Sex/gender differences in the brain and cognition in schizophrenia

• Published in: Neuroscience and biobehavioral reviews 2016-08, Vol.67, p.57-78
• Main Authors: Mendrek, Adrianna, Mancini-Marïe, Adham
• Format: Article
• Language: English
• Subjects: Brain; Brain morphology; Cognition; Female; Gender; Humans; Male; Neurocognitive function; Schizophrenia; Schizophrenic Psychology; Sex Characteristics; Sex differences; Sex steroid hormones
• ISSN: 0149-7634; 1873-7528
• DOI: 10.1016/j.neubiorev.2015.10.013

•Evidence of sex differences in the neurocognitive function in schizophrenia is presented.•Two trends emerge: a) normal sex differences in the lateral frontal network b) disturbed sexual dimorphism in the corticolimbic system.•Involvement of sex steroid hormones and gender role socialization is discussed. The early conceptualizations of schizophrenia have noted some sex/gender differences in epidemiology and clinical expression of the disorder. Over the past few decades, the interest in differences between male and female patients has expanded to encompass brain morphology and neurocognitive function. Despite some variability and methodological shortcomings, a few patterns emerge from the available literature. Most studies of gross neuroanatomy show more enlarged ventricles and smaller frontal lobes in men than in women with schizophrenia; finding reflecting normal sexual dimorphism. In comparison, studies of brain asymmetry and specific corticolimbic structures, suggest a disturbance in normal sexual dimorphism. The neurocognitive findings are somewhat consistent with this picture. Studies of cognitive functions mediated by the lateral frontal network tend to show sex differences in patients which are in the same direction as those observed in the general population, whereas studies of processes mediated by the corticolimbic system more frequently reveal reversal of normal sexual dimorphisms. These trends are faint and future research would need to delineate neurocognitive differences between men and women with various subtypes of schizophrenia (e.g., early versus late onset), while taking into consideration hormonal status and gender of tested participants.