Canosa Antonio, Martino Alessio, Manera Umberto, Giuliani Alessandro, Vasta Rosario, Palumbo Francesca, Grassano Maurizio, Morbelli Silvia Daniela, Pardini Matteo, Chiaravalloti Agostino, Schillaci Orazio, Leenders Klaus Leonard, Kogan Rosalie Vered, Polverari Giulia, Zocco Grazia, Pede Francesca Di, Mattei Filippo De, Cabras Sara, Matteoni Enrico, Moglia Cristina, Calvo Andrea, Chiò Adriano, Pagani Marco
ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy.
Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Neurology Unit 1U, Turin, Italy.
Eur J Neurol. 2025 Jan;32(1):e16588. doi: 10.1111/ene.16588.
We investigated sex-related brain metabolic differences in Amyotrophic Lateral Sclerosis (ALS) and healthy controls (HC).
We collected two equal-sized groups of male (m-ALS) and female ALS (f-ALS) patients (n = 130 each), who underwent 2-[F]FDG-PET at diagnosis, matched for site of onset, cognitive status and King's stage. We included 168 age-matched healthy controls, half female (f-HC) and half male (m-HC). We compared brain metabolism of males and females separately for ALS and HC, including age as covariate. A differential network analysis was performed to evaluate brain connectivity.
M-ALS showed relative hypometabolism of bilateral medial frontal, parietal and occipital cortices, and left temporal cortex, compared to f-ALS. In node-wise comparison, f-ALS showed significantly higher connectivity in right middle cingulate cortex and left superior and medial frontal gyrus. In HC we did not find any sex-related differences.
Sex resulted a major determinant of brain metabolism and connectivity in ALS patients.
我们研究了肌萎缩侧索硬化症（ALS）患者与健康对照者（HC）之间与性别相关的脑代谢差异。
我们收集了两组人数相等的男性（m-ALS）和女性ALS（f-ALS）患者（每组n = 130），他们在诊断时接受了2-[F]FDG-PET检查，在发病部位、认知状态和King分期方面进行了匹配。我们纳入了168名年龄匹配的健康对照者，其中一半为女性（f-HC），一半为男性（m-HC）。我们分别比较了ALS患者和健康对照者中男性和女性的脑代谢情况，将年龄作为协变量。进行了差异网络分析以评估脑连接性。
与f-ALS相比，m-ALS双侧内侧额叶、顶叶和枕叶皮质以及左侧颞叶皮质表现出相对代谢减低。在节点比较中，f-ALS在右侧中央扣带回皮质以及左侧额上回和额中回显示出显著更高的连接性。在健康对照者中，我们未发现任何与性别相关的差异。
性别是ALS患者脑代谢和连接性的主要决定因素。
