Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
SC Medicine-Haemostasis and Thrombosis, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Adv Ther. 2024 Dec;41(12):4377-4383. doi: 10.1007/s12325-024-03016-3. Epub 2024 Oct 23.
Sex and gender are crucial variables in understanding brain development and disease. Biological sex is determined by genetic and hormonal factors, whereas gender is a multidimensional construct shaped by social and cultural influences. The interplay of these factors contributes to sex-specific susceptibilities and disease progression in psychiatric and neurological disorders. However, sex and gender are often considered as a single variable, which can lead to biased data analysis and interpretation. This commentary aims to analyze how sex and gender influence brain structure and function, with implications for personalized medicine, research, and the development of gender-sensitive clinical guidelines.
Findings from various studies employing neuroimaging techniques and animal models are discussed, as well as the impact of biological sex, gender, environmental, cultural, and social factors on brain development, organization, and behavior.
Evidence suggests that sex differences in brain structure and function are not only genetically determined but are also influenced by gender-related experiences and societal contexts. Importantly, discrepancies between male and female brains are reduced in gender-equal societies. Preclinical studies play a pivotal role in determining the influence of biological sex, independent of gender, in different disease models.
The findings underscore the need to consider both sex and gender in research and clinical practice to avoid biases and promote equitable health outcomes. Moving forward, we advocate for gender-sensitive approaches to be integrated into brain research and in clinical guidelines to achieve personalized and precision medicine.
性别是理解大脑发育和疾病的关键变量。生物学性别由遗传和激素因素决定,而性别是由社会和文化影响塑造的多维结构。这些因素的相互作用导致了精神和神经疾病中特定性别的易感性和疾病进展。然而,性别通常被视为一个单一变量,这可能导致数据分析和解释存在偏差。本评论旨在分析性别如何影响大脑结构和功能,以及对个性化医学、研究和制定性别敏感的临床指南的影响。
讨论了各种使用神经影像学技术和动物模型的研究结果,以及生物学性别、性别、环境、文化和社会因素对大脑发育、组织和行为的影响。
有证据表明,大脑结构和功能的性别差异不仅由遗传决定,还受到与性别相关的经历和社会背景的影响。重要的是,在性别平等的社会中,男女大脑之间的差异会减少。临床前研究在确定不同疾病模型中生物学性别(独立于性别)的影响方面发挥着关键作用。
这些发现强调了在研究和临床实践中需要同时考虑性别和性别,以避免偏见并促进公平的健康结果。展望未来,我们提倡将性别敏感的方法纳入大脑研究和临床指南中,以实现个性化和精准医学。