Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands.
Mult Scler. 2012 Feb;18(2):164-73. doi: 10.1177/1352458511422245. Epub 2011 Sep 9.
Gender effects are strong in multiple sclerosis (MS), with male patients showing a worse clinical outcome than female patients. Functional reorganization of neural activity may contribute to limit disability, and possible gender differences in this process may have important clinical implications.
The aim of this study was to explore gender-related changes in functional connectivity and network efficiency in MS patients. Additionally, we explored the association of functional changes with cognitive function.
Sixty subjects were included in the study, matched for age, education level and intelligence quotient (IQ). Male and female patients were matched for disability, disease duration and white matter lesion load. Two cognitive domains often impaired in MS, i.e. visuospatial memory and information processing speed, were evaluated in all subjects. Functional connectivity between brain regions and network efficiency was explored using resting-state functional magnetic resonance imaging and graph analysis. Differences in cognitive and functional characteristics between groups, and correlations with cognitive performance, were examined.
Male patients showed worse performance on cognitive tests than female and male controls, while female patients were cognitively normal. Decreases in functional connectivity and network efficiency, observed in male patients, correlated with reduced visuospatial memory (r = -0.6 and r = -0.5, respectively). In the control group, no cognitive differences were found between genders, despite differences in functional connectivity between healthy men and women.
Functional connectivity differences were found in male patients only and were related to impaired visuospatial memory. These results underline the importance of gender in MS and require further investigation in larger and longitudinal studies.
多发性硬化症（MS）中存在明显的性别效应，男性患者的临床预后比女性患者差。神经活动的功能重组可能有助于限制残疾，而这一过程中的性别差异可能具有重要的临床意义。
本研究旨在探讨 MS 患者中与性别相关的功能连接和网络效率变化。此外，我们还探讨了功能变化与认知功能的关系。
本研究纳入了 60 名受试者，他们在年龄、教育水平和智商（IQ）方面相匹配。男性和女性患者在残疾、疾病持续时间和白质病变负荷方面相匹配。所有受试者均进行了两个在 MS 中常受损的认知领域的评估，即视空间记忆和信息处理速度。使用静息态功能磁共振成像和图分析来探讨脑区之间的功能连接和网络效率。我们检查了组间认知和功能特征的差异，以及与认知表现的相关性。
男性患者的认知测试表现比女性和男性对照组差，而女性患者的认知则正常。男性患者观察到的功能连接和网络效率下降与视空间记忆减退相关（r = -0.6 和 r = -0.5）。在对照组中，尽管健康男性和女性之间的功能连接存在差异，但性别之间没有发现认知差异。
仅在男性患者中发现了功能连接差异，并且与视空间记忆受损有关。这些结果强调了 MS 中性别差异的重要性，需要在更大规模和纵向研究中进一步研究。
