Neuroprotection by estrogen and progesterone in traumatic brain injury and spinal cord injury

Evgeni Brotfain, Shaun E. Gruenbaum, Matthew Boyko, Ruslan Kutz, Alexander Zlotnik, Moti Klein

Research output: Contribution to journalArticlepeer-review

95 Scopus citations

Abstract

In recent years there has been a growing body of clinical and laboratory evidence demonstrating the neuroprotective effects of estrogen and progesterone after traumatic brain injury (TBI) and spinal cord injury (SCI). In humans, women have been shown to have a lower incidence of morbidity and mortality after TBI compared with age-matched men. Similarly, numerous laboratory studies have demonstrated that estrogen and progesterone administration is associated with a mortality reduction, improvement in neurological outcomes, and a reduction in neuronal apoptosis after TBI and SCI. Here, we review the evidence that supports hormone-related neuroprotection and discuss possible underlying mechanisms. Estrogen and progesterone-mediated neuroprotection are thought to be related to their effects on hormone receptors, signaling systems, direct antioxidant effects, effects on astrocytes and microglia, modulation of the inflammatory response, effects on cerebral blood flow and metabolism, and effects on mediating glutamate excitotoxicity. Future laboratory research is needed to better determine the mechanisms underlying the hormones’ neuroprotective effects, which will allow for more clinical studies. Furthermore, large randomized clinical control trials are needed to better assess their role in human neurodegenerative conditions.

Original languageEnglish
Pages (from-to)641-653
Number of pages13
JournalCurrent Neuropharmacology
Volume14
Issue number6
DOIs
StatePublished - 1 Aug 2016

Keywords

  • Estrogen
  • Neuroprotection
  • Progesterone
  • Spinal cord injury
  • Traumatic brain injury

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