Oltra Javier, Segura Barbara, Strafella Antonio P, van Eimeren Thilo, Ibarretxe-Bilbao Naroa, Diez-Cirarda Maria, Eggers Carsten, Lucas-Jiménez Olaia, Monté-Rubio Gemma C, Ojeda Natalia, Peña Javier, Ruppert Marina C, Sala-Llonch Roser, Theis Hendrik, Uribe Carme, Junque Carme
Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Faculty of Medicine, Clínic Campus, Carrer de Casanova, 143, Ala Nord, 5th floor, 08036, Barcelona, Catalonia, Spain.
Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Catalonia, Spain.
NPJ Parkinsons Dis. 2024 Mar 23;10(1):69. doi: 10.1038/s41531-024-00686-2.
Clinical, cognitive, and atrophy characteristics depending on sex have been previously reported in Parkinson's disease (PD). However, though sex differences in cortical gray matter measures in early drug naïve patients have been described, little is known about differences in cortical thickness (CTh) as the disease advances. Our multi-site sample comprised 211 non-demented PD patients (64.45% males; mean age 65.58 ± 8.44 years old; mean disease duration 6.42 ± 5.11 years) and 86 healthy controls (50% males; mean age 65.49 ± 9.33 years old) with available T1-weighted 3 T MRI data from four international research centers. Sex differences in regional mean CTh estimations were analyzed using generalized linear models. The relation of CTh in regions showing sex differences with age, disease duration, and age of onset was examined through multiple linear regression. PD males showed thinner cortex than PD females in six frontal (bilateral caudal middle frontal, bilateral superior frontal, left precentral and right pars orbitalis), three parietal (bilateral inferior parietal and left supramarginal), and one limbic region (right posterior cingulate). In PD males, lower CTh values in nine out of ten regions were associated with longer disease duration and older age, whereas in PD females, lower CTh was associated with older age but with longer disease duration only in one region. Overall, male patients show a more widespread pattern of reduced CTh compared with female patients. Disease duration seems more relevant to explain reduced CTh in male patients, suggesting worse prognostic over time. Further studies should explore sex-specific cortical atrophy trajectories using large longitudinal multi-site data.
帕金森病（PD）中与性别相关的临床、认知和萎缩特征此前已有报道。然而，尽管已描述了早期未用药患者皮质灰质测量中的性别差异，但对于疾病进展过程中皮质厚度（CTh）的差异却知之甚少。我们的多中心样本包括211名非痴呆型PD患者（男性占64.45%；平均年龄65.58±8.44岁；平均病程6.42±5.11年）和86名健康对照者（男性占50%；平均年龄65.49±9.33岁），他们有来自四个国际研究中心的可用T1加权3T MRI数据。使用广义线性模型分析区域平均CTh估计值中的性别差异。通过多元线性回归研究在显示出性别差异的区域中CTh与年龄、病程和发病年龄之间的关系。PD男性在六个额叶区域（双侧尾侧额中回、双侧额上回、左侧中央前回和右侧眶部）、三个顶叶区域（双侧顶下小叶和左侧缘上回）和一个边缘系统区域（右侧后扣带回）的皮质比PD女性更薄。在PD男性中，十个区域中有九个区域较低的CTh值与较长的病程和较高的年龄相关，而在PD女性中，较低的CTh仅在一个区域与较高的年龄相关，但与较长的病程相关。总体而言与女性患者相比男性患者CTh降低的模式更为广泛。病程似乎与解释男性患者CTh降低更相关，提示随着时间推移预后更差。未来的研究应使用大型纵向多中心数据探索性别特异性的皮质萎缩轨迹。
