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Sex Differences in TBI & Depression: Results from multi-ethnic observational and treatment Studies
Objective:
The goal of this talk is to discuss the role of social and biological determinants of health in TBI outcome including sex, gender, and ethnicity. Approximately 40% of Americans experiencing emergency department visits, hospitalizations, or deaths related to TBI are women. Women have greater TBI risk following vehicle accidents, falls, and intimate partner violence. Women experience worse post-injury outcomes, including greater cognitive problems and increased risk of depressive disorders. Many factors may play a role in observed sex differences in outcomes after brain injury, including metabolic and hormonal factors, differences in cortical thickness, and social differences in how the injury is viewed. Preclinical, epidemiological, diagnostic, and rehabilitative treatment outcomes in current TBI-related research have disproportionately represented men.
Given the over-represenation of men in the TBI literature, a large gap exists in the inclusion, reporting, and understanding of how sex/gender differences may impact pathophysiological changes or predictors of recovery outcomes for many established interventions, especially in TBI with related cognitive and psychiatric symptoms. This talk will discuss research focusing specificall on outcomes in females in the US and Iran. new efforts using basic science approaches (Repetitive Transcranial Magnetic Stimulation; rTMS) as an intervention for psychiatric conditions such as major depressive disorder (MDD), while also recognizing important sex-based differences in outcome. While rTMS appears more efficacious in females, the mechanisms for these sex-based differences remain unknown. Finally, we extend these analyses beyond typical Western TBI samples including an international study where deep learning models were used to predict for EEG response to rTMS in Iranian women suffering from MDD.
The results presented here spanning distinct countries and cultures, highlight the potential for using brain stimulation methods to treat MDD symptoms after TBI. The findings also support the use of neuroimaging and EEG as a response predictor especially in designing treatment protocols for women with TBI and/or MDD.
Overall, this talk highlights the need for focused study of sex-based differences in muti-ethnic TBI samples and the use of TMS as an intervention for MDD after TBI.