Sex differences in brain atrophy in multiple sclerosis
Sex differences in brain atrophy in multiple sclerosis
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DOI：
10.1186/s13293-020-00326-3
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发表时间：
2020-08-28
影响因子：
7.9
通讯作者：
MacKenzie-Graham, Allan
中科院分区：
文献类型：
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作者：
Voskuhl, Rhonda R.;Patel, Kevin;MacKenzie-Graham, Allan
背景女性比男性更易患多发性硬化症(MS)，比例约为3：1。然而，男性是更严重残疾进展的危险因素。炎症基因与易感性有关，而神经退化是残疾进展的基础。因此，性对炎症和神经退行性变的影响似乎是不同的。此外，在多发性硬化症患者中，灰质(GM)萎缩在整个大脑中并不是统一的，而是表现出区域性的差异。在这里，我们通过比较患有多发性硬化症的男性和女性与他们各自年龄和性别匹配的健康对照组的区域性GM萎缩来研究神经退行性变中的性别差异。方法采用基于体素的形态计量学(VBM)、深部GM亚结构体积测量和皮质变薄等方法观察局部GM萎缩。结果VBM分析显示男性和女性MS患者丘脑区GM深度萎缩，而男性在壳核和局限性皮质区有额外萎缩。容量测定证实了严重的GM丢失，而局限性的皮质变薄证实了大脑皮层GM的丢失。此外，男性多发性硬化症患者在9孔钉测试(9HPT)上的表现比女性多发性硬化症患者差。我们观察到在男性多发性硬化症患者中丘脑体积和9HPT表现之间存在很强的相关性，而在女性多发性硬化症患者中则没有。结论男性多发性硬化症患者较女性多发性硬化症患者存在更多的区域性GM萎缩，这与以往的观察结果一致，即男性性别是疾病恶化的危险因素。
Background Women are more susceptible to multiple sclerosis (MS) than men by a ratio of approximately 3:1. However, being male is a risk factor for worse disability progression. Inflammatory genes have been linked to susceptibility, while neurodegeneration underlies disability progression. Thus, there appears to be a differential effect of sex on inflammation versus neurodegeneration. Further, gray matter (GM) atrophy is not uniform across the brain in MS, but instead shows regional variation. Here, we study sex differences in neurodegeneration by comparing regional GM atrophy in a cohort of men and women with MS versus their respective age- and sex-matched healthy controls. Methods Voxel-based morphometry (VBM), deep GM substructure volumetry, and cortical thinning were used to examine regional GM atrophy. Results VBM analysis showed deep GM atrophy in the thalamic area in both men and women with MS, whereas men had additional atrophy in the putamen as well as in localized cortical regions. Volumetry confirmed deep GM loss, while localized cortical thinning confirmed GM loss in the cerebral cortex. Further, MS males exhibited worse performance on the 9-hole peg test (9HPT) than MS females. We observed a strong correlation between thalamic volume and 9HPT performance in MS males, but not in MS females. Conclusion More regional GM atrophy was observed in men with MS than women with MS, consistent with previous observations that male sex is a risk factor for worse disease progression.