The Impact of Traumatic Brain Injury on Neurodegeneration in Women: A Systematic Review

Background: The pathophysiological response of the brain after a traumatic brain injury (TBI) is not fully understood. As the prevalence of female TBI increases the current limitations within the literature surrounding the development of neurodegenerative disease (NDD) after TBI’s could, consequently lead to poorer clinical outcomes and management of female TBI patients. Objective: Investigate the current evidence to determine whether TBI in females has long-term implications on neurodegeneration or the development of NDD. Materials and Methods: A systematic literature search was conducted across nine databases (Academic Search Complete, CINAHL, SPORTDiscus and MEDLINE via EBSCOhost, ScienceDirect, Taylor & Francis, Wiley Online, PubMED and Cochrane). Including primary research of cohort, retrospective and observational studies. Participants were aged 18 or older with a diagnosis of previous TBI. Studies where participants had a previous NDD diagnosis, male only studies and those that did not analyse results by sex were excluded. Results: One study found females to be at higher risk of developing NDD, whilst three found males were at more risk compared to females. A further, three studies identified no significant differences between sex after TBI on development of NDD or neurodegeneration. Conclusion: From the results, it can be concluded that sex may play a role in the development of NDD and presence of neurodegeneration following TBI. However, this review acknowledges further research on female TBI is required to establish whether differences are due to sex, severity or the physiological differences that exist between sex.

Keywords: traumatic brain injury, brain injury, female, neurodegeneration, neurodegenerative disease, dementia.