CHAPTER 23: Neurological Disorders in Women

Introduction Gender differences exist in the development and expression of several neurological disorders, potentially due to: – Sex-based biological variation – Gender-based psychosocial factors – Cultural interactions with sex and gender issues

Factors Related to Brain Variation in Men and Women Women’s brains may be more subject to changes in hormonal variation. – Receptors for sex steroids – Genetic factors can interact. – Brain plasticity

Migraine Headaches Migraine Epidemiology – 20% of U.S. women experience migraine each year. – Hormonal changes are partially responsible for women’s increased susceptibility to migraine.

Migraine Headaches Migraine Diagnosis and Disability – Hallmarks of migraine: Headache pain with a pulsating quality Pain on one side of the head Worsening of pain with physical exertion Moderate to severe pain intensity Sensitive to light and/or sound or nausea/vomiting

Migraine Headaches Biological Factors – Serotonin – Sex steroid hormones – Genetic factors

Migraine Headaches Behavioral, Environmental, and Psychosocial Factors in Migraine – Mental health issues – Income and socioeconomic status – Stress Interventions and Treatment Methods for Migraine Headaches – Both pharmacological and behavioral

Multiple Sclerosis MS is a progressive autoimmune disease affecting the brain and spinal cord. – Results in inflammation and destruction of myelin, the protective insulation that facilitates communication among neurons.

Multiple Sclerosis MS Epidemiology and Theories of Etiology – Prevalence: Approximately 1 to 120 in 100,000 – Age of onset: 20 to 40 years old – Cause is unknown, but is a combination of environmental and genetic factors

Multiple Sclerosis MS Diagnosis and Symptoms – Physical symptoms – Cognitive symptoms – Mental health Issues – Disease course

Multiple Sclerosis Reproductive Issues – Sexual functioning – Conception, pregnancy, and birth Psychosocial Factors Influencing the Experience of MS – Quality of life and disability – Stress – Coping strategies – Physical activity

Multiple Sclerosis Interventions and Treatment Methods for MS – Pharmacological to treat specific symptoms – Behavioral therapies to target physical and cognitive deficits

Conclusion Women are at greater risk for migraine and MS. – Specific factors underlying this difference have yet to be conclusively determined. Role of sex hormones should be further investigated.