Cited by 392Autism Spectrum Disorder ResearchGenetics and Neurodevelopmental DisordersSexual Differentiation and Disorders

Sex differences in autism spectrum disorder: a review

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Ferri, Sarah L., Abel, Ted, Brodkin, Edward S.·2018·Current Psychiatry Reports

Abstract

Purpose of review Neurodevelopmental disorders disproportionately affect males. The mechanisms underlying male vulnerability or female protection are not known and remain understudied. Determining the processes involved is crucial to understanding the etiology and advancing treatment of neurodevelopmental disorders. Here, we review current findings and theories that contribute to male preponderance of neurodevelopmental disorders, with a focus on autism.Recent findings Recent work on the biological basis of the male preponderance of autism and other neurodevelopmental disorders includes discussion of a higher genetic burden in females and sex-specific gene mutations or epigenetic changes that differentially confer risk to males or protection to females. Other mechanisms discussed are sex chromosome and sex hormone involvement. Specifically, fetal testosterone is involved in many aspects of development and may interact with neurotransmitter, neuropeptide, or immune pathways to contribute to male vulnerability. Finally, the possibilities of female underdiagnosis and a multi-hit hypothesis are discussed. This review highlights current theories of male bias in developmental disorders. Topics include environmental, genetic, and epigenetic mechanisms; theories of sex chromosomes, hormones, neuroendocrine, and immune function; underdiagnosis of females; and a multi-hit hypothesis.

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  1. [32]http://autismsciencefoundation.org/about-asf/media-center/press-releases/autism-sisters-project/.

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Authors
Ferri, S. L., Abel, T., & Brodkin, E. S.
Affiliations
  • University of Iowa (US)
  • University of Pennsylvania (US)
Corresponding author
Brodkin, Edward S.
Venue
Current Psychiatry Reports
Published
2018-02
Volume
20
Issue
2
Pages
9-9
ISSN
  • 1523-3812 (ISSN-L)
  • 1535-1645
OpenAlex
W2790546718
Cited by
392
References
225
Citations by year
2026: 33 · 2025: 54 · 2024: 63 · 2023: 51 · 2022: 58 · 2021: 50 · 2020: 44 · 2019: 30 · 2018: 7 · 2017: 1 · 2016: 1
FWCI
4.41
Type
journal article
Language
en
Open access
Locations
  • Current Psychiatry Reports (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • University of Pennsylvania
  • National Institute of Mental Health (R34MH104407)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
Keywords
autism spectrum disorder, sex differences, male preponderance, neurodevelopmental disorders, fetal testosterone, sex hormones, sex chromosomes, epigenetics, immune function, neurotransmitters, neuropeptides
MeSH terms
Autism Spectrum Disorder, Female, Humans, Male, Psychopathology, Sex Factors, Epigenesis, Genetic, Protective Factors

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