The why, when and how to consider sex and sex hormones when imaging the human brain in health and pathology.
Pharmacological treatment options for depression work well for some but a majority of depressed patients show limited efficacy. Depression is a debilitating disorder that affects approximately 20% of the world’s population and is the leading contributor to months lost to disability. Every year nearly twice as many women as men develop a depressive illness. While this suggests that sex hormones play a key role in depression, it is understood neither in depression, nor in health how they affect mood.
Preclinical and animal models of depression exist, but our understanding of depression may be hampered by the fact that many studies do not stratify their data by sex or sex hormone status. Women are particularly susceptible to depression during the reproductive years, when sex hormone levels fluctuate. In order to build a better model of depression, and for many other neuropsychiatric pathologies, it is necessary to leverage our knowledge of these sex and life stage differences in vulnerability to disease. Accumulating evidence also suggests sex differences in treatment efficacy and it is critical to acknowledge that treatment may need to be tailored for accurate precision medicine. In this talk, I provide an overview on the current debate on sex as a biological variable in the sneuroscienes and present specific examples of how to approach this when designing your study.
I present a neurobiological model of postpartum blues, argue for a broad spectrum-approach for treatment of postpartum mood disorders, and discuss sex differences in visceral fat accumulation and structural brain networks across the lifespan. In summary, the data highlight why the inclusion of biological sex and sex hormone manipulations are imperative in order to build a better translational models of disease.
Julia Sacher, MD PhD
Minerva-Research Group Leader Emotion Neuroimaging Lab,
Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig.