{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T13:40:50Z","timestamp":1794490850822,"version":"4.9.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Neurological autoimmune disorders (NADs) often intertwine with cognitive impairment (CI), representing a multi-layered challenge in both clinical understanding and therapeutic management. The compounded burden of NADs and CI not only significantly affects patient\u2019s quality of Life (QoL), condition\u2019s prognosis, and treatment outcomes, but disproportionately impacts women, who are inherently more susceptible to autoimmunity. This review endeavors to investigate gender-based cognitive deficits, their underlying mechanisms, and their clinical implications. We will focus on Hashimoto\u2019s thyroiditis (HT), Graves\u2019 disease (GD), fibromyalgia (FMS), Guillain-Barr\u00e9 syndrome (GBS), myasthenia gravis (MG), multiple sclerosis (MS), and narcolepsy type 1 (NT1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search of PubMed and the Cochrane Library was conducted for peer-reviewed articles published in the last decade. The search included the keywords \u201ccognitive impairment,\u201d \u201ccognitive decline,\u201d \u201cgender disparities,\u201d \u201cneurological autoimmune disorders,\u201d \u201cHashimoto\u2019s thyroiditis,\u201d \u201cgraves\u2019 disease,\u201d \u201cmultiple sclerosis,\u201d \u201cfibromyalgia,\u201d \u201cGuillain-Barre syndrome,\u201d \u201cmyasthenia gravis,\u201d and \u201cnarcolepsy type 1\u2033. A manual search also took place to uncover grey literature and additional studies we already know exist that did not appear in the two main databases. After applying inclusion and exclusion criteria, 14 articles were selected for analysis. These articles were evaluated for their contribution to unraveling gender-based cognitive impairment trends across NADs and the possible factors involved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The systematic search yielded a limited number of relevant studies addressing gender disparities in CI across NADs and, apart from MS, most conditions remain under-researched, indicating a significant research gap. While evidence suggests gender-based differences in the manifestations and severity of CI, these findings highlight the necessity for further investigations and innovative clinical approaches tailored to these distinctions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CI remains a critical, underexplored aspect of NADs, with gender disparities receiving even less attention. Our review highlights a research imbalance and a lack of specific investigations, leading to overgeneralized conclusions about CI across NADs and a limited understanding of the various involved mechanisms. Clinically, addressing CI in NADs requires comprehensive cognitive assessments that account for gender differences, alongside equitable access to resources and personalized treatment approaches. Future advancements are likely to revolve around diagnostic innovations, precision medicine, interdisciplinary collaborations, and holistic approaches to chronic disease management.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1555407","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T05:21:12Z","timestamp":1745385672000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Gender disparities in cognitive impairment across neurological autoimmune disorders: a systematic review"],"prefix":"10.3389","volume":"16","author":[{"given":"Rahma","family":"Ouled Toumi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chalachew","family":"Kassaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeriia","family":"Demareva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1089\/whr.2023.0073","article-title":"Long-term outcome of Graves' disease: a gender perspective","volume":"4","author":"Calissendorff","year":"2023","journal-title":"Women's Health Rep"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/j.mayocpiqo.2020.06.009","article-title":"Sex-related differences in symptoms and psychosocial outcomes in patients with fibromyalgia: a prospective questionnaire study","volume":"4","author":"Jiang","year":"2020","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"5135176","DOI":"10.1155\/2016\/5135176","article-title":"Gender differences in symptoms, health-related quality of life, sleep quality, mental health, cognitive performance, pain-cognition, and positive health in Spanish fibromyalgia individuals: the Al-\u00c1ndalus project","volume":"2016","author":"Segura-Jim\u00e9nez","year":"2016","journal-title":"Pain Res Manag"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2171","DOI":"10.1007\/s10067-022-06133-y","article-title":"Gender influence on clinical manifestations, depressive symptoms and brain-derived neurotrophic factor (BDNF) serum levels in patients affected by fibromyalgia","volume":"41","author":"Iannuccelli","year":"2022","journal-title":"Clin Rheumatol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1007\/s00415-010-5653-x","article-title":"Factors associated with long-term functional outcomes and psychological sequelae in Guillain-Barre syndrome","volume":"257","author":"Khan","year":"2010","journal-title":"J Neurol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1186\/s12955-020-01549-z","article-title":"Gender differences in quality of life among patients with myasthenia gravis in China","volume":"18","author":"Dong","year":"2020","journal-title":"Health Qual Life Outcomes"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1186\/s12883-023-03406-0","article-title":"Female sex and overweight are associated with a lower quality of life in patients with myasthenia gravis: a single center cohort study","volume":"23","author":"Wilcke","year":"2023","journal-title":"BMC Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1007\/s00415-018-9142-y","article-title":"Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German national early MS cohort (KKNMS)","volume":"266","author":"Johnen","year":"2019","journal-title":"J Neurol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2304","DOI":"10.3174\/ajnr.A3630","article-title":"Sex differences in resting-state functional connectivity in multiple sclerosis","volume":"34","author":"Koenig","year":"2013","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.3390\/jpm11101006","article-title":"What can we learn from sex differences in MS?","volume":"11","author":"Coyle","year":"2021","journal-title":"J Pers Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1175874","DOI":"10.3389\/fimmu.2023.1175874","article-title":"Potential biological contributers to the sex difference in multiple sclerosis progression","volume":"14","author":"Alvarez-Sanchez","year":"2023","journal-title":"Front Immunol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1136\/jnnp-2022-328994","article-title":"Quantitative effect of sex on disease activity and disability accumulation in multiple sclerosis","volume":"93","author":"Magyari","year":"2022","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e01086","DOI":"10.1002\/brb3.1086","article-title":"Estriol-mediated neuroprotection in multiple sclerosis localized by voxel-based morphometry","volume":"8","author":"MacKenzie-Graham","year":"2018","journal-title":"Brain Behav"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1392489","DOI":"10.3389\/fneur.2024.1392489","article-title":"Gender medicine and sleep disorders: from basic science to clinical research","volume":"15","author":"Perger","year":"2024","journal-title":"Front Neurol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1555407\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T05:21:13Z","timestamp":1745385673000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1555407\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,23]]},"references-count":14,"alternative-id":["10.3389\/fneur.2025.1555407"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1555407","relation":{"has-part":[{"id-type":"doi","id":"https:\/\/doi.org\/10.3389\/fneur.2025.1555407.s001","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.3389\/fneur.2025.1555407.s002","asserted-by":"subject"}]},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,23]]},"article-number":"1555407"}}