Interactions between age, sex, and hormones in experimental ischemic stroke

Abstract

Age, sex, and gonadal hormones have profound effects on ischemic stroke outcomes, although how these factors impact basic stroke pathophysiology remains unclear. There is a plethora of inconsistent data reported throughout the literature, primarily due to differences in the species examined, the timing and methods used to evaluate injury, the models used, and confusion regarding differences in stroke incidence as seen in clinical populations versus effects on acute neuroprotection or neurorepair in experimental stroke models. Sex and gonadal hormone exposure have considerable independent impact on stroke outcome, but these factors also interact with each other, and the contribution of each differs throughout the lifespan. The contribution of sex and hormones to experimental stroke will be the focus of this review. Recent advances and our current understanding of age, sex, and hormone interactions in ischemic stroke with a focus on inflammation will be discussed.

Gender difference in acquired seizure susceptibility in adult rats after early complex febrile seizures

“…Gender differences are associated with many neurological disorders including epilepsy [1][2][3][4] , and are involved in its diagnosis and treatment. For example, the prevalence of epilepsy is higher in men than in women [5] ; men are more vulnerable to seizure-associated brain damage than women [6] ; and gender differences may influence the treatment effect of anticonvulsants [7,8] .…”

High incidence of adverse cerebral blood flow responses to spreading depolarization in the aged ischemic rat brain

“…Aging emerges as a major independent risk factor for the incidence and prevalence of ischemic stroke and predicts poor patient outcomes (Chen et al, 2010;Liu and McCullough, 2012). Considering our aging population, it is becoming ever more urgent to identify targets for therapeutic intervention to restrain the evolution of ischemic brain injury and improve stroke outcome.…”

The impact of aging on spreading depolarization in the intact and ischemic rat brain

“…Background: Aging emerges as a major independent risk factor for the incidence and prevalence of ischemic stroke and predicts poor patient outcomes 41,42 . In our aging population, much of the primary injury in the acute phase of ischemic stroke may prove…”

“…Even though stroke may occur in any phase of life, aging predicts poor patient outcomes while it emerges as the most important independent risk factor for the incidence and prevalence of ischemic stroke 42 . The impact of age on stroke pathophysiology has been the target of intensive research in order to understand the reason for the increased susceptibility of the aged brain to stroke-related injury.…”

“…The impact of age on stroke pathophysiology has been the target of intensive research in order to understand the reason for the increased susceptibility of the aged brain to stroke-related injury. Aging was associated with the increased conversion of penumbra into infarction in patients 43 , more severe ischemia-related neurological impairment in old mice, 42 , and accelerated infarct development and neuronal degeneration in old rats 44 . Although SD may be implicated in all these events, the impact of aging on SD evolution, and the potential role SD might play in the age-related worsening of stroke outcome have remained largely unexplored 45 .…”