Sex differences in neurological disorders: Insights from ischemic stroke, Parkinson’s disease, and multiple sclerosis

IF 8.8 2区医学 Q1 IMMUNOLOGY

Brain, Behavior, and Immunity Pub Date : 2025-06-18 DOI:10.1016/j.bbi.2025.06.026

Cassandra J. Kaufhold, Kathiresh Kumar Mani, Zara Akbari, Farida Sohrabji

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引用次数: 0

Abstract

Ischemic stroke, Parkinson’s disease (PD), and multiple sclerosis (MS), are neurodegenerative disorders that exhibit significant sex differences in pathophysiology, clinical manifestations, and outcomes. Women are more likely to experience strokes in older age, with estrogen playing dual protective/detrimental roles depending on reproductive age. In PD, men show earlier onset and steadier decline, while women exhibit a protective estrogen-driven advantage and distinct gut-brain axis interactions. MS disproportionately affects women (3:1 ratio), particularly during reproductive years, with sex hormones and X-linked genes modulating autoimmune demyelination. This review synthesizes sex-specific mechanisms across these diseases, emphasizing immune dysregulation, hormonal influences, and emerging roles of the gut microbiome. Key modifiers such as epigenetic factors, microbiome composition, and sex chromosome interactions are discussed to inform personalized therapeutic strategies.

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神经系统疾病的性别差异：缺血性中风、帕金森病和多发性硬化症的见解

缺血性脑卒中、帕金森病（PD）和多发性硬化症（MS）是神经退行性疾病，在病理生理、临床表现和预后方面存在显著的性别差异。女性在老年时更容易中风，雌激素根据生育年龄发挥双重保护/有害作用。在PD中，男性表现出更早的发病和更稳定的下降，而女性表现出保护性的雌激素驱动优势和明显的肠-脑轴相互作用。多发性硬化症对女性的影响尤为严重（比例为3:1），特别是在生育年龄，性激素和x连锁基因调节自身免疫性脱髓鞘。这篇综述综合了这些疾病的性别特异性机制，强调了免疫失调、激素影响和肠道微生物组的新作用。关键的修饰因子，如表观遗传因素，微生物组组成和性染色体相互作用进行了讨论，以告知个性化的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain, Behavior, and Immunity 医学-免疫学

CiteScore

29.60

自引率

2.00%

发文量

290

审稿时长

28 days

期刊介绍： Established in 1987, Brain, Behavior, and Immunity proudly serves as the official journal of the Psychoneuroimmunology Research Society (PNIRS). This pioneering journal is dedicated to publishing peer-reviewed basic, experimental, and clinical studies that explore the intricate interactions among behavioral, neural, endocrine, and immune systems in both humans and animals. As an international and interdisciplinary platform, Brain, Behavior, and Immunity focuses on original research spanning neuroscience, immunology, integrative physiology, behavioral biology, psychiatry, psychology, and clinical medicine. The journal is inclusive of research conducted at various levels, including molecular, cellular, social, and whole organism perspectives. With a commitment to efficiency, the journal facilitates online submission and review, ensuring timely publication of experimental results. Manuscripts typically undergo peer review and are returned to authors within 30 days of submission. It's worth noting that Brain, Behavior, and Immunity, published eight times a year, does not impose submission fees or page charges, fostering an open and accessible platform for scientific discourse.