during the panel discussions. They challenged participants to identify the next steps necessary to overcome these challenges, other factors that could ease the successful translation of sex differences from preclinical to clinical studies, and additional priority areas for research.

Much of the workshop discussion focused on females because they often bear the greater burden across many parameters in the neurological disorders discussed. However, sex difference research offers the opportunity to determine why one sex may be more predisposed to certain diseases, or have worse outcomes, while the other sex is protected. Therefore, the results from sex differences research will have a significant impact on the public health of both sexes.

BARRIERS

Over the course of the workshop, a variety of barriers to conducting more appropriate, extensive, or prioritized sex-based research in diseases of the nervous system were identified (Box 6-1). Participants broadly acknowledged that sex differences are important in neurological disorders, but that current knowledge of underlying biology is insufficient, both in health and disease. Participants were very concerned that almost no attention is paid to the importance of personalized medicine (age, race, ethnicity, sex, genetics) in health science education curriculums.

Participants identified a lack of expertise by study section reviewers in recognizing the importance of sex differences research in funding applications. Another difficulty is that no study section or special emphasis panel exists that specifically funds research on sex differences. For example, locating funding to develop a mouse model for estrogen receptor action in the brain would be difficult. The study of sex differences transcends tissues, diseases, and the Institutes at the National Institutes of Health (NIH). The traditional way that the NIH has been organized does not allow for a concentrated interest in sex differences; they must be studied in the context of something else.

The absence of animal models of human neurological conditions was also highlighted by participants as a barrier, as was the fact that many studies predominantly use male animals. The absence of reliable animal models is a tremendous barrier to CNS drug development. As animal models are developed, strategies will need to be established that take into account potential sex differences.

Dissemination of information on sex differences was also a topic of interest. Even when studies include male and female animals, results are often not reported by sex. Journals generally have no standard policy about including information on the sex of subjects studied or cell lines used, or the



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