Biological Sex/Gender and Biopsychosocial Determinants of Traumatic Brain Injury Recovery Trajectories

  • Janet P. NiemeierEmail author
Brain Injury Medicine and Rehabilitation (G Galang, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Brain Injury Medicine and Rehabilitation


Purpose of Review

The goals of the report are to integrate recent and key foundational gender- and sex-related, post-traumatic brain injury (TBI) literature across several research domains, to highlight need for increased cross-field communication using an integrative biopsychosocial research model, and to provide recommendations for further research approaches and foci.

Recent Findings

Recent findings of TBI studies addressing gender and/or biological sex provide evidence of women’s unique risks for injury, significant differences in severity, type, and number of post-TBI symptoms reported by women vs. men, and complex, interactive molecular, genetic, psychosocial, and physiological factors that contribute differently to TBI outcomes for the sexes.


Brain injury researchers, following years of failed clinical trials and mixed findings, are adopting new methods for more precisely characterizing differing effects of sex on both responses to TBI and recovery trajectories as well as underlying causes of these differences. New approaches include analysis of large data sets, use of sophisticated statistical models, more consistent exploration of sex-specific effects of TBI in more TBI study domains, and use of more precise measures. Increased cross-field communication and collaboration, stratification by sex, and increased adoption of these approaches are recommended to help advance understanding of TBI and move us closer to treatment development.


Traumatic brain injury Sex, gender Rehabilitation Outcomes Biopsychosocial 


Compliance with Ethical Standards

Conflict of Interest

Janet Niemeier declares no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. 1.Department of Physical Medicine and Rehabilitation, School of MedicineUniversity of Alabama, BirminghamBirminghamUSA

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