Neurodevelopmental disorders, which emerge early in development, include a range
of neurological phenotypes and exhibit marked differences in prevalence between
sexes. A male predominance is particularly pronounced in autism spectrum
disorder (ASD). Although the precise cause of ASD is still unknown, certain
genetic variations and environmental influences have been implicated as risk
factors. Preclinical ASD models have been instrumental in shedding light on the
mechanisms behind the sexual dimorphism observed in this disorder. In this
review, we explore the potential processes contributing to sex bias by examining
both intrinsic differences in neuronal mechanisms and the influence of external
factors. We organize these mechanisms into six categories: 1) sexually dimorphic
phenotypes in mice with mutations in ASD-associated genes related to synaptic
dysfunction; 2) sex-specific microglial activity, which may disrupt neural
circuit development by excessively pruning synapses during critical periods; 3)
sex steroid hormones, such as testosterone and allopregnanolone, that
differentially influence brain structure and function; 4) escape from X
chromosome inactivation of the O-linked-N-acetylglucosamine transferase gene in
the placenta; 5) sexually dimorphic activation of the integrated stress response
pathway following maternal immune activation; and 6) immunological responses
that are differentially regulated by sex. Understanding these mechanisms is
essential for deciphering the underlying causes of ASD and may offer insights
into other disorders with notable sex disparities.