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Sexual Dimorphisms in Neurodevelopment May Affect TBI Recovery in Pediatric Patients
Moira F Taber1,2, Franklin D West1,2,3, Erin E Kaiser1,2,3
1Regenerative Bioscience Center, University of Georgia, Athens, GA 30602, USA.
Insights
Pediatric traumatic brain injury (TBI) recovery varies by sex. Understanding sex-based neurodevelopmental differences is crucial for tailored treatments and improved outcomes in children with TBI.
Area of Science:
- Neuroscience
- Pediatric Medicine
- Developmental Biology
Background:
- Traumatic brain injury (TBI) is a significant cause of death and disability, especially in children.
- Pediatric TBI patients exhibit diverse recovery patterns, with neurodevelopmental alterations impacting cognitive, behavioral, and motor functions.
- Sex-based differences in neuroanatomy and development may influence TBI outcomes, but are understudied in pediatric populations.
Purpose of the Study:
- To review and synthesize current evidence on how biological sex influences neurodevelopmental trajectories after pediatric TBI.
- To explore sex-specific alterations in brain structure, white and gray matter, and neural networks post-TBI.
- To identify how these sex-based differences correlate with functional recovery and inform precision medicine.
Main Methods:
- Systematic literature review and synthesis of existing research.
- Analysis of studies examining sex as a biological variable in pediatric TBI.
- Focus on neuroanatomical structures, white and gray matter, and network disruptions.
Main Results:
- Limited data exists on sex differences in pediatric TBI due to small sample sizes and underrepresentation of females.
- Sex influences neurodevelopmental trajectories and neural network organization, potentially leading to differential TBI impacts.
- Sex-specific deficits in social cognition, memory, and behavior are observed in pediatric TBI patients.
Conclusions:
- Acknowledging sex as a biological variable is critical for understanding pediatric TBI pathology and recovery.
- Further research with robust sex-stratified data is needed to elucidate sex-specific mechanisms.
- This knowledge can drive precision medicine strategies for improved pediatric TBI patient outcomes.
Abstract:
Traumatic brain injury (TBI) is a leading cause of death and disability, with broad heterogeneity in recovery outcomes particularly noted in pediatric patients. Children post-TBI are vulnerable to aberrant neurodevelopment, specifically in structural and functional neural networks as they correlate with cognitive, behavioral, and motor function outcomes. Consideration for sex as a biological variable which innately influences neuroanatomy, neurodevelopment, and functional organization may elucidate risk factors for negative outcomes in pediatric TBI. For example, TBI damage in sexually dimorphic neural structures and networks may explain deficits in social cognition, working memory, as well as internalizing and externalizing behaviors, which differentially impact the quality of life in male versus female TBI patients. However, characterization of sex in conjunction with developmental patterns in normal and injured pediatric populations is limited due to small sample sizes, the low representation of females, a lack of longitudinal data, and the utilization of analyses that are not sensitive enough to detect subtle differences in TBI pathologies and recovery between the sexes. This review aims to analyze and synthesize the existing evidence regarding the influence of sex on the developmental trajectories of neuroanatomical structures, white and gray matter compartments, and the network disruptions that align with sex-specific functional recovery outcomes following pediatric TBI. The delineation of these sex influences will facilitate better precision-based medicine approaches to improve patient outcomes.
