When talking about traumatic brain injuries, we usually tend to classify them as male-specific injuries. This is due primarily to the fact that more males than females partake in activities known for increasing a person's risk for suffering from TBIs. However, as female prevalence in these high-risk sports activities continues to grow, it has become increasingly imperative to address the differences in the effects experienced by males and females suffering from a traumatic brain injury.
Researchers like Dr. Claudia Spani at the University of Kentucky emphasize that these differences are due in large part to the female hormones estrogen and progesterone. According to Dr. Spani's compilation of various studies involving TBI in rodents, "females in their proestrus stage at time of injury had less edema formation compared to females in their nonproestrous stage," demonstrating the neuroprotective effects supplied by the female sex hormones. Moreover, another study discovered that "Progesterone supplementation in ovariectomized rats [significantly reduced] the loss of neuronal cells in [regions] of the hippocampus" while "Estrogen administration [...] in females that underwent an ovariectomy significantly reduced markers of programmed cell death." However, it is important to note that the effects of progesterone and estrogen treatment vary depending on a number of factors, including the sex of the affected individual, their age, and the severity of their injury.
While on the topic of traumatic brain injuries and sex differences, it is worth mentioning that several studies have demonstrated through their research the differences in recovery time between males and females after suffering from a TBI. This means that not only do males and females respond differently to the effects of TBIs, but they also differ drastically in their recovery times. One study conducted by Michael Collins, a concussion scientist from the University of Pittsburgh Medical Center, showed that women "tend to experience more eye movement and visual stability issues following a concussion than men, which can require longer recovery times." Countless research articles have supported this finding and have dug deeper into the biological differences between the sexes to explain why females experience longer recovery times. Some researchers have found that this could be the result of women having "higher rates of glucose metabolism" while another study "reported brain injuries during certain phases of the [menstrual] cycle might take longer to heal, which researchers think might be due to a sudden drop in levels of progesterone." Essentially, the research presented by Dr. Spani as well as other scientists highlights the significance of sex differences in responding to and recovering from traumatic brain injuries. However, while Dr. Spani focuses on TBIs in general, the second study goes a step further by discussing recovery times and a specific TBI, concussions.
Overall, as we continue to uncover more information about the effects of TBIs, we should strive to eliminate the male bias that exists in many pre-clinical research trials surrounding these TBIs. Doing so will pave the way for more studies involving males and females and increase our understanding and knowledge of how females react and respond to a number of injuries studied previously only in males.
Works Cited:
Kwon, Diana. "Concussion Recovery Is Slower in Girls, Mounting Evidence Suggests." Scientific American, 2 Oct. 2017, https://www.scientificamerican.com/article/concussion-recovery-is-slower-in-girls-mounting-evidence-suggests/
Spani, Claudia B., Braun, David J., Van Eldik, Linda J. (2018). Sex-related responses after traumatic brain injury: Considerations for preclinical modeling. Frontiers in Neuroendocrinology, 50, 52-66. https://www.sciencedirect.com/science/article/pii/S0091302218300086
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