Biomedical Sciences Institute, Trinity College Dublin , Dublin , Ireland.
Amyotroph Lateral Scler Frontotemporal Degener. 2014 Jun;15(3-4):235-43. doi: 10.3109/21678421.2013.865749. Epub 2013 Dec 18.
Our objective was to explore neuroanatomical differences between female and male ALS patients in the context of sexual dimorphism in healthy controls. Fourteen female ALS patients, 13 male ALS patients, 22 healthy male controls and 20 healthy female controls were recruited into a comprehensive neuroimaging study. Cortical thickness measurements and diffusion tensor imaging (DTI) were utilized to explore gender-specific anatomical vulnerability. DTI analysis across all study groups revealed higher fractional anisotropy in association with male gender in the brainstem, cerebellum, fornix, thalamus, anterior forceps and corticospinal tracts accounting for diagnosis and age. While females showed a trend of higher age-adjusted cortical thickness in the right parieto-occipital and left mid-frontal regions, males demonstrated higher cortical thickness in the left lingual and left superior temporal regions, accounting for diagnosis. Significant multifocal white matter differences have also been identified between healthy male and female controls. In conclusion, sexual dimorphism is an overlooked and potentially confounding factor in admixed ALS neuroimaging studies. Our results suggest that gender is an additional dimension of disease heterogeneity in ALS. Given the significant pre- and post-morbid gender differences, we feel that ALS imaging studies should be controlled for gender or, alternatively, single gender studies should be considered.
我们的目的是在健康对照组的性别二态性背景下，探索女性和男性肌萎缩侧索硬化症 (ALS) 患者之间的神经解剖差异。我们招募了 14 名女性 ALS 患者、13 名男性 ALS 患者、22 名健康男性对照者和 20 名健康女性对照者，进行了一项全面的神经影像学研究。我们利用皮质厚度测量和弥散张量成像 (DTI) 来探索性别特异性的解剖脆弱性。对所有研究组的 DTI 分析表明，在与男性性别相关的脑桥、小脑、穹窿、丘脑、前束和皮质脊髓束中，存在更高的各向异性分数，这与诊断和年龄有关。虽然女性在右侧顶枕叶和左侧额中回区域表现出较高的年龄校正皮质厚度趋势，但男性在左侧舌回和左侧颞上回区域表现出更高的皮质厚度，这与诊断有关。我们还在健康男性和女性对照者之间确定了显著的多灶性白质差异。总之，性别二态性是混杂 ALS 神经影像学研究中被忽视的潜在混杂因素。我们的研究结果表明，性别是 ALS 疾病异质性的另一个维度。鉴于发病前和发病后的性别差异显著，我们认为 ALS 影像学研究应该控制性别，或者考虑进行单性别研究。
