Sex Differences In Onset Research Articles

Sex Differences in Onset and Progression of Cerebral Amyloid Angiopathy.

Cerebral Amyloid Angiopathy (CAA) disease course is highly variable even in hereditary forms. Sex may be a possible modifying factor. We investigated biological sex differences in clinical disease course and magnetic resonance imaging-markers in sporadic (sCAA) and Dutch-type hereditary CAA (D-CAA). Patients with D-CAA and sCAA were included from hospital and research databases of the Leiden University Medical Center (2012-2020) and Massachusetts General Hospital (1994-2012). Key outcomes were: sex differences in symptomatic intracerebral hemorrhage (sICH) onset, recurrence and survival (analyzed using Kaplan Meier survival and regression analyses), and sex differences in magnetic resonance imaging-markers in D-CAA (explored using scatterplots), and in sCAA (investigated using regression analysis). We included 136 patients with D-CAA (mean age 57 years, 56% women, 64% with previous sICH) and 370 patients with sCAA (mean age 76 years, 51% women, all with previous sICH). Men and women with D-CAA did not differ for sICH onset (median age 54 in men and 56 in women [P=0.13]). Men with D-CAA had a slightly higher number of sICH compared with women (median 2 versus 1; adjusted RR, 1.5 [95% CI, 1.1-1.9]) and a shorter interval between the first and second sICH (median 1.8 years for men and 3.1 years for women, P=0.02). Men with sCAA had their first sICH at an earlier age (median 75 versus 78 years, respectively, P=0.003) and more lobar microbleeds (median 1 versus 0, P=0.022) compared with women with sCAA. No substantial differences were found in the other magnetic resonance imaging markers. Survival after first sICH was comparable between sexes for D-CAA (P=0.12) and sCAA (P=0.23). Men with CAA seem to have an earlier onset (sCAA) and more hemorrhagic disease course (sCAA and D-CAA) compared with women. Future studies are necessary to confirm these findings and determine the underlying role of sex-related factors.

Sex differences in onset to hospital arrival time, prestroke disability, and clinical symptoms in patients with a large vessel occlusion: a MR CLEAN Registry substudy

BackgroundWomen have been reported to have worse outcomes after endovascular treatment (EVT), despite a similar treatment effect in non-clinical trial populations. We aimed to assess sex differences at hospital presentation...

The impact of hypertension on chronic kidney disease and end-stage renal disease is greater in men than women: a systematic review and meta-analysis

BackgroundHypertension (HTN) is an established risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). Whether sex differences in the effect of HTN on CKD and ESRD incidence exist remains unclear. This systematic review and meta-analysis was conducted to evaluate the relative impact of HTN on CKD and ESRD risk in women compared with men.MethodsWe systematically searched Embase and PubMed for cohort studies until 24 July 2020. Studies were selected if they reported a sex-specific association between systolic blood pressure (SBP) and CKD or ESRD. Random effects meta-analyses with inverse variance weighting were used to pool sex-specific relative risks (RRs) and the women-to-men ratio of RRs (the RRR) for incident CKD and ESRD.ResultsData from six cohorts, including 2,382,712 individuals and 6856 incident CKD events, and 833 ESRD events, were included in the meta-analysis. The RR for incident CKD or ESRD associated with HTN (SBP ≥140 mmHg) versus ideal BP (SBP < 120 mmHg) was 1.56 (95% CI, 1.39–1.75) in women and 2.06 (95% CI, 1.64–2.60) in men. The RR for incident CKD or ESRD was 23% lower in women than in men RRR 0.77 [95% CI, 0.63–0.95] with no significant heterogeneity between studies (p-value for Q test = 0.507, I2 = 17.7%).ConclusionHTN confers about a fifth lower excess risk of incident CKD or ESRD in women than men. Sex differences in onset, duration, and severity of some risk factors, such as albuminuria, diabetes, cardiovascular disease, obesity, and socioeconomic status, may explain part of the excess risk in men. Another explanation could be that women might be under-diagnosed and less likely to initiate dialysis. Future studies are needed to demonstrate the mechanisms responsible for the observed sex difference.

Sex Differences in Variability of Brain Structure Across the Lifespan.

Several brain disorders exhibit sex differences in onset, presentation, and prevalence. Increased understanding of the neurobiology of sex-based differences in variability across the lifespan can provide insight into both disease vulnerability and resilience. In n= 3069 participants, from 8 to 95years of age, we found widespread greater variability in males compared with females in cortical surface area and global and subcortical volumes for discrete brain regions. In contrast, variance in cortical thickness was similar for males and females. These findings were supported by multivariate analysis accounting for structural covariance, and present and stable across the lifespan. Additionally, we examined variability among brain regions by sex. We found significant age-by-sex interactions across neuroimaging metrics, whereby in very early life males had reduced among-region variability compared with females, while in very late life this was reversed. Overall, our findings of greater regional variability, but less among-region variability in males in early life may aid our understanding of sex-based risk for neurodevelopmental disorders. In contrast, our findings in late life may provide a potential sex-based risk mechanism for dementia.

Sex differences in psychotomimetic-induced behaviours in rats

Animal model studies using equal numbers of males and females are sparse in psychiatry research. Given the marked sex differences observed in psychiatric disorders, such as schizophrenia, using both males and females in research studies is an important requirement. Thus the aim of this study was to examine sex differences in psychotomimetic-induced behavioural deficits relevant to psychosis. We therefore compared the acute effect of amphetamine or phencyclidine on locomotor activity and prepulse inhibition in adult male and female Sprague-Dawley rats. The results of this study were that: (1) amphetamine-induced distance travelled was greater in female rats than in male rats, (2) phencyclidine-induced locomotor hyperactivity was similar in male and female rats; (3) there were no sex differences in amphetamine- or phencyclidine-induced disruption of prepulse inhibition; (4) male rats had an increased startle response after amphetamine. These findings suggest that sensitivity to amphetamine, but not phencyclidine, differs between male and female rats, and that this sex difference is selective to locomotor hyperactivity and startle, but not prepulse inhibition. This study used two widely-used, validated preclinical assays relevant to psychosis; the results of this study have implications for psychiatry research, particularly for disorders where marked sex differences in onset and symptomology are observed.

Schizophrenia clinical symptom differences in women vs. men with and without a history of childhood physical abuse.

BackgroundChildhood abuse has been implicated as an environmental factor that increases the risk for developing schizophrenia. A recent large population-based case–control study found that abuse may be a risk factor for schizophrenia in women, but not men. Given the sex differences in onset and clinical course of schizophrenia, we hypothesized that childhood abuse may cause phenotypic differences in the disorder between men and women.MethodsWe examined the prevalence of childhood physical abuse in a cohort of men and women with schizophrenia and schizoaffective disorder. Specifically, we examined differences in positive, negative, cognitive and depressive symptoms in men and women who reported a history of childhood physical abuse. We recruited 100 subjects for a single visit and assessed a history of childhood physical abuse using the childhood trauma questionnaire (CTQ) and clinical symptoms and cognition using the brief psychiatric rating scale (BPRS), the calgary depression scale (CDS) and the repeatable battery of the assessment of neuropsychological status (RBANS) for cognition.ResultsNinety-two subjects completed the full CTQ with abuse classified as definitely present, definitely absent or borderline. Twelve subjects who reported borderline abuse scores were excluded. Of the 80 subjects whose data was analyzed, 10 of 24 (41.6 %) women and 11 of 56 (19.6 %) men reported a history of childhood physical abuse (χ2 = 4.21, df = 1, p = 0.04). Women who reported such trauma had significantly more psychotic (sex by abuse interaction; F = 4.03, df = 1.76, p = 0.048) and depressive (F = 4.23, df = 1.76, p = 0.04) symptoms compared to women who did not have a trauma history and men, regardless of trauma history. There were no differences in negative or cognitive symptoms.ConclusionsWomen with schizophrenia and schizoaffective disorder may represent a distinct phenotype or subgroup with distinct etiologies and may require different, individually tailored treatments.

Changes in response to odors during the reproductive period in male and female prairie voles (Microtus ochrogaster)

In prairie voles, Microtus ochrogaster (Wagner, 1842), the onset of parental caring differs by sex and reproductive condition. Maternal caring is displayed abruptly at parturition, whereas paternal caring intensifies gradually during the reproductive period. To determine if changes in odor responsiveness contribute to sex differences in onset of parental behavior, voles were given a choice to investigate various odors at different times during the reproductive cycle. Subjects were either sexually naïve or mated. Mated pairs cohabited until mid-gestation, late gestation, or 3 days postpartum. Voles crossed a tunnel to explore a row of three filter papers covered with infant odor, orange extract, or saline. Males and females exhibited different odor preferences. Males preferred infant odor to saline and orange extract, whereas females preferred infant odor and saline to orange extract. Mating changed the odor investigative behaviors in both males and females. Some voles vigorously manipulated odor-covered papers. The number of females manipulating the papers increased abruptly at late gestation. The number of males manipulating the papers was particularly high at mid-gestation and after the birth of young. Results suggest that mating and cohabitation in prairie voles influences odor responses in a sex-specific manner.

Relationship between sex differences in onset of schizophrenia and puberty

Some neurodevelopmental hypotheses of schizophrenia have postulated that sex differences in onset of illness could be explained by sexual dimorphism in onset of puberty, suggesting that early maturation accounts for the later onset of illness in women. The objective of this study was to analyse the relationship between age of menarche and age of onset of schizophrenia in a sample of Chilean patients. The medical records of 105 schizophrenic women diagnosed according to DSM-III-R criteria were studied. In all cases age of onset (first psychotic symptoms) and age of menarche were obtained. Pearson's correlation and student's t-test were used to analyse the data. The mean age of menarche in the sample of female patients (12.98 years, S.D.=1.49) was significantly different from that of the general population of Santiago, Chile (12.53 years, S.D.=1.32) ( t=2.38; P<0.05). The mean age of onset of schizophrenia in female patients (19.92 years, S.D.=5.13) was significantly earlier in the Chilean sample than that reported in European and North American samples ( P<0.05). No differences were observed when comparing the mean age at menarche. The subtypes with the earliest onset presented the earliest age of menarche and the subtypes with the latest onsets showed the latest ages at menarche. However, no correlation was observed between the age at onset of illness and the age at menarche, both in the total sample and in the analysis by subtype. The results of this study do not support a correlation between puberty and age of onset of illness.

Nursing posture is elicited rapidly in maternally naive, haloperidol-treated female and male rats in response to ventral trunk stimulation from active pups

Maternal responsiveness in rats can be induced in virgin females and males, without hormonal priming, following several days of cohabitation with pups. Because antagonism of dopamine (DA) facilitates nursing behavior in lactating rats, the response of nonlactating, maternally naive rats to effective stimulation of the ventral trunk (ventrum) from pups following similar treatment was investigated. Lactating dams, virgin females and males, both intact and gonadectomized, were treated with a catalepsy-inducing dose of haloperidol (5 mg/kg), a DA receptor antagonist, and tested with hungry pups 1 hr later. Subjects were placed over 8 pups and postures assessed every 3 min for 30 min. The nursing posture occurred in most subjects. Lactating and nonlactating females were similar in occurrence of the nursing crouch, though the intensity was somewhat higher in the former; females scored higher than males in terms of likelihood and intensity of crouching; and there was no effect of gonadectomy. The nursing posture was not elicited in intact virgin females if the stimulus pups were anesthetized or if the subjects were treated with saline instead of haloperidol. There were no sex differences in onset or intensity of catalepsy in response to the dose of haloperidol used. These results suggest that the nursing posture occurs reflexively, is not directly dependent upon ovarian hormones, and is diminished by the effects of androgens, prior and current.

Empirical tests of sexual selection theory: Predictions of sex differences in onset, intensity, and time course of sexual arousal

An evolutionary model of sexual behavior was used to generate predictions about sex differences in sexual arousal. Survey instruments were used to test these predictions with 388 adolescents, aged 12-18, from varying socioeconomic strata and geographic regions. Boys reported that their first arousal occurred at the start of puberty or before, usually in response to a visual stimulus, whereas girls generally reported first arousal as occurring 2-3 or more years after puberty, within a social/romantic context. The modal boy reported sexual arousal as occurring several times daily, the modal girl once or twice a week. Boys reported their arousal to be more discriminable, of greater intensity, and more distracting than the girls'. The sexes differed in attitudes related to sexual behavior. However, when reporting emotions and feelings coterminous with sexual arousal, the sexes did not differ. Retrospective college samples of 262 students from West Coast colleges replicated the adolescent data. A survey of 280 East Coast college students found that women's sexual arousal was significantly more partner-dependent than men's. Results were interpreted as supporting evolutionary models of sex differences in sexuality.