Bayram Ece, Coughlin David G, Koga Shunsuke, Ross Owen A, Litvan Irene, Dickson Dennis W
Movement Disorders Center Department of Neurology University of Colorado Anschutz Aurora Colorado USA.
Parkinson and Other Movement Disorders Center Department of Neurosciences University of California San Diego La Jolla California USA.
Alzheimers Dement (Amst). 2025 Jan 29;17(1):e70083. doi: 10.1002/dad2.70083. eCollection 2025 Jan-Mar.
Clinicopathological correlations differ by sex in Lewy body dementia (LBD). However, previous studies have focused on pathological staging systems that place less emphasis on regional pathologies.
We included 357 people (131 female, 226 male) with a high likelihood of LBD based on pathology from the Brain Bank for Neurodegenerative (Jacksonville, FL). Sex differences for regional Lewy body, senile plaque, and neurofibrillary tangle counts and their associations with clinical LBD diagnosis were assessed.
Females were less likely to have a clinical LBD diagnosis; they had more Lewy bodies, neurofibrillary tangles, and senile plaques in various regions than males (all 's < 0.05). A higher likelihood of clinical LBD diagnosis was associated with more middle frontal, cingulate, and entorhinal Lewy body pathology, and more so for males than for females (all 's < 0.045).
Sex differences for clinicopathological correlations in LBD also occur at the regional pathology level. Females have a higher frequency of clinical misdiagnosis than males.
Females have a higher risk of clinical underdiagnosis for Lewy body dementia (LBD) than males.Regional pathology counts differ by sex for people with a high likelihood of LBD.Regional pathology association with clinical LBD diagnosis differs by sex.Regional Lewy body counts have a stronger association with LBD phenotype for males.
路易体痴呆（LBD）的临床病理相关性存在性别差异。然而，既往研究主要集中在对区域病理学关注较少的病理分期系统上。
我们纳入了357名基于佛罗里达州杰克逊维尔神经退行性疾病脑库的病理学结果而高度疑似LBD的患者（女性131名，男性226名）。评估了路易体、老年斑和神经原纤维缠结计数的性别差异及其与临床LBD诊断的关联。
女性临床诊断为LBD的可能性较小；与男性相比，她们在各个区域有更多的路易体、神经原纤维缠结和老年斑（所有P值均<0.05）。临床LBD诊断的较高可能性与额中回、扣带回和内嗅区更多的路易体病理改变相关，且男性的相关性高于女性（所有P值均<0.045）。
LBD临床病理相关性的性别差异也出现在区域病理学水平。女性临床误诊的频率高于男性。
女性路易体痴呆（LBD）临床漏诊的风险高于男性。高度疑似LBD的患者区域病理学计数存在性别差异。区域病理学与临床LBD诊断的关联存在性别差异。区域路易体计数与男性LBD表型的关联更强。
