Abstract
Background and Objective: Brain atrophy and cognitive impairment in neurodegenerative diseases are influenced by sex. We aimed to investigate sex differences in brain atrophy and cognition in de novo Parkinson's disease (PD) patients.Methods: Clinical, neuropsychological and T1-weighted MRI data from 205 PD patients (127 males: 78 females) and 69 healthy controls (40 males: 29 females) were obtained from the PPMI dataset.Results: PD males had a greater motor and rapid eye movement sleep behavior disorder symptomatology than PD females. They also showed cortical thinning in postcentral and precentral regions, greater global cortical and subcortical atrophy and smaller volumes in thalamus, caudate, putamen, pallidum, hippocampus, and brainstem, compared with PD females. Healthy controls only showed reduced hippocampal volume in males compared to females. PD males performed worse than PD females in global cognition, immediate verbal recall, and mental processing speed. In both groups males performed worse than females in semantic verbal fluency and delayed verbal recall; as well as females performed worse than males in visuospatial function.Conclusions: Sex effect in brain and cognition is already evident in de novo PD not explained by age per se, being a relevant factor to consider in clinical and translational research in PD.
Highlights
Parkinson’s disease (PD) has a 2-fold higher incidence in males reported in early population-based studies (Baldereschi et al, 2000)
Males were significantly older than females in the PD and healthy control groups, as well that the control group had more years of education than the PD group (Table 1)
In the PD group, our results showed larger subcortical gray matter volume in females than in males in the bilateral thalamus
Summary
Parkinson’s disease (PD) has a 2-fold higher incidence in males reported in early population-based studies (Baldereschi et al, 2000). Females have increased impairment in visuospatial functions (Liu et al, 2015; Lin et al, 2018; Bakeberg et al, 2021). A recent metaanalysis highlights that twenty-two studies reported segregated results for males and females regarding executive functions, ten for visuospatial skills, and nine for memory. In this context, significant effect sizes showed more impairment in males for executive functions (Curtis et al, 2019). We aimed to investigate sex differences in brain atrophy and cognition in de novo Parkinson’s disease (PD) patients
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