Editor’s Pick: Precision Medicine in Neurology: Advancing Care for Female Patients

Growing evidence suggests that biological sex influences disease risk, clinical presentation, treatment response, and prognosis across neurological conditions. Despite this increasing awareness of important sex differences, neurological research and clinical care remain insufficiently tailored to females. In this review, the authors highlight the importance of integrating sex-specific considerations into precision medicine for neurological disorders. Focusing on five high-prevalence and high-burden neurological conditions (epilepsy, migraine, stroke, multiple sclerosis, and neurodegenerative diseases), this review identifies critical knowledge gaps and actionable opportunities for advancing care for females. Such gaps and opportunities include: 1) improved pregnancy and lactation data in epilepsy; 2) hormonal influences across the menstrual cycle, pregnancy, and menopause in migraine; 3) sex-based disparities in symptom recognition, treatment access, and rehabilitation for stroke patients; 4) the influence of sex hormones on disease onset, progression, and prognosis in multiple sclerosis; and 5) sex differences in pathophysiology and clinical trajectories in neurodegenerative diseases. This review proposes a roadmap for integrating sex-based considerations into three key domains: clinical care, research, and neurology training. Prioritising and advancing these initiatives is essential for improving neurological care and represents a critical step towards equitable precision medicine.