Sex and Gender Differences in the Brain Cholinergic System and in the Response to Therapy of Alzheimer Disease with Cholinesterase Inhibitors

2018 ◽  
Vol 15 (11) ◽  
pp. 1077-1084 ◽  
Author(s):  
Ezio Giacobini ◽  
Giancarlo Pepeu
Keyword(s):  
Gender Differences ◽  
Cholinergic System ◽  
Cholinesterase Inhibitors ◽  
Memory Function ◽  
Response To Therapy ◽  
Nucleus Basalis ◽  
Toxic Effects ◽  
Sex And Gender ◽  
And Gender ◽  
The Brain

This review has two aims. First, to examine whether or not sex and gender may influence the brain cholinergic system in animals and in humans. Second, to examine the available evidence of sexually dimorphic response to the therapeutic and toxic effects of cholinesterase inhibitors. Animal research reveals no marked difference in the general morphology of the brain cholinergic system but subtle functional gender differences have been reported. In humans, gender differences in nucleus basalis of Meynert (NBM) exist. In animals, some cholinergic neurons express estrogen alpha receptors in females and androgens in males. It is known that sex hormones exert trophic effects on the cholinergic system. Females show higher frontal cortex cholinergic activity whereas males have higher activity in the hippocampus. Gender differences in the pharmacological effects result in higher sensitivity to the toxic effects of organophosphate cholinesterase inhibitors in males. A stronger and more selective benefit of ChEI treatment in AD has been reported in men by several authors. Sex and estrogen receptor phenotype may both influence the response to donepezil and rivastigmine. Hence, aged male and female individuals might respond differently to ChEI due to either sex-specific differences in structures and function of the cholinergic system, pharmacokinetics, memory function or in the way aging or AD affects these processes.

scholarly journals Vascular Dementia and Underlying Sex Differences

2021 ◽  
Vol 13 ◽  
Author(s):  
Firoz Akhter ◽  
Alicia Persaud ◽  
Younis Zaokari ◽  
Zhen Zhao ◽  
Donghui Zhu
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Vascular Dementia ◽  
Synergistic Effects ◽  
Sex And Gender ◽  
First Case ◽  
Severe Stage ◽  
And Gender ◽  
The Brain ◽  
Sex And Gender Differences

Vascular dementia (VaD) is the second most common form of dementia after Alzheimer’s disease (AD); where Alzheimer’s accounts for 60–70% of cases of dementia and VaD accounts for 20% of all dementia cases. VaD is defined as a reduced or lack of blood flow to the brain that causes dementia. VaD is also known occasionally as vascular contributions to cognitive impairment and dementia (VCID) or multi-infarct dementia (MID). VCID is the condition arising from stroke and other vascular brain injuries that cause significant changes to memory, thinking, and behavior, and VaD is the most severe stage while MID is produced by the synergistic effects caused by multiple mini strokes in the brain irrespective of specific location or volume. There are also subtle differences in the presentation of VaD in males and females, but they are often overlooked. Since 1672 when the first case of VaD was reported until now, sex and gender differences have had little to no research done when it comes to the umbrella term of dementia in general. This review summarizes the fundamentals of VaD followed by a focus on the differences between sex and gender when an individual is diagnosed. In addition, we provide critical evidence concerning sex and gender differences with a few of the main risk factors of VaD including pre-existing health conditions and family history, gene variants, aging, hormone fluctuations, and environmental risk factors. Additionally, the pharmaceutical treatments and possible mitigation of risk factors is explored.

Sex and Gender Differences

2012 ◽  
Vol 220 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Markus Hausmann ◽  
Barbara Schober
Keyword(s):  
Gender Differences ◽  
Sex And Gender ◽  
And Gender ◽  
Sex And Gender Differences

scholarly journals Influence of sex and gender on the management of late-stage knee osteoarthritis

2021 ◽  
Author(s):  
B. Moretti ◽  
A. Spinarelli ◽  
G. Varrassi ◽  
L. Massari ◽  
A. Gigante ◽  
...  
Keyword(s):  
Gender Differences ◽  
Knee Osteoarthritis ◽  
Healthcare Professionals ◽  
Pain Tolerance ◽  
Exact Nature ◽  
Sex And Gender ◽  
Physician Practices ◽  
Knee Oa ◽  
And Gender ◽  
Sex And Gender Differences

Abstract Purpose The exact nature of sex and gender differences in knee osteoarthritis (OA) among patient candidates for total knee arthroplasty (TKA) remains unclear and requires better elucidation to guide clinical practice. The purpose of this investigation was to survey physician practices and perceptions about the influence of sex and gender on knee OA presentation, care, and outcomes after TKA. Methods The survey questions were elaborated by a multidisciplinary scientific board composed of 1 pain specialist, 4 orthopedic specialists, 2 physiatrists, and 1 expert in gender medicine. The survey included 5 demographic questions and 20 topic questions. Eligible physician respondents were those who treat patients during all phases of care (pain specialists, orthopedic specialists, and physiatrists). All survey responses were anonymized and handled via remote dispersed geographic participation. Results Fifty-six physicians (71% male) accepted the invitation to complete the survey. In general, healthcare professionals expressed that women presented worse symptomology, higher pain intensity, and lower pain tolerance and necessitated a different pharmacological approach compared to men. Pain and orthopedic specialists were more likely to indicate sex and gender differences in knee OA than physiatrists. Physicians expressed that the absence of sex and gender-specific instruments and indications is an important limitation on available studies. Conclusions Healthcare professionals perceive multiple sex and gender-related differences in patients with knee OA, especially in the pre- and perioperative phases of TKA. Sex and gender bias sensitivity training for physicians can potentially improve the objectivity of care for knee OA among TKA candidates.

Rethinking an Assessment of Nicotine Dependence: A Sex, Gender and Diversity Analysis of the Fagerstrom Test for Nicotine Dependence

2007 ◽  
Vol 2 (2) ◽  
pp. 59-67 ◽  
Author(s):  
Lindsay Richardson ◽  
Lorraine Greaves ◽  
Natasha Jategaonkar ◽  
Kirsten Bell ◽  
Ann Pederson ◽  
...  
Keyword(s):  
Gender Differences ◽  
Nicotine Dependence ◽  
Diversity Analysis ◽  
Sex And Gender ◽  
Accurate Picture ◽  
And Gender ◽  
Diverse Groups ◽  
Sex And Gender Differences

AbstractThis article assesses whether the Fagerstrom Test for Nicotine Dependence (FTND), adequately reflects sex, gender and diversity related differences in nicotine dependence. Available studies on the FTND were reviewed and a sex, gender and diversity analysis (SGBA) of this instrument was conducted. Results indicate that sex and gender differences in nicotine dependence may undermine the ability of the FTND to present an adequate picture of dependence. Conducting a SGBA on this Fagerstrom test reveals that sex and gender differences likely limit the ability of this instrument to present an accurate picture of dependence in diverse groups. Further research is needed to enhance the sensitivity of the FTND.

scholarly journals Gender Differences in Diabetic Kidney Disease: Focus on Hormonal, Genetic and Clinical Factors

2021 ◽  
Vol 22 (11) ◽  
pp. 5808
Author(s):  
Annalisa Giandalia ◽  
Alfio Edoardo Giuffrida ◽  
Guido Gembillo ◽  
Domenico Cucinotta ◽  
Giovanni Squadrito ◽  
...  
Keyword(s):  
Gender Differences ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Clinical Manifestations ◽  
Current Evidence ◽  
Sex And Gender ◽  
Clinical Factors ◽  
Diabetic Kidney ◽  
And Gender ◽  
The Impact

Diabetic kidney disease (DKD) is one of the most serious complications of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Current guidelines recommend a personalized approach in order to reduce the burden of DM and its complications. Recognizing sex and gender- differences in medicine is considered one of the first steps toward personalized medicine, but the gender issue in DM has been scarcely explored so far. Gender differences have been reported in the incidence and the prevalence of DKD, in its phenotypes and clinical manifestations, as well as in several risk factors, with a different impact in the two genders. Hormonal factors, especially estrogen loss, play a significant role in explaining these differences. Additionally, the impact of sex chromosomes as well as the influence of gene–sex interactions with several susceptibility genes for DKD have been investigated. In spite of the increasing evidence that sex and gender should be included in the evaluation of DKD, several open issues remain uncovered, including the potentially different effects of newly recommended drugs, such as SGLT2i and GLP1Ras. This narrative review explored current evidence on sex/gender differences in DKD, taking into account hormonal, genetic and clinical factors.

Arrhythmia in Cardiomyopathy: Sex and Gender Differences

2021 ◽  
Author(s):  
Sul Ki Kim ◽  
Richard Bennett ◽  
Jodie Ingles ◽  
Saurabh Kumar ◽  
Sarah Zaman
Keyword(s):  
Gender Differences ◽  
Sex And Gender ◽  
And Gender ◽  
Sex And Gender Differences
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