A groundbreaking review published today in Brain Medicine by renowned neuroendocrinologist Professor Hyman M. Schipper from McGill University’s Department of Neurology and Neurosurgery highlights the profound influence of reproductive hormones on neurological health and disease. This comprehensive review, featured in a special Festschrift edition commemorating Dr. Seymour Reichlin’s 100th birthday, provides an in-depth examination of how sex hormones shape a wide range of neurological conditions.
Professor Schipper’s review delves into the intricate ways in which reproductive hormones affect neurological function, exploring mechanisms such as direct interactions with nerve cells, epigenetic changes, and the recently identified brain glymphatic system. The analysis spans a broad spectrum of neurological disorders, including:
- Vascular conditions like migraines (which affect up to 60% of women during menstruation) and stroke
- Movement disorders, with a focus on Parkinson’s disease, Wilson’s disease, and chorea
- Epilepsy, especially its relationship with hormonal cycles
- Multiple sclerosis, which presents differently during pregnancy
- Alzheimer’s disease and its complex hormonal interactions
- Sleep disorders, with significant gender-based differences
- Hormone-sensitive brain tumors, particularly meningiomas
- Neuromuscular disorders like myasthenia gravis
- Other conditions, including intracranial hypertension and the porphyrias
“Our understanding of the impact of reproductive hormones on neurological conditions has evolved significantly,” Professor Schipper said. “These hormones are not only critical for reproductive functions, but they also fundamentally influence the development, functioning, and response of the nervous system to disease or injury.”
Key findings from the review include:
- The cytochrome P450 system, which is induced in the liver by certain anti-epileptic and neurological drugs, may accelerate the breakdown of circulating sex steroids, potentially leading to the failure of oral contraceptives
- Neurosteroids, hormone-derived molecules produced in the brain, hold considerable therapeutic potential
- Hormonal fluctuations during menstruation, pregnancy, and menopause can significantly affect disease progression and treatment outcomes
- A sex-specific approach may be necessary for managing many neurological diseases
The review raises several crucial questions for future research, such as:
- How do sex hormones interact with the brain’s waste-clearance system, the glymphatic system?
- Could targeting neurosteroid pathways offer new therapeutic possibilities?
- How can hormone-based treatments be optimized for individual patients?
These insights carry important implications for clinical practice, suggesting that neurologists should consider hormonal factors more thoroughly when diagnosing and treating patients. “The key lies in understanding how these hormones operate in various contexts,” Professor Schipper explained. “This knowledge could pave the way for more personalized treatment strategies.”
A Tribute to Dr. Seymour Reichlin
This article also appears in a special Festschrift dedicated to Dr. Seymour Reichlin, a distinguished physician-scientist who turned 100 last year. Dr. Reichlin’s pioneering work in neuroendocrinology revolutionized our understanding of how the immune system interacts with endocrine pathways. His research has had a lasting impact on neuroimmunology, shaping the careers of countless clinicians and scholars. At 100, Dr. Reichlin remains cognitively sharp and an ongoing source of inspiration.
Reflecting on Dr. Reichlin’s mentorship, Professor Schipper noted, “His visionary work on neuroendocrine interactions has shaped the field’s understanding of how hormones influence neurological disease.”
This Festschrift article bridges Dr. Reichlin’s groundbreaking legacy with today’s technological advances, emphasizing a long history of scientific innovation. From the earliest hormone assays to modern genomic profiling tools, the article underscores the evolving understanding that biological responses are not solely genetic or environmental, but rather a dynamic interplay of both.
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