Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
Neuroradiology. 2023 Apr;65(4):751-763. doi: 10.1007/s00234-022-03099-1. Epub 2022 Dec 11.
Sex differences in Alzheimer's disease (AD) progression provide clues to pathogenesis and better patient management. We examined sex differences in emotional memory among AD patients, amnestic mild cognitive impairment (aMCI) patients, and healthy controls (HCs) as well as potential associations with altered regional cerebral blood flow (rCBF).
The recognition memory task with emotional pictures was applied to evaluate enhancement of emotional memory (EEM) and 3D pseudo-continuous arterial spin labeling MRI was performed to measure the rCBF in 74 AD patients (41 females), 74 aMCI patients (45 females), and 74 HCs (43 females). Group differences in EEM were tested by two-way analysis of covariance (ANCOVA) with repeated measures. The main effects of clinical group and sex as well as group × sex interactions on rCBF were assessed by two-way ANCOVA. Correlation analyses were conducted to investigate associations between EEM and rCBF.
With disease progression, EEM gradually disappeared. Among aMCI patients, females exhibited a greater index of recollection (Pr) for positive/high-arousal and negative/low-arousal pictures versus neutral pictures (P = 0.005, P = 0.003), while males exhibited a greater Pr for negative/high-arousal versus neutral pictures (P = 0.001). There were significant sex × group effects on rCBF in left inferior parietal, supramarginal, superior temporal and middle temporal gyri, and rCBF of left inferior parietal gyrus was correlated with Pr for positive/high-arousal pictures among female aMCI patients (r = 0.584, q = 0.005).
Males and females exhibit distinct changes in EEM associated with altered rCBF, which should be considered in future neuroimaging studies.
阿尔茨海默病(AD)进展过程中的性别差异为发病机制提供了线索,并有助于更好地管理患者。我们研究了 AD 患者、遗忘型轻度认知障碍(aMCI)患者和健康对照者(HCs)之间情绪记忆的性别差异,以及与改变的局部脑血流(rCBF)的潜在关联。
采用情绪图片识别记忆任务评估情绪记忆增强(EEM),并进行 3D 伪连续动脉自旋标记 MRI 测量 74 例 AD 患者(41 例女性)、74 例 aMCI 患者(45 例女性)和 74 例 HCs(43 例女性)的 rCBF。采用重复测量的两因素协方差分析(ANCOVA)检验 EEM 的组间差异。采用两因素 ANCOVA 评估临床组和性别以及组间性别交互作用对 rCBF 的主要影响。进行相关分析以探讨 EEM 与 rCBF 之间的关系。
随着疾病的进展,EEM 逐渐消失。在 aMCI 患者中,女性对正性/高唤醒和负性/低唤醒图片与中性图片的回忆指数(Pr)更高(P=0.005,P=0.003),而男性对负性/高唤醒图片与中性图片的 Pr 更高(P=0.001)。rCBF 在左顶下小叶、缘上回、颞上回和中颞回存在显著的性别-组间效应,左顶下小叶的 rCBF 与女性 aMCI 患者对正性/高唤醒图片的 Pr 相关(r=0.584,q=0.005)。
男性和女性的 EEM 表现出与改变的 rCBF 相关的不同变化,这在未来的神经影像学研究中应加以考虑。