Modak Anurag, Zappi Kyle E, Catoya Alexander J, Lemdani Mehdi S, Koller Gretchen M, Seltzer Laurel, Radwanski Ryan E, Pannullo Susan C
Department of Neurosurgery, New Jersey Medical School, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA.
Center for Advanced Biotechnology and Medicine, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA.
Neurotrauma Rep. 2024 Apr 11;5(1):417-423. doi: 10.1089/neur.2023.0066. eCollection 2024.
Pediatric traumatic brain injury (pTBI) is a major risk factor associated with adulthood incarceration. Most research into the link between pTBI and adulthood incarceration has focused on incarcerated males, who comprise the vast majority of incarcerated adults, particularly in industrialized nations. In this review, we sought to identify sex-related differences in the incidence and pathophysiology of pTBI and subsequent risk of adulthood incarceration. A scoping review was undertaken using PubMed, Scopus, Ovid, and the Cochrane Library. Articles analyzing sex-related differences in pTBI and adult incarceration rates, studies conducted on an incarcerated population, and cohort studies, cross-sectional studies, clinical trials, systematic reviews, or meta-analyses were included in this review. Of the 85 unique results, 25 articles met our inclusion criteria. Male children are 1.5 times more likely to suffer a TBI than females; however, the prevalence of incarcerated adults with a history of pTBI is ∼35-45% for both sexes. Neurophysiologically, female sex hormones are implicated in neuroprotective roles, mitigating central nervous system (CNS) damage post-TBI, although this role may be more complex, given that injury severity and sequelae have been correlated with male sex whereas increased mortality has been correlated with female sex. Further investigation into the relationship between estrogen and subsequent clinical measurements of CNS function is needed to develop interventions that may alleviate the pathophysiological consequences of pTBI.
小儿创伤性脑损伤（pTBI）是与成年期监禁相关的主要风险因素。大多数关于pTBI与成年期监禁之间联系的研究都集中在被监禁的男性身上，他们占被监禁成年人的绝大多数，尤其是在工业化国家。在本综述中，我们试图确定pTBI的发病率和病理生理学以及成年期监禁后续风险方面的性别差异。我们使用PubMed、Scopus、Ovid和Cochrane图书馆进行了一项范围综述。分析pTBI与成人监禁率性别差异的文章、对被监禁人群进行的研究以及队列研究、横断面研究、临床试验、系统评价或荟萃分析均纳入本综述。在85个独特结果中，有25篇文章符合我们的纳入标准。男童患创伤性脑损伤的可能性是女童的1.5倍；然而，有pTBI病史的被监禁成年人的患病率在两性中均约为35%-45%。在神经生理学方面，女性性激素具有神经保护作用，可减轻创伤性脑损伤后中枢神经系统（CNS）的损伤，不过鉴于损伤严重程度和后遗症与男性相关，而死亡率增加与女性相关，这一作用可能更为复杂。需要进一步研究雌激素与中枢神经系统功能后续临床测量之间的关系，以开发可能减轻pTBI病理生理后果的干预措施。
