosum (CC). FA values showed significant differences in the middle portion of the CST tract (nodes 38-51) across the training period. MWF showed a similar cluster in the inferior portion of the tract (nodes 18-29) but did not reach significance. Additionally, at baseline, males showed significantly higher levels of MWF measures in the middle body of the CC. Combining data from females and males would have resulted in reduced sensitivity, making it harder to detect differences in neuroplasticity. These findings offer initial insights into possible female versus male differences in white matter neuroplasticity during motor learning. This warrants investigations into specific patterns of white matter neuroplasticity for females versus males across the lifespan. Understanding biological sex-specific differences in white matter neuroplasticity may have significant implications for the interpretation of change associated with learning or rehabilitation.
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Affiliation(s)
- Eric D Kirby
- BrainNet, Health and Technology District, Vancouver, BC, Canada
- Faculty of Individualized Interdisciplinary Studies, Simon Fraser University, Burnaby, BC, Canada
- Faculty of Science, Simon Fraser University, Burnaby, BC, Canada
| | - Justin W Andrushko
- DM Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK
- Brain Behaviour Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Shie Rinat
- Brain Behaviour Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Ryan C N D'Arcy
- BrainNet, Health and Technology District, Vancouver, BC, Canada.
- DM Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
- Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada.
| | - Lara A Boyd
- DM Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
- Brain Behaviour Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Wierenga LM, Ruigrok A, Aksnes ER, Barth C, Beck D, Burke S, Crestol A, van Drunen L, Ferrara M, Galea LAM, Goddings AL, Hausmann M, Homanen I, Klinge I, de Lange AM, Geelhoed-Ouwerkerk L, van der Miesen A, Proppert R, Rieble C, Tamnes CK, Bos MGN. Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100283. [PMID: 38312851 PMCID: PMC10837069 DOI: 10.1016/j.bpsgos.2023.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 02/06/2024] Open
Abstract
There are prominent sex/gender differences in the prevalence, expression, and life span course of mental health and neurodiverse conditions. However, the underlying sex- and gender-related mechanisms and their interactions are still not fully understood. This lack of knowledge has harmful consequences for those with mental health problems. Therefore, we set up a cocreation session in a 1-week workshop with a multidisciplinary team of 25 researchers, clinicians, and policy makers to identify the main barriers in sex and gender research in the neuroscience of mental health. Based on this work, here we provide recommendations for methodologies, translational research, and stakeholder involvement. These include guidelines for recording, reporting, analysis beyond binary groups, and open science. Improved understanding of sex- and gender-related mechanisms in neuroscience may benefit public health because this is an important step toward precision medicine and may function as an archetype for studying diversity.
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Affiliation(s)
- Lara Marise Wierenga
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Amber Ruigrok
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Eira Ranheim Aksnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dani Beck
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Sarah Burke
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Arielle Crestol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lina van Drunen
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Maria Ferrara
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Liisa Ann Margaret Galea
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Lise Goddings
- University College London Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Markus Hausmann
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Inka Homanen
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Ineke Klinge
- Dutch Society for Gender & Health, the Netherlands
- Gendered Innovations at European Commission, Brussels, Belgium
| | - Ann-Marie de Lange
- Laboratory for Research in Neuroimaging, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Lineke Geelhoed-Ouwerkerk
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
| | - Anna van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ricarda Proppert
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Carlotta Rieble
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Christian Krog Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Marieke Geerte Nynke Bos
- Institute of Psychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
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13
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Cherian CM, Reeves HR, De Silva D, Tsao S, Marshall KE, Rideout EJ. Consideration of sex as a biological variable in diabetes research across twenty years. Biol Sex Differ 2024; 15:19. [PMID: 38409052 PMCID: PMC10895746 DOI: 10.1186/s13293-024-00595-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Sex differences exist in the risk of developing type 1 and type 2 diabetes, and in the risk of developing diabetes-associated complications. Sex differences in glucose homeostasis, islet and β cell biology, and peripheral insulin sensitivity have also been reported. Yet, we lack detailed information on the mechanisms underlying these differences, preventing the development of sex-informed therapeutic strategies for persons living with diabetes. To chart a path toward greater inclusion of biological sex as a variable in diabetes research, we first need a detailed assessment of common practices in the field. METHODS We developed a scoring system to evaluate the inclusion of biological sex in manuscripts published in Diabetes, a journal published by the American Diabetes Association. We chose Diabetes as this journal focuses solely on diabetes and diabetes-related research, and includes manuscripts that use both clinical and biomedical approaches. We scored papers published across 3 years within a 20-year period (1999, 2009, 2019), a timeframe that spans the introduction of funding agency and journal policies designed to improve the consideration of biological sex as a variable. RESULTS Our analysis showed fewer than 15% of papers used sex-based analysis in even one figure across all study years, a trend that was reproduced across journal-defined categories of diabetes research (e.g., islet studies, signal transduction). Single-sex studies accounted for approximately 40% of all manuscripts, of which > 87% used male subjects only. While we observed a modest increase in the overall inclusion of sex as a biological variable during our study period, our data highlight significant opportunities for improvement in diabetes research practices. We also present data supporting a positive role for journal policies in promoting better consideration of biological sex in diabetes research. CONCLUSIONS Our analysis provides significant insight into common practices in diabetes research related to the consideration of biological sex as a variable. Based on our analysis we recommend ways that diabetes researchers can improve inclusion of biological sex as a variable. In the long term, improved practices will reveal sex-specific mechanisms underlying diabetes risk and complications, generating knowledge to enable the development of sex-informed prevention and treatment strategies.
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Affiliation(s)
- Celena M Cherian
- Department of Cellular and Physiological Sciences, Life Sciences Institute, The University of British Columbia, Vancouver, Canada
| | - Hayley R Reeves
- Department of Cellular and Physiological Sciences, Life Sciences Institute, The University of British Columbia, Vancouver, Canada
- School of Molecular Biosciences, University of Glasgow, Glasgow, UK
| | - Duneesha De Silva
- Department of Cellular and Physiological Sciences, Life Sciences Institute, The University of British Columbia, Vancouver, Canada
- Department of Orthopaedics, The University of British Columbia, Vancouver, Canada
| | - Serena Tsao
- Department of Cellular and Physiological Sciences, Life Sciences Institute, The University of British Columbia, Vancouver, Canada
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
| | - Katie E Marshall
- Department of Zoology, The University of British Columbia, Vancouver, Canada
| | - Elizabeth J Rideout
- Department of Cellular and Physiological Sciences, Life Sciences Institute, The University of British Columbia, Vancouver, Canada.
- Life Sciences Center, 2350 Health Sciences Mall (RM3308), Vancouver, BC, V6T 1Z3, Canada.
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14
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Melbourne JK, Wooden JI, Carlson ER, Anasooya Shaji C, Nixon K. Neuroimmune Activation and Microglia Reactivity in Female Rats Following Alcohol Dependence. Int J Mol Sci 2024; 25:1603. [PMID: 38338883 PMCID: PMC10855949 DOI: 10.3390/ijms25031603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 02/12/2024] Open
Abstract
The rates of alcohol use disorder among women are growing, yet little is known about how the female brain is affected by alcohol. The neuroimmune system, and specifically microglia, have been implicated in mediating alcohol neurotoxicity, but most preclinical studies have focused on males. Further, few studies have considered changes to the microglial phenotype when examining the effects of ethanol on brain structure and function. Therefore, we quantified microglial reactivity in female rats using a binge model of alcohol dependence, assessed through morphological and phenotypic marker expression, coupled with regional cytokine levels. In a time- and region-dependent manner, alcohol altered the microglial number and morphology, including the soma and process area, and the overall complexity within the corticolimbic regions examined, but no significant increases in the proinflammatory markers MHCII or CD68 were observed. The majority of cytokine and growth factor levels examined were similarly unchanged. However, the expression of the proinflammatory cytokine TNFα was increased, and the anti-inflammatory IL-10, decreased. Thus, female rats showed subtle differences in neuroimmune reactivity compared to past work in males, consistent with reports of enhanced neuroimmune responses in females across the literature. These data suggest that specific neuroimmune reactions in females may impact their susceptibility to alcohol neurotoxicity and other neurodegenerative events with microglial contributions.
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Affiliation(s)
| | | | | | | | - Kimberly Nixon
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, USA; (J.K.M.)
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15
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Saha P, Weigle IQ, Slimmon N, Poli PB, Patel P, Zhang X, Cao Y, Michalkiewicz J, Gomm A, Zhang C, Tanzi RE, Dylla N, Al-Hendy A, Sisodia SS. Early modulation of the gut microbiome by female sex hormones alters amyloid pathology and microglial function. Sci Rep 2024; 14:1827. [PMID: 38246956 PMCID: PMC10800351 DOI: 10.1038/s41598-024-52246-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
It is well-established that women are disproportionately affected by Alzheimer's disease. The mechanisms underlying this sex-specific disparity are not fully understood, but several factors that are often associated-including interactions of sex hormones, genetic factors, and the gut microbiome-likely contribute to the disease's etiology. Here, we have examined the role of sex hormones and the gut microbiome in mediating Aβ amyloidosis and neuroinflammation in APPPS1-21 mice. We report that postnatal gut microbiome perturbation in female APPPS1-21 mice leads to an elevation in levels of circulating estradiol. Early stage ovariectomy (OVX) leads to a reduction of plasma estradiol that is correlated with a significant alteration of gut microbiome composition and reduction in Aβ pathology. On the other hand, supplementation of OVX-treated animals with estradiol restores Aβ burden and influences gut microbiome composition. The reduction of Aβ pathology with OVX is paralleled by diminished levels of plaque-associated microglia that acquire a neurodegenerative phenotype (MGnD-type) while estradiol supplementation of OVX-treated animals leads to a restoration of activated microglia around plaques. In summary, our investigation elucidates the complex interplay between sex-specific hormonal modulations, gut microbiome dynamics, metabolic perturbations, and microglial functionality in the pathogenesis of Alzheimer's disease.
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Affiliation(s)
- Piyali Saha
- Department of Neurobiology, The University of Chicago, Chicago, IL, USA
| | - Ian Q Weigle
- Department of Neurobiology, The University of Chicago, Chicago, IL, USA
| | - Nicholas Slimmon
- School of Biomedical Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Pedro Blauth Poli
- Department of Neurobiology, The University of Chicago, Chicago, IL, USA
| | - Priyam Patel
- Center for Genetic Medicine, Northwestern University, Chicago, IL, USA
| | - Xiaoqiong Zhang
- Department of Neurobiology, The University of Chicago, Chicago, IL, USA
| | - Yajun Cao
- Genomic Facility, The University of Chicago, Chicago, IL, USA
| | - Julia Michalkiewicz
- Department of Physiology and Biophysics, The University of Illinois, Chicago, IL, USA
| | - Ashley Gomm
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Can Zhang
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Rudolph E Tanzi
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Nicholas Dylla
- Duchossois Family Institute, The University of Chicago, Chicago, IL, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL, USA
| | - Sangram S Sisodia
- Department of Neurobiology, The University of Chicago, Chicago, IL, USA.
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16
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Thornton HF, LaHue SC, Bove R, Waters J, O'Neal MA, Bui E. Emerging Subspecialties in Neurology: Women's Neurology. Neurology 2024; 102:e208009. [PMID: 38165380 PMCID: PMC10834140 DOI: 10.1212/wnl.0000000000208009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/27/2023] [Indexed: 01/03/2024] Open
Abstract
The influence of sex and gender on neurologic disease has become increasingly recognized in science and medicine. This is evident across a woman's lifespan especially during periods of hormonal transitions. Leaders in neurology have advocated for the importance of sex and gender-enriched clinical care, education, and research. The scope of women's neurology spans across a woman's life including puberty, adolescence, peripartum care, menopause, and aging. Women's neurology is a new subspecialty that aligns with a specific patient population and intersects with established neurology subspecialties and other specialties such as obstetrics, maternal fetal medicine, endocrinology, and psychiatry. Its establishment and collaboration with existing and emerging fields enables a more comprehensive approach to neurologic illness through the lens of sex and gender. Women's neurology is rapidly evolving through increased focus at academic centers, including expanded women's neurology curricula, dedicated women's neurology fellowship programs, improved understanding of sex and gender issues in neurosciences, and expansion of therapeutic options. Herein, we describe the history of the women's neurology field, emerging need for women's neurology specialists, information about training and career opportunities, and future directions.
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Affiliation(s)
- Hayley F Thornton
- From the Department of Clinical Neurosciences (H.F.T.), Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Neurology (S.C.L., R.B.), and UCSF Weill Institute for Neurosciences (S.C.L., R.B.), Department of Neurology, University of California, San Francisco; Buck Institute for Research on Aging (S.C.L.), Novato, CA; Department of Neurology (J.W.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.A.O.N.), Brigham and Women's Hospital, Boston, MA; Division of Neurology (E.B.), Department of Medicine, University of Toronto; and Krembil Brain Institute (E.B.), University Health Network, Toronto, Ontario, Canada
| | - Sara C LaHue
- From the Department of Clinical Neurosciences (H.F.T.), Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Neurology (S.C.L., R.B.), and UCSF Weill Institute for Neurosciences (S.C.L., R.B.), Department of Neurology, University of California, San Francisco; Buck Institute for Research on Aging (S.C.L.), Novato, CA; Department of Neurology (J.W.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.A.O.N.), Brigham and Women's Hospital, Boston, MA; Division of Neurology (E.B.), Department of Medicine, University of Toronto; and Krembil Brain Institute (E.B.), University Health Network, Toronto, Ontario, Canada
| | - Riley Bove
- From the Department of Clinical Neurosciences (H.F.T.), Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Neurology (S.C.L., R.B.), and UCSF Weill Institute for Neurosciences (S.C.L., R.B.), Department of Neurology, University of California, San Francisco; Buck Institute for Research on Aging (S.C.L.), Novato, CA; Department of Neurology (J.W.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.A.O.N.), Brigham and Women's Hospital, Boston, MA; Division of Neurology (E.B.), Department of Medicine, University of Toronto; and Krembil Brain Institute (E.B.), University Health Network, Toronto, Ontario, Canada
| | - Janet Waters
- From the Department of Clinical Neurosciences (H.F.T.), Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Neurology (S.C.L., R.B.), and UCSF Weill Institute for Neurosciences (S.C.L., R.B.), Department of Neurology, University of California, San Francisco; Buck Institute for Research on Aging (S.C.L.), Novato, CA; Department of Neurology (J.W.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.A.O.N.), Brigham and Women's Hospital, Boston, MA; Division of Neurology (E.B.), Department of Medicine, University of Toronto; and Krembil Brain Institute (E.B.), University Health Network, Toronto, Ontario, Canada
| | - Mary A O'Neal
- From the Department of Clinical Neurosciences (H.F.T.), Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Neurology (S.C.L., R.B.), and UCSF Weill Institute for Neurosciences (S.C.L., R.B.), Department of Neurology, University of California, San Francisco; Buck Institute for Research on Aging (S.C.L.), Novato, CA; Department of Neurology (J.W.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.A.O.N.), Brigham and Women's Hospital, Boston, MA; Division of Neurology (E.B.), Department of Medicine, University of Toronto; and Krembil Brain Institute (E.B.), University Health Network, Toronto, Ontario, Canada
| | - Esther Bui
- From the Department of Clinical Neurosciences (H.F.T.), Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Neurology (S.C.L., R.B.), and UCSF Weill Institute for Neurosciences (S.C.L., R.B.), Department of Neurology, University of California, San Francisco; Buck Institute for Research on Aging (S.C.L.), Novato, CA; Department of Neurology (J.W.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.A.O.N.), Brigham and Women's Hospital, Boston, MA; Division of Neurology (E.B.), Department of Medicine, University of Toronto; and Krembil Brain Institute (E.B.), University Health Network, Toronto, Ontario, Canada
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17
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Kundakovic M, Tickerhoof M. Epigenetic mechanisms underlying sex differences in the brain and behavior. Trends Neurosci 2024; 47:18-35. [PMID: 37968206 PMCID: PMC10841872 DOI: 10.1016/j.tins.2023.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/21/2023] [Accepted: 09/26/2023] [Indexed: 11/17/2023]
Abstract
Sex differences are found across brain regions, behaviors, and brain diseases. Sexual differentiation of the brain is initiated prenatally but it continues throughout life, as a result of the interaction of three major factors: gonadal hormones, sex chromosomes, and the environment. These factors are thought to act, in part, via epigenetic mechanisms which control chromatin and transcriptional states in brain cells. In this review, we discuss evidence that epigenetic mechanisms underlie sex-specific neurobehavioral changes during critical organizational periods, across the estrous cycle, and in response to diverse environments throughout life. We further identify future directions for the field that will provide novel mechanistic insights into brain sex differences, inform brain disease treatments and women's brain health in particular, and apply to people across genders.
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Affiliation(s)
- Marija Kundakovic
- Department of Biological Sciences, Fordham University, Bronx, NY 10458, USA.
| | - Maria Tickerhoof
- Department of Biological Sciences, Fordham University, Bronx, NY 10458, USA
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18
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Berardelli I, Aguglia A, Amerio A, Sarubbi S, Rogante E, Trocchia MA, Zelletta D, Longhini L, Erbuto D, Pastorino F, Lamis DA, Innamorati M, Serafini G, Pompili M. Characterization of Psychiatric Inpatients: The Role of Gender Differences in Clinical and Pharmacological Patterns. J Psychiatr Pract 2024; 30:2-12. [PMID: 38227722 DOI: 10.1097/pra.0000000000000756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Severe mental disorders that require hospitalization are disabling conditions that contribute to the burden of mental diseases. They pose increased clinical challenges and highlight the need to thoroughly explore variables emerging from daily clinical practice. In this study, we assessed to what extent gender differences may characterize a large population of psychiatric inpatients. METHODS We conducted a cross-sectional study in 2 Italian teaching medical centers, which included 2358 patients who were consecutively admitted to the psychiatric emergency units. We explored and characterized gender differences for variables such as prevalence of psychiatric diagnosis, presence of suicidal ideation, suicide attempts, age at onset of psychiatric illness, presence of substance or alcohol abuse, length of stay, number of hospitalizations, presence of involuntary admission, type of discharge from the hospital, and pharmacological treatment at discharge. RESULTS Female patients were primarily diagnosed with bipolar disorder or personality disorders. Female patients had a significantly higher prevalence of lifetime suicide attempts (23.1% vs. 16.5%, P<0.001) and a longer length of hospitalization (11.43±10.73 d vs. 10.52±10.37 d, t=-2.099, gl=2356, P=0.036) compared with male patients. Male patients had more involuntary admissions (25.1% vs. 19.7%, χ2=9.616, gl=1, P=0.002), more use of illicit substances (34.1% vs. 20.9%, χ2=51.084, gl=1, P<0.001), and higher rates of alcohol abuse (21.3% vs. 14.7%, χ2=17.182, gl=1, P<0.001) compared with female patients. Finally, antidepressants and lithium were prescribed more frequently to the female patients, whereas other mood stabilizers were more often prescribed to the male patients. CONCLUSIONS Our real-world results highlighted gender differences among patients with severe mental disorders admitted to psychiatric units, and suggest further investigations that may help in understanding trajectories accompanying disabling clinical conditions.
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19
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Barth C, Nerland S, Jørgensen KN, Haatveit B, Wortinger LA, Melle I, Haukvik UK, Ueland T, Andreassen OA, Agartz I. Altered Sex Differences in Hippocampal Subfield Volumes in Schizophrenia. Schizophr Bull 2024; 50:107-119. [PMID: 37354490 PMCID: PMC10754184 DOI: 10.1093/schbul/sbad091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND AND HYPOTHESIS The hippocampus is a heterogenous brain structure that differs between the sexes and has been implicated in the pathophysiology of psychiatric illnesses. Here, we explored sex and diagnostic group differences in hippocampal subfield volumes, in individuals with schizophrenia spectrum disorder (SZ), bipolar disorders (BD), and healthy controls (CTL). STUDY DESIGN One thousand and five hundred and twenty-one participants underwent T1-weighted magnetic resonance imaging (SZ, n = 452, mean age 30.7 ± 9.2 [SD] years, males 59.1%; BD, n = 316, 33.7 ± 11.4, 41.5%; CTL, n = 753, 34.1 ± 9.1, 55.6%). Total hippocampal, subfield, and intracranial volumes were estimated with Freesurfer (v6.0.0). Analysis of covariance and multiple regression models were fitted to examine sex-by-diagnostic (sub)group interactions in volume. In SZ and BD, separately, associations between volumes and clinical as well as cognitive measures were examined between the sexes using regression models. STUDY RESULTS Significant sex-by-group interactions were found for the total hippocampus, dentate gyrus, molecular layer, presubiculum, fimbria, hippocampal-amygdaloid transition area, and CA4, indicating a larger volumetric deficit in male patients relative to female patients when compared with same-sex CTL. Subgroup analyses revealed that this interaction was driven by males with schizophrenia. Effect sizes were overall small (partial η < 0.02). We found no significant sex differences in the associations between hippocampal volumes and clinical or cognitive measures in SZ and BD. CONCLUSIONS Using a well-powered sample, our findings indicate that the pattern of morphological sex differences in hippocampal subfields is altered in individuals with schizophrenia relative to CTL, due to higher volumetric deficits in males.
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Affiliation(s)
- Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, NORMENT, Oslo, Norway
| | - Stener Nerland
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, NORMENT, Oslo, Norway
| | - Kjetil N Jørgensen
- Institute of Clinical Medicine, University of Oslo, NORMENT, Oslo, Norway
- Department of Psychiatry, Telemark Hospital, Skien, Norway
| | - Beathe Haatveit
- Institute of Clinical Medicine, University of Oslo, NORMENT, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, NORMENT, Oslo, Norway
| | - Laura A Wortinger
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, NORMENT, Oslo, Norway
| | - Ingrid Melle
- Institute of Clinical Medicine, University of Oslo, NORMENT, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, NORMENT, Oslo, Norway
| | - Unn K Haukvik
- Division of Mental Health and Addiction, Oslo University Hospital, NORMENT, Oslo, Norway
- Department of Adult Mental Health, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Torill Ueland
- Division of Mental Health and Addiction, Oslo University Hospital, NORMENT, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Institute of Clinical Medicine, University of Oslo, NORMENT, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, NORMENT, Oslo, Norway
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, NORMENT, Oslo, Norway
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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20
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Hodes GE, Bangasser D, Sotiropoulos I, Kokras N, Dalla C. Sex Differences in Stress Response: Classical Mechanisms and Beyond. Curr Neuropharmacol 2024; 22:475-494. [PMID: 37855285 PMCID: PMC10845083 DOI: 10.2174/1570159x22666231005090134] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/28/2023] [Accepted: 08/09/2023] [Indexed: 10/20/2023] Open
Abstract
Neuropsychiatric disorders, which are associated with stress hormone dysregulation, occur at different rates in men and women. Moreover, nowadays, preclinical and clinical evidence demonstrates that sex and gender can lead to differences in stress responses that predispose males and females to different expressions of similar pathologies. In this curated review, we focus on what is known about sex differences in classic mechanisms of stress response, such as glucocorticoid hormones and corticotrophin-releasing factor (CRF), which are components of the hypothalamicpituitary- adrenal (HPA) axis. Then, we present sex differences in neurotransmitter levels, such as serotonin, dopamine, glutamate and GABA, as well as indices of neurodegeneration, such as amyloid β and Tau. Gonadal hormone effects, such as estrogens and testosterone, are also discussed throughout the review. We also review in detail preclinical data investigating sex differences caused by recentlyrecognized regulators of stress and disease, such as the immune system, genetic and epigenetic mechanisms, as well neurosteroids. Finally, we discuss how understanding sex differences in stress responses, as well as in pharmacology, can be leveraged into novel, more efficacious therapeutics for all. Based on the supporting evidence, it is obvious that incorporating sex as a biological variable into preclinical research is imperative for the understanding and treatment of stress-related neuropsychiatric disorders, such as depression, anxiety and Alzheimer's disease.
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Affiliation(s)
| | - Debra Bangasser
- Center for Behavioral Neuroscience, Georgia State University, Atlanta, GA, USA
| | - Ioannis Sotiropoulos
- Institute of Biosciences & Applications NCSR “Demokritos”, Athens, Greece
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Nikolaos Kokras
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Dalla
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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21
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Kępińska AP, Johnson JS, Huckins LM. Open Science Practices in Psychiatric Genetics: A Primer. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:110-119. [PMID: 38298792 PMCID: PMC10829621 DOI: 10.1016/j.bpsgos.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/04/2023] [Accepted: 08/11/2023] [Indexed: 02/02/2024] Open
Abstract
Open science ensures that research is transparently reported and freely accessible for all to assess and collaboratively build on. Psychiatric genetics has led among the health sciences in implementing some open science practices in common study designs, such as replication as part of genome-wide association studies. However, thorough open science implementation guidelines are limited and largely not specific to data, privacy, and research conduct challenges in psychiatric genetics. Here, we present a primer of open science practices, including selection of a research topic with patients/nonacademic collaborators, equitable authorship and citation practices, design of replicable, reproducible studies, preregistrations, open data, and privacy issues. We provide tips for informative figures and inclusive, precise reporting. We discuss considerations in working with nonacademic collaborators and distributing research through preprints, blogs, social media, and accessible lecture materials. Finally, we provide extra resources to support every step of the research process.
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Affiliation(s)
- Adrianna P. Kępińska
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Jessica S. Johnson
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, New York
- Psychiatry Department, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - Laura M. Huckins
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Psychiatry, Yale University, New Haven, Connecticut
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22
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Oo TT, Pratchayasakul W, Chattipakorn K, Siri-Angkul N, Choovuthayakorn J, Charumporn T, Ongnok B, Arunsak B, Chunchai T, Kongkaew A, Songtrai S, Kaewsuwan S, Chattipakorn N, Chattipakorn S. Cyclosorus Terminans Extract Alleviates Neuroinflammation in Insulin Resistant Rats. Mol Neurobiol 2023:10.1007/s12035-023-03883-x. [PMID: 38148371 DOI: 10.1007/s12035-023-03883-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023]
Abstract
High-fat diet consumption for an extended period causes obesity, systemic metabolic disturbance, and brain insulin resistance, resulting in neuroinflammation. Although the beneficial effect of Cyclosorus terminans extract on obesity-related insulin resistance has been demonstrated, little is known about how it affects neuroinflammation and brain insulin resistance in obese rats. Male Wistar rats were given either a normal diet (ND, n = 6) or a high-fat diet (HFD, n = 24) for a total of 14 weeks. At the beginning of the week, 13 rats in the ND group were given vehicle orally for 2 weeks, while rats on HFD diets were randomized to one of four groups and given either vehicle, 100 mg/kg/day of Cyclosorus terminans extract, 200 mg/kg/day of Cyclosorus terminans extract, or 20 mg/kg/day of pioglitazone orally for 2 weeks. After the experimental period, blood and brain samples were taken to assess metabolic and brain parameters. HFD-fed rats had obesity, systemic and brain insulin resistance, brain inflammation, microglial and astrocyte hyperactivity, and brain necroptosis. Treatment with 200 mg/kg/day of Cyclosorus terminans extract and pioglitazone equally attenuated obesity, insulin resistance, brain insulin dysfunction, and neuroinflammation in insulin resistant rats. Our findings suggest that Cyclosorus terminans extract may hold promise as a therapeutic agent for insulin resistance and neuroinflammation in obese conditions.
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Affiliation(s)
- Thura Tun Oo
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Wasana Pratchayasakul
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kenneth Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Natthapat Siri-Angkul
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jirachaya Choovuthayakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Thanapat Charumporn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Benjamin Ongnok
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Busarin Arunsak
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Titikorn Chunchai
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Aphisek Kongkaew
- Research Administration Section, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sujinda Songtrai
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
- Phytomedicine and Pharmaceutical Biotechnology Excellence Center, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
| | - Sireewan Kaewsuwan
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
- Phytomedicine and Pharmaceutical Biotechnology Excellence Center, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand.
- Department of Oral Biology and Diagnostic Science, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
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23
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Rocks D, Purisic E, Gallo EF, Greally JM, Suzuki M, Kundakovic M. Egr1 is a sex-specific regulator of neuronal chromatin, synaptic plasticity, and behaviour. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.20.572697. [PMID: 38187614 PMCID: PMC10769422 DOI: 10.1101/2023.12.20.572697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Sex differences are found in brain structure and function across species, and across brain disorders in humans1-3. The major source of brain sex differences is differential secretion of steroid hormones from the gonads across the lifespan4. Specifically, ovarian hormones oestrogens and progesterone are known to dynamically change structure and function of the adult female brain, having a major impact on psychiatric risk5-7. However, due to limited molecular studies in female rodents8, very little is still known about molecular drivers of female-specific brain and behavioural plasticity. Here we show that overexpressing Egr1, a candidate oestrous cycle-dependent transcription factor9, induces sex-specific changes in ventral hippocampal neuronal chromatin, gene expression, and synaptic plasticity, along with hippocampus-dependent behaviours. Importantly, Egr1 overexpression mimics the high-oestrogenic phase of the oestrous cycle, and affects behaviours in ovarian hormone-depleted females but not in males. We demonstrate that Egr1 opens neuronal chromatin directly across the sexes, although with limited genomic overlap. Our study not only reveals the first sex-specific chromatin regulator in the brain, but also provides functional evidence that this sex-specific gene regulation drives neuronal gene expression, synaptic plasticity, and anxiety- and depression-related behaviour. Our study exemplifies an innovative sex-based approach to studying neuronal gene regulation1 in order to understand sex-specific synaptic and behavioural plasticity and inform novel brain disease treatments.
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Affiliation(s)
- Devin Rocks
- Department of Biological Sciences, Fordham University, Bronx, NY, USA
| | - Eric Purisic
- Department of Biological Sciences, Fordham University, Bronx, NY, USA
| | - Eduardo F. Gallo
- Department of Biological Sciences, Fordham University, Bronx, NY, USA
| | - John M. Greally
- Center for Epigenomics, Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Masako Suzuki
- Center for Epigenomics, Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Nutrition, Texas A&M University, College Station, TX, USA
| | - Marija Kundakovic
- Department of Biological Sciences, Fordham University, Bronx, NY, USA
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24
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Hakvoort K, Conzen-Dilger C, Gutzmann A, Losse E, Tauber SC, Chechko N, Höllig A. Is there a gender gap in clinical neurosciences? A cross-sectional analysis of female participation in academic neurology, neurosurgery, and psychiatry. Neurosci Biobehav Rev 2023; 155:105458. [PMID: 37931690 DOI: 10.1016/j.neubiorev.2023.105458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/03/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023]
Abstract
Gender equality or the lack thereof is a constantly recurring theme. Here, we sought to provide an overview of the status with respect to the participation and leadership of female doctors in clinical neuroscience analyzing different disciplines (neurosurgery, neurology and psychiatry). A total of 1910 articles published in six representative journals (07-12/2020) were reviewed. Of these, 1327 were original research papers, 145 invited publications and 303 letters/comments. Out of a total of 15,080 authors, 4365 (29%) were women. The percentage of female authors was found to differ significantly between the different specialties (19% in neurosurgery, 39% in neurology and 45% in psychiatry). Women were last authors in 9.5% of the papers in neurosurgery, 29% in neurology and 39% in psychiatry Based on these findings, it can be concluded that gender disparity in academic neuroscience is quite conspicuous. Our review seeks to address the reasons behind this phenomenon in the context of new publications as well as various cultural and historical underpinnings.
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Affiliation(s)
- K Hakvoort
- Department of Neurosurgery, University Hospital RWTH Aachen, Germany
| | - C Conzen-Dilger
- Department of Neurosurgery, University Hospital RWTH Aachen, Germany
| | - A Gutzmann
- Department of Neurology, University Hospital RWTH Aachen, Germany
| | - E Losse
- Department of Psychiatry, University Hospital RWTH Aachen, Germany
| | - S C Tauber
- Department of Neurology, University Hospital RWTH Aachen, Germany
| | - N Chechko
- Department of Psychiatry, University Hospital RWTH Aachen, Germany
| | - A Höllig
- Department of Neurosurgery, University Hospital RWTH Aachen, Germany.
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25
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Elberling F, Spulber S, Bose R, Keung HY, Ahola V, Zheng Z, Ceccatelli S. Sex Differences in Long-term Outcome of Prenatal Exposure to Excess Glucocorticoids-Implications for Development of Psychiatric Disorders. Mol Neurobiol 2023; 60:7346-7361. [PMID: 37561236 PMCID: PMC10657788 DOI: 10.1007/s12035-023-03522-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023]
Abstract
Exposure to prenatal insults, such as excess glucocorticoids (GC), may lead to pathological outcomes, including neuropsychiatric disorders. The aim of the present study was to investigate the long-term effects of in utero exposure to the synthetic GC analog dexamethasone (Dex) in adult female offspring. We monitored spontaneous activity in the home cage under a constant 12 h/12 h light/dark cycle, as well as the changes following a 6-h advance of dark onset (phase shift). For comparison, we re-analysed data previously recorded in males. Dex-exposed females were spontaneously more active, and the activity onset re-entrained slower than in controls. In contrast, Dex-exposed males were less active, and the activity onset re-entrained faster than in controls. Following the phase shift, control females displayed a transient reorganisation of behaviour in light and virtually no change in dark, while Dex-exposed females showed limited variations from baseline in both light and dark, suggesting weaker photic entrainment. Next, we ran bulk RNA-sequencing in the suprachiasmatic nucleus (SCN) of Dex and control females. SPIA pathway analysis of ~ 2300 differentially expressed genes identified significantly downregulated dopamine signalling, and upregulated glutamate and GABA signalling. We selected a set of candidate genes matching the behaviour alterations and found consistent differential regulation for ~ 73% of tested genes in SCN and hippocampus tissue samples. Taken together, our data highlight sex differences in the outcome of prenatal exposure to excess GC in adult mice: in contrast to depression-like behaviour in males, the phenotype in females, defined by behaviour and differential gene expression, is consistent with ADHD models.
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Affiliation(s)
- Frederik Elberling
- Department of Neuroscience, Karolinska Institutet, Biomedicum, Solnavägen 9, 171 77, Stockholm, Sweden
| | - Stefan Spulber
- Department of Neuroscience, Karolinska Institutet, Biomedicum, Solnavägen 9, 171 77, Stockholm, Sweden.
| | - Raj Bose
- Department of Neuroscience, Karolinska Institutet, Biomedicum, Solnavägen 9, 171 77, Stockholm, Sweden
| | - Hoi Yee Keung
- Ming Wai Lau Centre for Reparative Medicine, Karolinska Institutet, 15W Science and Technology W Ave, Sha Tin, Hong Kong Special Administrative Region, People's Republic of China
| | - Virpi Ahola
- Ming Wai Lau Centre for Reparative Medicine, Karolinska Institutet, 15W Science and Technology W Ave, Sha Tin, Hong Kong Special Administrative Region, People's Republic of China
| | - Zongli Zheng
- Ming Wai Lau Centre for Reparative Medicine, Karolinska Institutet, 15W Science and Technology W Ave, Sha Tin, Hong Kong Special Administrative Region, People's Republic of China
| | - Sandra Ceccatelli
- Department of Neuroscience, Karolinska Institutet, Biomedicum, Solnavägen 9, 171 77, Stockholm, Sweden
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26
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Barth C, Crestol A, de Lange AMG, Galea LAM. Sex steroids and the female brain across the lifespan: insights into risk of depression and Alzheimer's disease. Lancet Diabetes Endocrinol 2023; 11:926-941. [PMID: 37865102 DOI: 10.1016/s2213-8587(23)00224-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 10/23/2023]
Abstract
Despite widespread sex differences in prevalence and presentation of numerous illnesses affecting the human brain, there has been little focus on the effect of endocrine ageing. Most preclinical studies have focused on males only, and clinical studies often analyse data by covarying for sex, ignoring relevant differences between the sexes. This sex- (and gender)-neutral approach is biased and contributes to the absence of targeted treatments and services for all sexes (and genders). Female health has been historically understudied, with grave consequences for their wellbeing and health equity. In this Review, we spotlight female brain health across the lifespan by informing on the role of sex steroids, particularly oestradiol, on the female brain and on risk for diseases more prevalent in females, such as depression and Alzheimer's disease.
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Affiliation(s)
- Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Arielle Crestol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ann-Marie G de Lange
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychology, University of Oslo, Oslo, Norway
| | - Liisa A M Galea
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
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27
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Ramon-Gonen R, Dori A, Shelly S. Towards a practical use of text mining approaches in electrodiagnostic data. Sci Rep 2023; 13:19483. [PMID: 37945618 PMCID: PMC10636146 DOI: 10.1038/s41598-023-45758-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023] Open
Abstract
Healthcare professionals produce abounding textual data in their daily clinical practice. Text mining can yield valuable insights from unstructured data. Extracting insights from multiple information sources is a major challenge in computational medicine. In this study, our objective was to illustrate how combining text mining techniques with statistical methodologies can yield new insights and contribute to the development of neurological and neuromuscular-related health information. We demonstrate how to utilize and derive knowledge from medical text, identify patient groups with similar diagnostic attributes, and examine differences between groups using demographical data and past medical history (PMH). We conducted a retrospective study for all patients who underwent electrodiagnostic (EDX) evaluation in Israel's Sheba Medical Center between May 2016 and February 2022. The data extracted for each patient included demographic data, test results, and unstructured summary reports. We conducted several analyses, including topic modeling that targeted clinical impressions and topic analysis to reveal age- and sex-related differences. The use of suspected clinical condition text enriched the data and generated additional attributes used to find associations between patients' PMH and the emerging diagnosis topics. We identified 6096 abnormal EMG results, of which 58% (n = 3512) were males. Based on the latent Dirichlet allocation algorithm we identified 25 topics that represent different diagnoses. Sex-related differences emerged in 7 topics, 3 male-associated and 4 female-associated. Brachial plexopathy, myasthenia gravis, and NMJ Disorders showed statistically significant age and sex differences. We extracted keywords related to past medical history (n = 37) and tested them for association with the different topics. Several topics revealed a close association with past medical history, for example, length-dependent symmetric axonal polyneuropathy with diabetes mellitus (DM), length-dependent sensory polyneuropathy with chemotherapy treatments and DM, brachial plexopathy with motor vehicle accidents, myasthenia gravis and NMJ disorders with botulin treatments, and amyotrophic lateral sclerosis with swallowing difficulty. Summarizing visualizations were created to easily grasp the results and facilitate focusing on the main insights. In this study, we demonstrate the efficacy of utilizing advanced computational methods in a corpus of textual data to accelerate clinical research. Additionally, using these methods allows for generating clinical insights, which may aid in the development of a decision-making process in real-life clinical practice.
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Affiliation(s)
- Roni Ramon-Gonen
- The Graduate School of Business Administration, Bar-Ilan University, Ramat Gan, Israel.
| | - Amir Dori
- Department of Neurology, Sheba Medical Center, Tel HaShomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shahar Shelly
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
- Neuroimmunology Laboratory, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
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28
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Brouillard A, Davignon LM, Turcotte AM, Marin MF. Morphologic alterations of the fear circuitry: the role of sex hormones and oral contraceptives. Front Endocrinol (Lausanne) 2023; 14:1228504. [PMID: 38027091 PMCID: PMC10661904 DOI: 10.3389/fendo.2023.1228504] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background Endogenous sex hormones and oral contraceptives (OCs) have been shown to influence key regions implicated in fear processing. While OC use has been found to impact brain morphology, methodological challenges remain to be addressed, such as avoiding selection bias between OC users and non-users, as well as examining potential lasting effects of OC intake. Objective We investigated the current and lasting effects of OC use, as well as the interplay between the current hormonal milieu and history of hormonal contraception use on structural correlates of the fear circuitry. We also examined the role of endogenous and exogenous sex hormones within this network. Methods We recruited healthy adults aged 23-35 who identified as women currently using (n = 62) or having used (n = 37) solely combined OCs, women who never used any hormonal contraceptives (n = 40), or men (n = 41). Salivary endogenous sex hormones and current users' salivary ethinyl estradiol (EE) were assessed using liquid chromatography - tandem mass spectrometry. Using structural magnetic resonance imaging, we extracted surface-based gray matter volumes (GMVs) and cortical thickness (CT) for regions of interest of the fear circuitry. Exploratory whole-brain analyses were conducted with surface-based and voxel-based morphometry methods. Results Compared to men, all three groups of women exhibited a larger GMV of the dorsal anterior cingulate cortex, while only current users showed a thinner ventromedial prefrontal cortex. Irrespective of the menstrual cycle phase, never users exhibited a thicker right anterior insular cortex than past users. While associations with endogenous sex hormones remain unclear, we showed that EE dosage in current users had a greater influence on brain anatomy compared to salivary EE levels and progestin androgenicity, with lower doses being associated with smaller cortical GMVs. Discussion Our results highlight a sex difference for the dorsal anterior cingulate cortex GMV (a fear-promoting region), as well as a reduced CT of the ventromedial prefrontal cortex (a fear-inhibiting region) specific to current OC use. Precisely, this finding was driven by lower EE doses. These findings may represent structural vulnerabilities to anxiety and stress-related disorders. We showed little evidence of durable anatomical effects, suggesting that OC intake can (reversibly) affect fear-related brain morphology.
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Affiliation(s)
- Alexandra Brouillard
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | - Lisa-Marie Davignon
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | | | - Marie-France Marin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
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29
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Peters JR, Stumper A, Schmalenberger KM, Taubman AJ, Eisenlohr-Moul TA. Improving rigor through gender inclusivity in reproductive psychiatric science. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100194. [PMID: 37560411 PMCID: PMC10407113 DOI: 10.1016/j.cpnec.2023.100194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 08/11/2023] Open
Abstract
Accurately defining the individuals that research involves and generalizes to is critical for rigorous and reproducible science. In reproductive psychiatry, which historically focuses on the impact of the menstrual cycle, pregnancy, and menopause on mental health, this means moving beyond characterizing samples and relevant populations as "women" in favor of language that precisely identifies the physiological characteristics pertinent to the research being conducted and accurately reflects the varied genders represented in those populations. Concrete recommendations are provided for precise use of sex and gender terminology and gender inclusivity throughout the scientific process, including study conceptualization, etiquette in research environments, recruitment, methods, and dissemination. Recommendations are discussed in depth and presented in a checklist format for ease of use by research teams. Suggested items for assessing gender and relevant sex-related physiology in the context of reproductive psychiatry are also provided.
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Affiliation(s)
- Jessica R. Peters
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
| | - Allison Stumper
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
| | - Katja M. Schmalenberger
- Department of Psychiatry, University of Illinois at Chicago, 912 S. Wood Street, M/C 913, Chicago, IL 60612, USA
| | - Andy J. Taubman
- Youth Pride Inc, 743 Westminster St, Providence, RI 02903, USA
| | - Tory A. Eisenlohr-Moul
- Department of Psychiatry, University of Illinois at Chicago, 912 S. Wood Street, M/C 913, Chicago, IL 60612, USA
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30
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Williams JS, Fattori MR, Honeyborne IR, Ritz SA. Considering hormones as sex- and gender-related factors in biomedical research: Challenging false dichotomies and embracing complexity. Horm Behav 2023; 156:105442. [PMID: 37913648 DOI: 10.1016/j.yhbeh.2023.105442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/05/2023] [Accepted: 10/15/2023] [Indexed: 11/03/2023]
Abstract
The inclusion of sex and gender considerations in biomedicine has been increasing in light of calls from research and funding agencies, governmental bodies, and advocacy groups to direct research attention to these issues. Although the inclusion of both female and male participants is often an important element, overreliance on a female-male binary tends to oversimplify the interactions between sex- and gender-related factors and health, and runs a risk of being influenced by cultural stereotypes about sex and gender. When biomedical researchers are examining how hormones associated with gender and sex may influence pathways of interest, it is of crucial importance to approach this work with a critical lens on the rhetoric used, and in ways that acknowledge the complexity of hormone physiology. Here, we document the ways in which discourses around sex, gender and hormones shape our scientific thinking and practice in biomedical research, and review how the existing scientific knowledge about hormones reflects a complex and dynamic reality that is often not reflected outside of specialist niches of hormone biology. Where biomedical scientists take up sex- and gender-associated hormones as a way of addressing sex and gender considerations, it is valuable for us to bring a critical lens to the rhetoric and discourses used, to employ a sex contextualist approach in designing experimentation, and be rigorous and reflexive about the approaches used in analysis and interpretation of data. These strategies will allow us to design experimentation that goes beyond binaries, and grapples more directly with the material intricacies of sex, gender, and hormones.
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Affiliation(s)
| | - Michelle R Fattori
- Health Sciences Education Program, McMaster University, Hamilton, Ontario, Canada
| | - Isabella R Honeyborne
- Bachelor of Health Sciences (Honours) Program, McMaster University, Hamilton, Ontario, Canada
| | - Stacey A Ritz
- Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
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Kühnel A, Hagenberg J, Knauer-Arloth J, Ködel M, Czisch M, Sämann PG, Binder EB, Kroemer NB. Stress-induced brain responses are associated with BMI in women. Commun Biol 2023; 6:1031. [PMID: 37821711 PMCID: PMC10567923 DOI: 10.1038/s42003-023-05396-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023] Open
Abstract
Overweight and obesity are associated with altered stress reactivity and increased inflammation. However, it is not known whether stress-induced changes in brain function scale with BMI and if such associations are driven by peripheral cytokines. Here, we investigate multimodal stress responses in a large transdiagnostic sample using predictive modeling based on spatio-temporal profiles of stress-induced changes in activation and functional connectivity. BMI is associated with increased brain responses as well as greater negative affect after stress and individual response profiles are associated with BMI in females (pperm < 0.001), but not males. Although stress-induced changes reflecting BMI are associated with baseline cortisol, there is no robust association with peripheral cytokines. To conclude, alterations in body weight and energy metabolism might scale acute brain responses to stress more strongly in females compared to males, echoing observational studies. Our findings highlight sex-dependent associations of stress with differences in endocrine markers, largely independent of peripheral inflammation.
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Affiliation(s)
- Anne Kühnel
- Section of Medical Psychology, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Bonn, Bonn, Germany.
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany.
| | - Jonas Hagenberg
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Institute of Computational Biology, Helmholtz Zentrum Munich, Neuherberg, Germany
| | - Janine Knauer-Arloth
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Computational Biology, Helmholtz Zentrum Munich, Neuherberg, Germany
| | - Maik Ködel
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | | | | | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.
- German Center for Mental Health, Tübingen, Germany.
| | - Nils B Kroemer
- Section of Medical Psychology, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Bonn, Bonn, Germany
- German Center for Mental Health, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
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32
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Cavanaugh C, Rucci S, Vasquez-Home O. Sex/gender differences in the associations between adverse childhood experiences and intimate partner violence with mental disorders. Psychiatry Res 2023; 328:115456. [PMID: 37688838 DOI: 10.1016/j.psychres.2023.115456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023]
Abstract
Sex and gender differences exist in mental and substance use disorders (MSUDs). Studies examining the moderating effects of sex/gender on MSUDs may help understand these differences. This national study explored whether sex/gender moderated (1) the associations between adverse childhood experience (ACEs; i.e., child abuse, child neglect, and child household dysfunction) and intimate partner violence (IPV) with MSUDs and (2) more associations with past year than lifetime MSUDs or mental (i.e., mood disorder, anxiety disorder, and posttraumatic stress disorder) than substance use disorders (i.e., alcohol use disorder and nicotine dependence). Data was used from participants in the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression tested the main effects of ACEs, IPV, and sex/gender on five, past-year and lifetime MSUDs along with the ACE-sex/gender and IPV-sex/gender interactions. Sex/gender moderated 60% of the ACEs-MSUD and IPV-MSUD associations and more associations with lifetime (54%) than past year MSUDs (46%) and substance use (94%) than mental disorders (38%). For nearly half of the moderated associations, ACEs and IPV were associated with greater odds of MSUDs for males. Males who experienced IPV had greater odds of lifetime mood, anxiety, and alcohol use disorders than females. This study advances sex and gender informed research.
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Affiliation(s)
- Courtenay Cavanaugh
- Department of Psychology, Rutgers University, 311 North Fifth Street, Camden, NJ 08108, USA.
| | - Skylar Rucci
- Department of Psychology, Rutgers University, 311 North Fifth Street, Camden, NJ 08108, USA
| | - Orgelys Vasquez-Home
- Department of Psychology, Rutgers University, 311 North Fifth Street, Camden, NJ 08108, USA
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33
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Eliot L, Beery AK, Jacobs EG, LeBlanc HF, Maney DL, McCarthy MM. Why and How to Account for Sex and Gender in Brain and Behavioral Research. J Neurosci 2023; 43:6344-6356. [PMID: 37704386 PMCID: PMC10500996 DOI: 10.1523/jneurosci.0020-23.2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 09/15/2023] Open
Abstract
Long overlooked in neuroscience research, sex and gender are increasingly included as key variables potentially impacting all levels of neurobehavioral analysis. Still, many neuroscientists do not understand the difference between the terms "sex" and "gender," the complexity and nuance of each, or how to best include them as variables in research designs. This TechSights article outlines rationales for considering the influence of sex and gender across taxa, and provides technical guidance for strengthening the rigor and reproducibility of such analyses. This guidance includes the use of appropriate statistical methods for comparing groups as well as controls for key covariates of sex (e.g., total intracranial volume) and gender (e.g., income, caregiver stress, bias). We also recommend approaches for interpreting and communicating sex- and gender-related findings about the brain, which have often been misconstrued by neuroscientists and the lay public alike.
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Affiliation(s)
- Lise Eliot
- Stanson Toshok Center for Brain Function and Repair, Chicago Medical School, Rosalind Franklin University of Medicine & Science, North Chicago, Illinois 60064
| | - Annaliese K Beery
- Department of Integrative Biology, University of California-Berkeley, Berkeley, California 94720
| | - Emily G Jacobs
- Department of Psychological & Brain Sciences, University of California-Santa Barbara, Santa Barbara, California 93106
| | - Hannah F LeBlanc
- Division of the Humanities & Social Sciences, California Institute of Technology, Pasadena, California 91125
| | - Donna L Maney
- Department of Psychology, Emory University, Atlanta, Georgia 30322
| | - Margaret M McCarthy
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, Maryland 21201
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Kovacs M. A commentary on "Don't mind the gap: Why we do not care about the gender gap in mental health?" by P. Patalay and O. Demkowicz. Child Adolesc Ment Health 2023; 28:449-451. [PMID: 37194120 PMCID: PMC10686259 DOI: 10.1111/camh.12653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/18/2023]
Abstract
In their article, Drs. Patalay and Demkowicz raise important questions about research regarding the sex/gender gap in depression rates. However, their perspective on this topic is rather polarizing and yields statements of questionable accuracy. In this Commentary, I respond to several statements in the Article, which I consider potentially misleading. My goal is to present a broader perspective on sex/gender and depression and encourage further discussion of this important topic.
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Affiliation(s)
- Maria Kovacs
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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35
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Maney DL, Rich-Edwards JW. Sex-Inclusive Biomedicine: Are New Policies Increasing Rigor and Reproducibility? Womens Health Issues 2023; 33:461-464. [PMID: 37087311 DOI: 10.1016/j.whi.2023.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/20/2023] [Accepted: 03/20/2023] [Indexed: 04/24/2023]
Affiliation(s)
- Donna L Maney
- Department of Psychology, Emory University, Atlanta, Georgia.
| | - Janet W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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36
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Rehmann-Sutter C, Hiort O, Krämer UM, Malich L, Spielmann M. Is sex still binary? MED GENET-BERLIN 2023; 35:173-180. [PMID: 38840819 PMCID: PMC10842549 DOI: 10.1515/medgen-2023-2039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
In this perspective article we discuss the limitations of sex as a binary concept and how it is challenged by medical developments and a better understanding of gender diversity. Recent data indicate that sex is not a simple binary classification based solely on genitalia at birth or reproductive capacity but encompasses various biological characteristics such as chromosomes, hormones, and secondary sexual characteristics. The existence of individuals with differences in sex development (DSD) who do not fit typical male or female categories further demonstrates the complexity of sex. We argue that the belief that sex is strictly binary based on gametes is insufficient, as there are multiple levels of sex beyond reproductivity. We also explore the role of sex in sex determination, gene expression, brain development, and behavioural patterns and emphasize the importance of recognizing sex diversity in personalized medicine, as sex can influence disease presentation, drug response, and treatment effectiveness. Finally, we call for an inter- and transdisciplinary approach to study sex diversity and develop new categories and methodologies that go beyond a binary model.
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Affiliation(s)
- Christoph Rehmann-Sutter
- Universität zu LübeckInstitut für Medizingeschichte und WissenschaftsforschungKönigstraße 2023552LübeckDeutschland
| | - Olaf Hiort
- Universität zu LübeckKlinik für Kinder- und Jugendmedizin, Sektion für Pädiatrische Endokrinologie und DiabetologieRatzeburger Allee 16023538LübeckDeutschland
| | - Ulrike M. Krämer
- Universität zu LübeckKlinik für NeurologieRatzeburger Allee 16023538LübeckDeutschland
| | - Lisa Malich
- Universität zu LübeckInstitut für Medizingeschichte und WissenschaftsforschungKönigstraße 2023552LübeckDeutschland
| | - Malte Spielmann
- University Medical Center Schleswig-Holstein, University of Lübeck & Kiel University, Institute of Human GeneticsRatzeburger Allee 16023562LübeckDeutschland
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37
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Muñoz-Ballester C, Robel S. Astrocyte-mediated mechanisms contribute to traumatic brain injury pathology. WIREs Mech Dis 2023; 15:e1622. [PMID: 37332001 PMCID: PMC10526985 DOI: 10.1002/wsbm.1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023]
Abstract
Astrocytes respond to traumatic brain injury (TBI) with changes to their molecular make-up and cell biology, which results in changes in astrocyte function. These changes can be adaptive, initiating repair processes in the brain, or detrimental, causing secondary damage including neuronal death or abnormal neuronal activity. The response of astrocytes to TBI is often-but not always-accompanied by the upregulation of intermediate filaments, including glial fibrillary acidic protein (GFAP) and vimentin. Because GFAP is often upregulated in the context of nervous system disturbance, reactive astrogliosis is sometimes treated as an "all-or-none" process. However, the extent of astrocytes' cellular, molecular, and physiological adjustments is not equal for each TBI type or even for each astrocyte within the same injured brain. Additionally, new research highlights that different neurological injuries and diseases result in entirely distinctive and sometimes divergent astrocyte changes. Thus, extrapolating findings on astrocyte biology from one pathological context to another is problematic. We summarize the current knowledge about astrocyte responses specific to TBI and point out open questions that the field should tackle to better understand how astrocytes shape TBI outcomes. We address the astrocyte response to focal versus diffuse TBI and heterogeneity of reactive astrocytes within the same brain, the role of intermediate filament upregulation, functional changes to astrocyte function including potassium and glutamate homeostasis, blood-brain barrier maintenance and repair, metabolism, and reactive oxygen species detoxification, sex differences, and factors influencing astrocyte proliferation after TBI. This article is categorized under: Neurological Diseases > Molecular and Cellular Physiology.
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Affiliation(s)
- Carmen Muñoz-Ballester
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Stefanie Robel
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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38
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Fleischer AW, Frick KM. New perspectives on sex differences in learning and memory. Trends Endocrinol Metab 2023; 34:526-538. [PMID: 37500421 PMCID: PMC10617789 DOI: 10.1016/j.tem.2023.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023]
Abstract
Females have historically been disregarded in memory research, including the thousands of studies examining roles for the hippocampus, medial prefrontal cortex, and amygdala in learning and memory. Even when included, females are often judged based on male-centric behavioral and neurobiological standards, generating and perpetuating scientific stereotypes that females exhibit worse memories compared with males in domains such as spatial navigation and fear. Recent research challenges these dogmas by identifying sex-specific strategies in common memory tasks. Here, we discuss rodent data illustrating sex differences in spatial and fear memory, as well as the neural mechanisms underlying memory formation. The influence of sex steroid hormones in both sexes is discussed, as is the importance to basic and translational neuroscience of studying sex differences.
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Affiliation(s)
- Aaron W Fleischer
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
| | - Karyn M Frick
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
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39
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Rebić N, Law MR, Cragg J, Brotto LA, Ellis U, Garg R, Park JY, De Vera MA. "What's Sex and Gender Got to Do With It?" A Scoping Review of Sex- and Gender-Based Analysis in Pharmacoepidemiologic Studies of Medication Adherence. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:1413-1424. [PMID: 37068558 DOI: 10.1016/j.jval.2023.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 03/03/2023] [Accepted: 04/04/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Medication taking is a complex multidimensional behavior that may be impeded by a range of biological and psychosocial factors, including sex and gender. We aimed to synthesize how sex and gender have been reported and analyzed in pharmacoepidemiologic studies of medication. METHODS We searched for English-language peer-reviewed articles of observational studies (eg, cross-sectional, cohort, and case-control) that examined medication adherence among adults and included sex or gender in their reporting. RESULTS We included 937 studies among 530 537 287 participants published between the year 1979 and 2021. Most studies were cross-sectional (47%), lasted ≤ 1 year (35%), examined self-reported adherence (53%), did not assess specific adherence problem(s) (40%), and included medications for cardiovascular conditions (24%) or systemic infections (24%). A quarter of studies (25%) used sex and gender interchangeably, more than one third of studies (36%) that reported gender data likely collected data on sex, and < 1% of studies described sex and gender as distinct variables. Studies of cisgender participants more often reported that females/women experienced greater adherence problems often than males/men (31% vs 20%), particularly discontinuation and cost-related nonadherence. Only 21 studies (2%) reported on transgender individuals, and these predominantly examined antiretroviral medications for HIV. CONCLUSIONS Our review revealed substantial conflation of sex and gender in studies of medication adherence and a paucity of research among transgender individuals. Moreover, our synthesis showed sex/gender disparities in medication taking with studies reporting greater medication adherence problems among cisgender women and transgender participants than cisgender men.
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Affiliation(s)
- Nevena Rebić
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Centre of Canada, Vancouver, Canada
| | - Michael R Law
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jacquelyn Cragg
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Lori A Brotto
- Department of Obstetrics and Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ursula Ellis
- Woodward Library, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ria Garg
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jamie Y Park
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Centre of Canada, Vancouver, Canada; Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, British Columbia, Canada.
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Williams ZA, Szyszkowicz JK, Osborne N, Allehyany B, Nadon C, Udechukwu MC, Santos A, Audet MC. Sex-specific effects of voluntary wheel running on behavior and the gut microbiota-immune-brain axis in mice. Brain Behav Immun Health 2023; 30:100628. [PMID: 37396336 PMCID: PMC10308214 DOI: 10.1016/j.bbih.2023.100628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 07/04/2023] Open
Abstract
Physical exercise has been positioned as a promising strategy to prevent and/or alleviate anxiety and depression, but the biological processes associated with its effects on mental health have yet to be entirely determined. Although the prevalence of depression and anxiety in women is about twice that of men, very few studies have examined whether physical exercise could affect mental health differently according to sex. This study examined, in singly-housed mice, the sex-specific effects of voluntary exercise on depressive- and anxiety-like behaviors as well as on different markers along the gut microbiota-immune-brain axis. Male and female C57BL/6N mice had voluntary access to running wheels in their home-cages for 24 days or were left undisturbed in identical home-cages without running wheels. Behaviors were then examined in the open field, splash, elevated plus maze, and tail suspension tests. Gene expression of pro-inflammatory cytokines, microglia activation-related genes, and tight junction proteins was determined in the jejunum and the hippocampus, while microbiota composition and predicted function were verified in cecum contents. Voluntary exercise reduced anxiety-like behaviors and altered grooming patterns in males exclusively. Although the exercise intervention resulted in changes to brain inflammatory activity and to cecal microbiota composition and inferred function in both sexes, reductions in the jejunal expression of pro-inflammatory markers were observed in females only. These findings support the view that voluntary exercise, even when performed during a short period, is beneficial for mental and intestinal health and that its sex-specific effects on behavior could be, at least in part, related to some components of the gut microbiota-immune-brain axis.
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Affiliation(s)
| | - Joanna Kasia Szyszkowicz
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, Canada
| | - Natasha Osborne
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
| | | | - Christophe Nadon
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
| | | | - Ana Santos
- Department of Neuroscience, Carleton University, Ottawa, Canada
| | - Marie-Claude Audet
- Department of Neuroscience, Carleton University, Ottawa, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
- School of Nutrition Sciences, University of Ottawa, Ottawa, Canada
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41
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Stranges TN, Namchuk AB, Splinter TFL, Moore KN, Galea LAM. Are we moving the dial? Canadian health research funding trends for women's health, 2S/LGBTQ + health, sex, or gender considerations. Biol Sex Differ 2023; 14:40. [PMID: 37322516 PMCID: PMC10273719 DOI: 10.1186/s13293-023-00524-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Sex and gender impacts health outcomes and disease risk throughout life. The health of women and members of the Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning (2S/LGBTQ +) community is often compromised as they experience delays in diagnosis. Distinct knowledge gaps in the health of these populations have prompted funding agencies to mandate incorporation of sex and gender into research. Sex- and gender-informed research perspectives and methodology increases rigor, promotes discovery, and expands the relevance of health research. Thus, the Canadian Institutes of Health Research (CIHR) implemented a sex and gender-based analysis (SGBA) framework recommending the inclusion of SGBA in project proposals in 2010 and then mandating the incorporation of SGBA into grant proposals in 2019. To examine whether this mandate resulted in increased mention of sex or gender in funded research abstracts, we searched the publicly available database of grant abstracts funded by CIHR to analyze the percentage of abstracts that mentioned sex or gender of the population to be studied in the funded research. To better understand broader health equity issues we also examined whether the funded grant abstracts mentioned either female-specific health research or research within the 2S/LGBTQ + community. RESULTS We categorized a total of 8,964 Project and Operating grant abstracts awarded from 2009 to 2020 based on their study of female-specific or a 2S/LGBTQ + populations or their mention of sex or gender. Overall, under 3% of grant abstracts funded by CIHR explicitly mentioned sex and/or gender, as 1.94% of grant abstracts mentioned sex, and 0.66% mentioned gender. As one of the goals of SGBA is to inform on health equity and understudied populations with respect to SGBA, we also found that 5.92% of grant abstracts mentioned female-specific outcomes, and 0.35% of grant abstracts focused on the 2S/LGBTQ + community. CONCLUSIONS Although there was an increased number of funded grants with abstracts that mentioned sex and 2S/LGBTQ + health across time, these increases were less than 2% between 2009 and 2020. The percentage of funded grants with abstracts mentioning female-specific health or gender differences did not change significantly over time. The percentage of funding dollars allocated to grants in which the abstracts mentioned sex or gender also did not change substantially from 2009 to 2020, with grant abstracts mentioning sex or female-specific research increasing by 1.26% and 3.47%, respectively, funding allocated to research mentioning gender decreasing by 0.49% and no change for 2S/LGBTQ +-specific health. Our findings suggest more work needs to be done to ensure the public can evaluate what populations will be examined with the funded research with respect to sex and gender to advance awareness and health equity in research.
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Affiliation(s)
- Tori N. Stranges
- Women’s Health Research Cluster, University of British Columbia, Vancouver, BC Canada
- School of Health and Exercise Sciences, University of British Columbia, Okanagan, Kelowna, BC Canada
| | - Amanda B. Namchuk
- Women’s Health Research Cluster, University of British Columbia, Vancouver, BC Canada
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, BC Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC Canada
| | | | - Katherine N. Moore
- Women’s Health Research Cluster, University of British Columbia, Vancouver, BC Canada
| | - Liisa A. M. Galea
- Women’s Health Research Cluster, University of British Columbia, Vancouver, BC Canada
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, BC Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC Canada
- Centre for Addiction and Mental Health, Toronto, ON Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
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Affiliation(s)
- Liisa Am Galea
- Centre for Addiction and Mental Health, Department of Psychiatry, Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Rulan S Parekh
- Departments of Medicine, Paediatrics, Epidemiology, and Health Policy and Management Evaluation at Women's College Hospital, Hospital for Sick Children, and University of Toronto, Toronto, Canada
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Phillips B, Haschler TN, Karp NA. Statistical simulations show that scientists need not increase overall sample size by default when including both sexes in in vivo studies. PLoS Biol 2023; 21:e3002129. [PMID: 37289836 PMCID: PMC10284409 DOI: 10.1371/journal.pbio.3002129] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/21/2023] [Accepted: 04/18/2023] [Indexed: 06/10/2023] Open
Abstract
In recent years, there has been a strong drive to improve the inclusion of animals of both sexes in the design of in vivo research studies, driven by a need to increase sex representation in fundamental biology and drug development. This has resulted in inclusion mandates by funding bodies and journals, alongside numerous published manuscripts highlighting the issue and providing guidance to scientists. However, progress is slow and barriers to the routine use of both sexes remain. A frequent, major concern is the perceived need for a higher overall sample size to achieve an equivalent level of statistical power, which would result in an increased ethical and resource burden. This perception arises from either the belief that sex inclusion will increase variability in the data (either through a baseline difference or a treatment effect that depends on sex), thus reducing the sensitivity of statistical tests, or from misapprehensions about the correct way to analyse the data, including disaggregation or pooling by sex. Here, we conduct an in-depth examination of the consequences of including both sexes on statistical power. We performed simulations by constructing artificial datasets that encompass a range of outcomes that may occur in studies studying a treatment effect in the context of both sexes. This includes both baseline sex differences and situations in which the size of the treatment effect depends on sex in both the same and opposite directions. The data were then analysed using either a factorial analysis approach, which is appropriate for the design, or a t test approach following pooling or disaggregation of the data, which are common but erroneous strategies. The results demonstrate that there is no loss of power to detect treatment effects when splitting the sample size across sexes in most scenarios, providing that the data are analysed using an appropriate factorial analysis method (e.g., two-way ANOVA). In the rare situations where power is lost, the benefit of understanding the role of sex outweighs the power considerations. Additionally, use of the inappropriate analysis pipelines results in a loss of statistical power. Therefore, we recommend analysing data collected from both sexes using factorial analysis and splitting the sample size across male and female mice as a standard strategy.
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Affiliation(s)
- Benjamin Phillips
- Data Sciences & Quantitative Biology, Discovery Sciences, R&D, AstraZeneca, Cambridge, United Kingdom
| | - Timo N. Haschler
- Bioscience Renal, Research and Early Development Cardiovascular, Renal and Metabolism, Biopharmaceutical R&D, AstraZeneca, Cambridge, United Kingdom
| | - Natasha A. Karp
- Data Sciences & Quantitative Biology, Discovery Sciences, R&D, AstraZeneca, Cambridge, United Kingdom
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Puri TA, Richard JE, Galea LAM. Beyond sex differences: short- and long-term effects of pregnancy on the brain. Trends Neurosci 2023; 46:459-471. [PMID: 37120339 DOI: 10.1016/j.tins.2023.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/06/2023] [Accepted: 03/21/2023] [Indexed: 05/01/2023]
Abstract
Growing attention has been directed to the inclusion of females in neuroscience studies, and to the importance of studying sex as a biological variable. However, how female-specific factors such as menopause and pregnancy, affect the brain remains understudied. In this review, we use pregnancy as a case in point of a female-unique experience that can alter neuroplasticity, neuroinflammation, and cognition. We examine studies in both humans and rodents indicating that pregnancy can modify neural function in the short term, as well as alter the trajectory of brain aging. Furthermore, we discuss the influence of maternal age, fetal sex, number of pregnancies, and presence of pregnancy complications on brain health outcomes. We conclude by encouraging the scientific community to prioritize researching female health by recognizing and including factors such as pregnancy history in research.
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Affiliation(s)
- Tanvi A Puri
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer E Richard
- Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, BC, Canada; Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Liisa A M Galea
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, BC, Canada; Department of Psychology, University of British Columbia, Vancouver, BC, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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45
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Bölte S, Neufeld J, Marschik PB, Williams ZJ, Gallagher L, Lai MC. Sex and gender in neurodevelopmental conditions. Nat Rev Neurol 2023; 19:136-159. [PMID: 36747038 PMCID: PMC10154737 DOI: 10.1038/s41582-023-00774-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2023] [Indexed: 02/08/2023]
Abstract
Health-related conditions often differ qualitatively or quantitatively between individuals of different birth-assigned sexes and gender identities, and/or with different gendered experiences, requiring tailored care. Studying the moderating and mediating effects of sex-related and gender-related factors on impairment, disability, wellbeing and health is of paramount importance especially for neurodivergent individuals, who are diagnosed with neurodevelopmental conditions with uneven sex/gender distributions. Researchers have become aware of the myriad influences that sex-related and gender-related variables have on the manifestations of neurodevelopmental conditions, and contemporary work has begun to investigate the mechanisms through which these effects are mediated. Here we describe topical concepts of sex and gender science, summarize current knowledge, and discuss research and clinical challenges related to autism, attention-deficit/hyperactivity disorder and other neurodevelopmental conditions. We consider sex and gender in the context of epidemiology, behavioural phenotypes, neurobiology, genetics, endocrinology and neighbouring disciplines. The available evidence supports the view that sex and gender are important contributors to the biological and behavioural variability in neurodevelopmental conditions. Methodological caveats such as frequent conflation of sex and gender constructs, inappropriate measurement of these constructs and under-representation of specific demographic groups (for example, female and gender minority individuals and people with intellectual disabilities) limit the translational potential of research so far. Future research and clinical implementation should integrate sex and gender into next-generation diagnostics, mechanistic investigations and support practices.
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Affiliation(s)
- Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
| | - Janina Neufeld
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Swedish Collegium for Advanced Study (SCAS), Uppsala, Sweden
| | - Peter B Marschik
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen and Leibniz ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Zachary J Williams
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
| | - Louise Gallagher
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, and Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, and Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
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Schuller J, Koch M. Blockade of the orexin 1-receptors and 'cocaine- and amphetamine-regulated transcript' in the nucleus accumbens shell alters impulse control in rats. Behav Brain Res 2023; 440:114268. [PMID: 36539163 DOI: 10.1016/j.bbr.2022.114268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/02/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Impulsivity is a multifaceted construct and alterations in impulsiveness are often associated with psychiatric diseases, including drug addiction and binge eating disorder. Impulse control involves several brain regions. The present study assessed the role of the orexigenic, appetite stimulating neuropeptide orexin (OX) and the anorexigenic, appetite reducing neuropeptide cocaine- and amphetamine-regulated transcript (CART) within the nucleus accumbens shell (NAcSh) in impulse control in rats. The animals were ranked for their trait impulsivity based on a screening in the 5-choice serial reaction time task (5-CSRTT). The rats' performances were analysed after bilateral infusions of the OX 1-receptor antagonist SB-334867 (SB) and CART-antibodies (CART-ABs) into the NAcSh. After SB infusions, there was no change in premature responses observed on average. Further analysis revealed a negative linear correlation between the effect of intra-NAcSh SB infusions on premature responses and trait impulsivity. The effect of SB ranged from an increase, no change to a decrease in premature responses in the individual animals with increasing trait impulsivity. Infusions of CART-ABs led to consistently enhanced impulse control with fewer irrelevant actions, independent of trait impulsivity. These data suggest that both OX, especially OX A, and CART in the NAcSh, can be considered endogenous regulators of impulsive action, dependent on underlying impulsivity in the case of OX and independent from trait impulsivity in the case of CART.
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Affiliation(s)
- Julia Schuller
- Department of Neuropharmacology, Brain Research Institute, University of Bremen, Hochschulring 18, D-28359 Bremen, Germany.
| | - Michael Koch
- Department of Neuropharmacology, Brain Research Institute, University of Bremen, Hochschulring 18, D-28359 Bremen, Germany.
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Cartas-Cejudo P, Lachén-Montes M, Ferrer I, Fernández-Irigoyen J, Santamaría E. Sex-divergent effects on the NAD+-dependent deacetylase sirtuin signaling across the olfactory-entorhinal-amygdaloid axis in Alzheimer's and Parkinson's diseases. Biol Sex Differ 2023; 14:5. [PMID: 36755296 PMCID: PMC9906849 DOI: 10.1186/s13293-023-00487-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Smell impairment is one of the earliest features in Alzheimer's (AD) and Parkinson's diseases (PD). Due to sex differences exist in terms of smell and olfactory structures as well as in the prevalence and manifestation of both neurological syndromes, we have applied olfactory proteomics to favor the discovery of novel sex-biased physio-pathological mechanisms and potential therapeutic targets associated with olfactory dysfunction. METHODS SWATH-MS (sequential window acquisition of all theoretical fragment ion spectra mass spectrometry) and bioinformatic workflows were applied in 57 post-mortem olfactory tracts (OT) derived from controls with no known neurological history (n = 6F/11M), AD (n = 4F/13M) and PD (n = 7F/16M) subjects. Complementary molecular analyses by Western-blotting were performed in the olfactory bulb (OB), entorhinal cortex (EC) and amygdala areas. RESULTS 327 and 151 OT differentially expressed proteins (DEPs) were observed in AD women and AD men, respectively (35 DEPs in common). With respect to PD, 198 DEPs were identified in PD women, whereas 95 DEPs were detected in PD men (20 DEPs in common). This proteome dyshomeostasis induced a disruption in OT protein interaction networks and widespread sex-dependent pathway perturbations in a disease-specific manner, among them Sirtuin (SIRT) signaling. SIRT1, SIRT2, SIRT3 and SIRT5 protein levels unveiled a tangled expression profile across the olfactory-entorhinal-amygdaloid axis, evidencing disease-, sex- and brain structure-dependent changes in olfactory protein acetylation. CONCLUSIONS Alteration in the OT proteostasis was more severe in AD than in PD. Moreover, protein expression changes were more abundant in women than men independent of the neurological syndrome. Mechanistically, the tangled SIRT profile observed across the olfactory pathway-associated brain regions in AD and PD indicates differential NAD (+)-dependent deacetylase mechanisms between women and men. All these data shed new light on differential olfactory mechanisms across AD and PD, pointing out that the evaluation of the feasibility of emerging sirtuin-based therapies against neurodegenerative diseases should be considered with caution, including further sex dimension analyses in vivo and in clinical studies.
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Affiliation(s)
- Paz Cartas-Cejudo
- grid.410476.00000 0001 2174 6440Clinical Neuroproteomics Unit, Proteomics Platform, Navarrabiomed, Hospitalario Universitario de Navarra (HUN), IdiSNA, Navarra Institute for Health Research, Universidad Pública de Navarra (UPNA), Irunlarrea 3, 31008 Pamplona, Spain
| | - Mercedes Lachén-Montes
- grid.410476.00000 0001 2174 6440Clinical Neuroproteomics Unit, Proteomics Platform, Navarrabiomed, Hospitalario Universitario de Navarra (HUN), IdiSNA, Navarra Institute for Health Research, Universidad Pública de Navarra (UPNA), Irunlarrea 3, 31008 Pamplona, Spain
| | - Isidro Ferrer
- grid.5841.80000 0004 1937 0247Department of Pathology and Experimental Therapeutics, CIBERNED (Network Centre of Biomedical Research of Neurodegenerative Diseases), Bellvitge University Hospital/Bellvitge Biomedical Research Institute (IDIBELL), Institute of Health Carlos III, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Joaquín Fernández-Irigoyen
- grid.410476.00000 0001 2174 6440Clinical Neuroproteomics Unit, Proteomics Platform, Navarrabiomed, Hospitalario Universitario de Navarra (HUN), IdiSNA, Navarra Institute for Health Research, Universidad Pública de Navarra (UPNA), Irunlarrea 3, 31008 Pamplona, Spain
| | - Enrique Santamaría
- Clinical Neuroproteomics Unit, Proteomics Platform, Navarrabiomed, Hospitalario Universitario de Navarra (HUN), IdiSNA, Navarra Institute for Health Research, Universidad Pública de Navarra (UPNA), Irunlarrea 3, 31008, Pamplona, Spain.
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Kataoka H, Nitta K, Hoshino J. Visceral fat and attribute-based medicine in chronic kidney disease. Front Endocrinol (Lausanne) 2023; 14:1097596. [PMID: 36843595 PMCID: PMC9947142 DOI: 10.3389/fendo.2023.1097596] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/13/2023] [Indexed: 02/11/2023] Open
Abstract
Visceral adipose tissue plays a central role in obesity and metabolic syndrome and is an independent risk factor for both cardiovascular and metabolic disorders. Increased visceral adipose tissue promotes adipokine dysregulation and insulin resistance, leading to several health issues, including systemic inflammation, oxidative stress, and activation of the renin-angiotensin-aldosterone system. Moreover, an increase in adipose tissue directly and indirectly affects the kidneys by increasing renal sodium reabsorption, causing glomerular hyperfiltration and hypertrophy, which leads to increased proteinuria and kidney fibrosis/dysfunction. Although the interest in the adverse effects of obesity on renal diseases has grown exponentially in recent years, the relationship between obesity and renal prognosis remains controversial. This may be attributed to the long clinical course of obesity, numerous obesity-related metabolic complications, and patients' attributes. Multiple individual attributes influencing the pathophysiology of fat accumulation make it difficult to understand obesity. In such cases, it may be effective to elucidate the pathophysiology by conducting research tailored to individual attributes from the perspective of attribute-based medicine/personalized medicine. We consider the appropriate use of clinical indicators necessary, according to attributes such as chronic kidney disease stage, level of visceral adipose tissue accumulation, age, and sex. Selecting treatments and clinical indicators based on individual attributes will allow for advancements in the clinical management of patients with obesity and chronic kidney disease. In the clinical setting of obesity-related nephropathy, it is first necessary to accumulate attribute-based studies resulting from the accurate evaluation of visceral fat accumulation to establish evidence for promoting personalized medicine.
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Helman TJ, Headrick JP, Stapelberg NJC, Braidy N. The sex-dependent response to psychosocial stress and ischaemic heart disease. Front Cardiovasc Med 2023; 10:1072042. [PMID: 37153459 PMCID: PMC10160413 DOI: 10.3389/fcvm.2023.1072042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Stress is an important risk factor for modern chronic diseases, with distinct influences in males and females. The sex specificity of the mammalian stress response contributes to the sex-dependent development and impacts of coronary artery disease (CAD). Compared to men, women appear to have greater susceptibility to chronic forms of psychosocial stress, extending beyond an increased incidence of mood disorders to include a 2- to 4-fold higher risk of stress-dependent myocardial infarction in women, and up to 10-fold higher risk of Takotsubo syndrome-a stress-dependent coronary-myocardial disorder most prevalent in post-menopausal women. Sex differences arise at all levels of the stress response: from initial perception of stress to behavioural, cognitive, and affective responses and longer-term disease outcomes. These fundamental differences involve interactions between chromosomal and gonadal determinants, (mal)adaptive epigenetic modulation across the lifespan (particularly in early life), and the extrinsic influences of socio-cultural, economic, and environmental factors. Pre-clinical investigations of biological mechanisms support distinct early life programming and a heightened corticolimbic-noradrenaline-neuroinflammatory reactivity in females vs. males, among implicated determinants of the chronic stress response. Unravelling the intrinsic molecular, cellular and systems biological basis of these differences, and their interactions with external lifestyle/socio-cultural determinants, can guide preventative and therapeutic strategies to better target coronary heart disease in a tailored sex-specific manner.
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Affiliation(s)
- Tessa J. Helman
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
- Correspondence: Tessa J. Helman
| | - John P. Headrick
- Schoolof Pharmacy and Medical Sciences, Griffith University, Southport, QLD, Australia
| | | | - Nady Braidy
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, NSW, Sydney, Australia
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50
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Sex-specific morphs: the genetics and evolution of intra-sexual variation. Nat Rev Genet 2023; 24:44-52. [PMID: 35971002 DOI: 10.1038/s41576-022-00524-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 11/08/2022]
Abstract
Sex-specific morphs exhibit discrete phenotypes, often including many disparate traits, that are observed in only one sex. These morphs have evolved independently in many different animals and are often associated with alternative mating strategies. The remarkable diversity of sex-specific morphs offers unique opportunities to understand the genetic basis of complex phenotypes, as the distinct nature of many morphs makes it easier to both categorize and compare genomes than for continuous traits. Sex-specific morphs also expand the study of sexual dimorphism beyond traditional bimodal comparisons of male and female averages, as they allow for a more expansive range of sexualization. Although ecological and endocrinological studies of sex-specific morphs have been advancing for some time, genomic and transcriptomic studies of morphs are far more recent. These studies reveal not only many different paths to the evolution of sex-specific morphs but also many commonalities, such as the role of sex-determining genes and hormone signalling in morph development, and the mixing of male and female traits within some morphs.
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