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Sex differences in neurology: a scoping review
Ginette Moores1, Patrick E Steadman2, Amirah Momen2
1Department of Medicine, University of Toronto, Toronto, Ontario, Canada ginette.moores@medportal.ca.
BMJ Open
|April 11, 2023
Summary
Neurology research shows a persistent sex bias, with inconsistent use of sex and gender terms. More action is needed to address sex differences in neuroscience and improve terminology.
Area of Science:
- Neurology
- Neuroscience
- Sex and Gender Differences in Health
Background:
- Historically, neurology research has been characterized by a significant sex bias, with a predominant inclusion of male subjects in clinical trials and insufficient reporting of data stratified by sex.
- Recent years have seen a growing emphasis on increasing female participant representation and explicitly evaluating sex differences in clinical research.
Purpose of the Study:
- To conduct a scoping review of the literature examining sex differences across four key neurology subspecialty areas: demyelination, headache, stroke, and epilepsy.
- To assess the appropriate and consistent use of sex and gender terminology within this body of research.
Main Methods:
- A comprehensive scoping review was conducted using multiple databases (Ovid MEDLINE, Cochrane Central, EMBASE, Emcare, PsycINFO) for articles published between 2014 and 2020.
- Studies focusing on sex or gender differences in adults with neurological conditions were included after title, abstract, and full-text screening by independent reviewers.
- The review analyzed the scope, content, and trends of studies evaluating sex differences in neurology.
Main Results:
- The search yielded 22,745 articles, with 585 meeting the inclusion criteria.
- The majority of included studies were observational, with few randomized controlled trials specifically designed to assess sex differences.
- A significant issue identified was the interchangeable or incorrect use of "sex" and "gender" terms in 36% of the articles.
Conclusions:
- Despite the recognized importance of sex and gender as determinants of health, their explicit consideration in clinical literature has not led to substantial changes in neuroscience research regarding sex differences.
- There is an ongoing and urgent need for informed action to acknowledge and address sex differences in scientific discovery.
- Correcting the inconsistent and inaccurate use of sex and gender terminology is crucial for advancing neuroscience research.
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