#BreakTheBias is the theme of International Women’s Day 2022, when advocates across Canada join the call to imagine a world that is diverse, equitable and inclusive. At Brain Canada and Women’s Brain Health Initiative (WBHI), this means celebrating the impact of female scientists as well as calling attention to long standing research gaps that impact the health outcomes for women.

In her 15 years of studying Parkinson’s disease, Janelle Drouin- Ouellet only recently came across information about the role of sex hormones in disease expression in patient blogs.

“Women with Parkinson’s shared that symptoms can be amplified in the days before their period. Menopause is also very challenging as symptoms can overlap,” says Dr. Drouin-Ouellet, an assistant professor and Canada Research Chair in Direct Neural Reprogramming at Université de Montréal. “That’s something researchers have historically not been very interested in. Even animal models [used in research] would typically be male animals, since hormones were thought to cause fluctuations that could obscure findings.”

Yet in order to create successful interventions, it is important to understand the various factors – including hormones like estrogen – that influence patient health, she explains.

“We are working with a technology called cellular reprogramming, where we take easily accessible cells, for example, from the skin, and convert them into brain cells.”

These brain cells enable the study of disease mechanisms, and resulting insights could help to shape tools for personalized medicine, she says. “We think that women with Parkinson’s experience different symptoms, such as a slower motor decline, but more pain, depression and tremors, due to differences at the molecular level.”

Dr. Drouin-Ouellet is among the recipients of an expansion grant awarded by WBHI and Brain Canada, says Lynn Posluns, WBHI founder and president, who sees the program as “a call to action for gender equity in scientific research.

“[It] plays a pivotal role in helping to address the research disparity in women’s brain health. Women suffer from depression, stroke and dementia twice as much as men as we age, and almost 70 per cent of those with Alzheimer’s are women,” she says. “By incentivizing gender-based research, we can combat brain aging diseases that disproportionately affect women as well as make research findings more inclusive – and ultimately more relevant.”

Viviane Poupon, president and CEO of Brain Canada, welcomes a growing focus on “research that examines health differences between men, women and gender-diverse individuals.”

Over three decades ago, the National Institutes of Health (NIH) issued guidelines that required women to be part of any NIH-funded clinical research. “This was based on the realization that research and clinical practices needed to change to understand the differences in disease manifestation and prevalence in men and women,” she says. “For example, everyone will immediately recognize the clinical symptoms of a heart attack in men, like chest pain and a heavy arm. Yet women seeking help for discomfort in their upper body or fatigue, which can also point to a heart attack, have often been misdiagnosed.”

Brain Canada and WBHI are actively supporting efforts to close this critical knowledge gap; for example, by encouraging researchers to incorporate a sex and gender analysis component in their research through the Brain Canada-WBHI Expansion Grants: Considering Sex and Gender Program. Dr. Poupon adds that for research funded by Brain Canada, investigators need to show a sex and gender component or, alternatively, prove that these components are not relevant.

Beyond encouraging the scientific community to study women’s brains, Posluns is especially interested in research that can shed light on preventing cognitive decline; for example, in Alzheimer’s patients. “While we’ve discovered drugs that can slow the disease progression, there isn’t one to prevent it,” she says. “However, we know that certain lifestyle choices can reduce the risk of dementia by as much as 40 per cent, which means we have more control over our cognitive destiny than we realized.”

Research has also shown that damage likely happens decades before symptoms allow a conclusive diagnosis, and Posluns suggests, “We want to focus on how to keep our brains healthy. We also need to amplify the message that for good science, research needs to look at both men and women.”

In addition to a sex and gender component, it is important to apply an equity and diversity lens to research, notes Dr. Poupon. “Whether you’re male or female, and whether you come from a minority, you bring who you are – and everything you learned and experienced – to your research. Therefore, we need diverse researchers.”

Enhancing the visibility of diverse voices and recognizing that there are many factors impacting the health outcomes for men, women and gender-diverse individuals – including biological, social and cultural influences – can help Canadians rally behind the call to break the bias, she adds.

Six Canadian research teams have been awarded funding for the implementation and/ or continuation of sex and gender considerations in research on aging, neurodegeneration and stroke through the Brain Canada- Women’s Brain Health Initiative (WBHI) expansion grant program:

  • EMPOW-HER: Exploring methods to improve participation of women in clinical trials to help enhance stroke recovery research – team led by Mark Bayley, University Health Network (UHN)
  • Sex differences in the innate immune response associated with Parkinson’s Disease – team led by Janelle Drouin-Ouellet, Université de Montréal
  • CanStim Platform: Sex and gender-based analysis expansion – team led by Jodi Edwards, University of Ottawa Heart Institute
  • Brain and cognitive effects of long-term gender affirming hormone therapy in aging trans women – team led by Gillian Einstein, University of Toronto
  • Functional Connectivity and Cognitive Decline in a Mouse Model of Alzheimer’s Disease – team led by Jonathan Epp, University of Calgary
  • Sex-Differences in Dopaminergic Regulation of Stroke Recovery in Rats – team led by Christian Ethier, Université Laval

This story was originally published on March 8, 2022, as part of the International Women’s Day special feature in The Globe and Mail, produced by Randall Anthony Communications

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