Sant Pau Memory Unit, Department of Neurology, Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain.
Alzheimers Dement. 2021 Aug;17(8):1329-1341. doi: 10.1002/alz.12299. Epub 2021 Feb 16.
Biological sex is an increasingly recognized factor driving clinical and structural heterogeneity in Alzheimer's disease, but its role in the behavioral variant of frontotemporal dementia (bvFTD) is unknown.
We included 216 patients with bvFTD and 235 controls with magnetic resonance imaging (MRI) from a large multicenter cohort. We compared the clinical characteristics and cortical thickness between men and women with bvFTD and controls. We followed the residuals approach to study behavioral and cognitive reserve.
At diagnosis, women with bvFTD showed greater atrophy burden in the frontotemporal regions compared to men despite similar clinical characteristics. For a similar amount of atrophy, women demonstrated better-than-expected scores on executive function and fewer changes in apathy, sleep, and appetite than men.
Our findings suggest that women might have greater behavioral and executive reserve than men, and neurodegeneration must be more severe in women to produce symptoms similar in severity to those in men.
生物性别是导致阿尔茨海默病临床和结构异质性的一个日益被认可的因素，但它在额颞叶痴呆（bvFTD）的行为变异型中的作用尚不清楚。
我们纳入了来自一个大型多中心队列的 216 名 bvFTD 患者和 235 名 MRI 对照者。我们比较了 bvFTD 患者和对照组中男性和女性的临床特征和皮质厚度。我们采用残差方法研究行为和认知储备。
在诊断时，尽管临床特征相似，但与男性相比，女性 bvFTD 患者的额颞叶区域的萎缩负担更大。对于相同程度的萎缩，女性在执行功能方面的得分优于预期，而在淡漠、睡眠和食欲方面的变化则少于男性。
我们的研究结果表明，女性可能比男性具有更大的行为和执行储备，而且女性的神经退行性变必须更为严重，才能产生与男性相似严重程度的症状。
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