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Published on: August 16, 2019
Understanding Traumatic Brain Injury in Females: A State-of-the-Art Summary and Future Directions.
Eve M Valera1, Annie-Lori C Joseph, Katherine Snedaker
1Departments of Psychiatry (Dr Valera) and Pediatrics and Emergency Medicine (Dr Mannix), Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts (Dr Valera and Ms Joseph); Department of Psychology, Suffolk University, Boston, Massachusetts (Ms Joseph); PINK Concussions, Norwalk, Connecticut (Ms Snedaker); Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Breiding); US Public Health Service, Rockville, Maryland (Dr Breiding); Departments of Anesthesiology and Critical Care Medicine, and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Robertson); Rehabilitation Sciences Institute, Department of Occupational Science and Occupational Therapy, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (Dr Colantonio); Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas (Dr Levin); Michael E. Debakey Veterans Affairs Medical Center, Houston, Texas (Dr Levin); VA Salt Lake City Healthcare System, Salt Lake City, Utah (Drs Pugh and Yurgelun-Todd); Department of Medicine, University of Utah School of Medicine, Salt Lake City (Dr Pugh); Department of Psychiatry, University of Utah School of Medicine, Salt Lake City (Dr Yurgelun-Todd); Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts (Dr Mannix); Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York (Dr Bazarian); Neuroscience Center (Drs Cummings and Bellgowan), National Institute of Neurological Disorders and Stroke (Dr Turtzo), and Office of Research on Women's Health, Office of the Director/DPCPSI (Dr Begg), National Institutes of Health, Bethesda, Maryland; and School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada (Dr Turkstra).
Research on traumatic brain injury (TBI) in females is lacking, with women underrepresented in studies. This hinders a complete understanding of TBI in females and necessitates more sex-specific research.
Area of Science:
- Neuroscience
- Traumatic Brain Injury Research
- Sex Differences in Medicine
Background:
- Females are underrepresented in traumatic brain injury (TBI) research and clinical trials.
- Preclinical TBI studies have often excluded female subjects or used ovariectomy, leading to incomplete data.
- Existing research highlights significant sex differences in TBI, yet these are not adequately incorporated into studies.
Purpose of the Study:
- To identify challenges and issues in TBI research concerning females.
- To provide future research directions for understanding TBI in women.
- To summarize the state of science regarding sex differences in TBI, building on the "Understanding TBI in Women" workshop.
Main Methods:
- Literature review and synthesis of existing TBI research focusing on females.
- Analysis of findings and discussions from the "Understanding TBI in Women" workshop.
- Incorporation of updates and recent developments in the field.
Main Results:
- Females remain significantly underrepresented in TBI studies and clinical trials.
- Exclusion or manipulation of female subjects in preclinical research contributes to knowledge gaps.
- Despite some progress, research predominantly focuses on males, with limited explicit investigation into females.
Conclusions:
- There is a critical need to increase the inclusion of females in TBI research.
- Future research must address sex-specific differences to improve understanding and treatment of TBI in women.
- Addressing these research gaps is essential for a comprehensive understanding of TBI across all populations.
