Sex, Genes, and Traumatic Brain Injury (TBI): A Call for a Gender Inclusive Approach to the Study of TBI in the Lab

Duncan, Kelli A.; Garijo-Garde, Sarah

doi:10.3389/fnins.2021.681599

Cited by 11 publications

(8 citation statements)

References 114 publications

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“…This might be another reason why hormonal theories have mostly been proven in laboratory settings, where hormone levels are always in natural occurrence and are not manipulated ( Duncan and Garijo-Garde, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…The number of cases entered are therefore not yet statistically significant. While we believe that our very large study population would not be influenced significantly by the rather small population identifying as trans- or cisgender, the effect of TBI on the transgender community should be considered in future studies ( Deutsche Gesellschaft für Unfallchirurgie [DGU] et al, 2021 ; Duncan and Garijo-Garde, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

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The outcome of severely injured patients following traumatic brain injury is affected by gender—A retrospective, multicenter, matched-pair analysis utilizing data of the TraumaRegister DGU®

Mair

Greve²,

Lefering³

et al. 2022

Front. Neurosci.

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IntroductionTraumatic brain injury (TBI) causes a major health-concern globally. Gender-dependent differences in mortality outcome after TBI have been controversially discussed.Materials and methodsWe conducted a retrospective, multicenter, matched-pair analysis using data collected by the TraumaRegister DGU® of the German Trauma Society between 2009 and 2020. All patients after severe trauma with the leading injury of TBI (AIS ≥ 3), above 18 years of age were included. Thereby, 42,034 cases were identified. We used 12 different matching criteria to ensure highly accurate matching and were able to match 11,738 pairs of one female and one male patient.ResultsAverage age at injury was 67.5 ± 19.6 years in women and 66.7 ± 19.1 years in men. Mean Injury Severity Score (ISS) was 21.3 ± 8.1 in women and 21.6 ± 8.2 in men. While women were more likely to die within the first week after trauma, the mortality was significantly higher in men overall (30.8 vs. 29.2%, p < 0.002). Women were less likely to suffer from multi organ failure (MOF) (27.5 vs. 33.0%) or sepsis (4.5 vs. 7.1%). When comparing younger (≤ 45-years) and older (> 45 years) patients, overall mortality was lower in men (13.1% men vs. 13.4% women) in the younger age group, but in the older group mortality was lower in women (33.8% men vs. 31.8% women).DiscussionGender-specific differences in the clinical outcome of severely injured patients with leading TBI could be detected. While women are overall characterized by an advantage in survival, this feature is not equally reproducible in premenopausal women. Therefore, the exact pathophysiological reasons for the described survival advantages of women will have to be explored in further prospective clinical studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The outcome of severely injured patients following traumatic brain injury is affected by gender—A retrospective, multicenter, matched-pair analysis utilizing data of the TraumaRegister DGU®

Mair

Greve²,

Lefering³

et al. 2022

Front. Neurosci.

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“…Emerging evidence in neuroscience and behavioral sciences challenges this binary view (124) and calls for researchers to take a more inclusive approach to better understand sex/gender and the brain, and how that relates to outcomes. However, analytical methods that would allow study of non-binary gender variability in outcomes are yet to be developed, and this effort may be seen to be redundant in the realm of personalized medicine (125)(126)(127). On a positive note, sex/gender effects have started to attract significant attention in TBI research (13,19,111,126,127); and new policies have been developed to capture these effects (128)(129)(130)(131)(132).…”

Section: Implications For Research and Policymentioning

confidence: 99%

“…However, analytical methods that would allow study of non-binary gender variability in outcomes are yet to be developed, and this effort may be seen to be redundant in the realm of personalized medicine (125)(126)(127). On a positive note, sex/gender effects have started to attract significant attention in TBI research (13,19,111,126,127); and new policies have been developed to capture these effects (128)(129)(130)(131)(132).…”

Section: Implications For Research and Policymentioning

confidence: 99%

Systematic Review of Sex and Gender Effects in Traumatic Brain Injury: Equity in Clinical and Functional Outcomes

Mollayeva

Pacheco

et al. 2021

Front. Neurol.

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Background: Although traumatic brain injury (TBI) is a leading cause of death and disability in male and female patients worldwide, little is known about the effect of sex and gender on TBI outcomes.Objectives: This systematic review summarizes the evidence on the effect of sex and gender on core TBI outcomes.Methods: All English-language studies from six literature databases that addressed core outcomes in adults with TBI and included sex or gender, TBI severity, and age in their analyses were considered eligible. Two reviewers extracted data, and two reviewers assessed study quality using tools recommended by the National Institutes of Health. The results were sorted according to time post-injury, injury severity, gender equity ranking of the study's country of origin, and outcomes studied. The results from the included studies were grouped based on the approach taken in reporting their respective findings.Results and Limitations: Of 172 articles assessed, 58 studies were selected, comprising 1, 265, 955 participants with TBI (67% male across all studies) of all injury severities. All studies were conducted in countries with a very high or high human development index, while the Gender Inequality Index (GII) varied. While the heterogeneity across studies limited any meaningful conclusions with respect to the role of sex and gender, we did observe that as gender equality ranking improved, differences between male and female participants in outcomes would diminish. Inclusion of social equity parameters in the studies was limited.Conclusions and Implications: The non-uniform findings observed bring forth the need to develop and use a comprehensive and consistent methodology in the study of sex and gender post-TBI, incorporating social equity parameters to uncover the potential social underpinnings of gender effects on health and functional outcomes.Systematic Review Registration: CRD42018098697.

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“…[9] The clinical presentations and treatment outcomes after TBI are highly dependent on the patient's age, gender, type of brain injury, injury severity, site of injury, preexisting medical conditions, comorbidity, genetic variability, and acute injury management. [2,10,11] While some TBI patients can fully recover within days, others may be burdened with the symptoms for months to decades, requiring continuous medical treatment and rehabilitation to manage their residual symptoms, which can significantly impact their quality of life. Some patients may also experience various secondary complications such as frequent headaches, seizures, deep vein thrombosis, hypotension, intracerebral hemorrhages, sleep disorders, vestibular agnosia, respiratory infections, constipation, urinary tract infections, pneumonia, septicemia, personality charges, and psychiatric disorders (such as depression, DOI: 10.1002/anbr.202300010 Traumatic brain injury (TBI) is one of the most common causes of disability and mortality worldwide, creating a large socioeconomic burden annually.…”

Section: Introductionmentioning

confidence: 99%

Multifunctional Nanoparticles and Nanoclusters as a Theranostics and Symptoms Disappearing Agent for Traumatic Brain Injury

Zoey,

Ghosh,

Palanivel

et al. 2023

Advanced NanoBiomed Research

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Traumatic brain injury (TBI) is one of the most common causes of disability and mortality worldwide, creating a large socioeconomic burden annually. Secondary injury physiopathology is known to play a prominent role in exacerbating neurodegeneration post‐TBI and is potentially preventable by therapies. However, due to the heterogeneity of TBI and the complexity of the pathological mechanisms that ensue, there are currently no effective disease‐modifying treatments to prevent TBI‐associated disability and mortality. Nanotechnology has emerged in recent decades as a promising platform for the development of multifunctional neuroprotective agents for TBI. Herein, current multifunctional innovations are explored in this review in nanotechnology, which target the secondary injury pathological mechanisms of TBI and show promise in improving future post‐TBI management. Also, potential new directions for the future development of TBI treatment are discussed.

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Sex, Genes, and Traumatic Brain Injury (TBI): A Call for a Gender Inclusive Approach to the Study of TBI in the Lab

Cited by 11 publications

References 114 publications

The outcome of severely injured patients following traumatic brain injury is affected by gender—A retrospective, multicenter, matched-pair analysis utilizing data of the TraumaRegister DGU®

The outcome of severely injured patients following traumatic brain injury is affected by gender—A retrospective, multicenter, matched-pair analysis utilizing data of the TraumaRegister DGU®

Systematic Review of Sex and Gender Effects in Traumatic Brain Injury: Equity in Clinical and Functional Outcomes

Multifunctional Nanoparticles and Nanoclusters as a Theranostics and Symptoms Disappearing Agent for Traumatic Brain Injury

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