Kleineberg Nina N, Schmidt Claudia C, Fink Gereon R, Weiss Peter H
Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Cognitive Neuroscience, Institute of Neurosciences and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany.
Eur J Neurol. 2025 May;32(5):e70201. doi: 10.1111/ene.70201.
The motor-cognitive syndrome apraxia is a common stroke sequela and severely affects the outcome after stroke by impairing activities of daily living. Notably, like in many health conditions, there is a massive backlog regarding studies on sex differences in patients with apraxia despite common knowledge that sex influences praxis performance in healthy participants. We investigated putative sex differences in apraxic stroke patients at the behavioral and neural levels.
We retrospectively analysed the data of a cohort of 102 left-hemisphere stroke patients in the (sub)acute phase who were apraxic according to the Cologne Apraxia Screening (KAS). We conducted voxel-based lesion-symptom mapping (VLSM) to elucidate the lesion patterns. Further, in an age-matched subsample (tolerance of 5 years) with equal numbers of men and women, behavioral comparisons and a VLSM analysis were conducted to explore differential sex-related lesion patterns.
Overall, apraxic deficits were associated with lesions in the parietal, temporal, and frontal regions in the cohort of 102 left-hemisphere stroke patients. The age-matched cohort consisted of 30 women and 30 men and showed no significant differences in demographic and clinical characteristics. There were no performance differences between men and women at the behavioral level regarding praxis functions. In contrast, VLSM revealed differential lesion patterns by sex. Male compared to female apraxic stroke patients significantly more often showed lesions that affected the left inferior frontal gyrus.
The data suggest a differential organization of the praxis system in men and women, warranting further exploration.
运动认知综合征失用症是一种常见的中风后遗症，通过损害日常生活活动严重影响中风后的预后。值得注意的是，与许多健康状况一样，尽管人们普遍知道性别会影响健康参与者的实践表现，但关于失用症患者性别差异的研究仍有大量积压。我们在行为和神经层面研究了失用性中风患者可能存在的性别差异。
我们回顾性分析了一组102例处于（亚）急性期的左半球中风患者的数据，这些患者根据科隆失用症筛查（KAS）被判定为失用症。我们进行了基于体素的病变-症状映射（VLSM）以阐明病变模式。此外，在一个年龄匹配的子样本（年龄容忍度为5岁）中，男女数量相等，我们进行了行为比较和VLSM分析，以探索与性别相关的差异病变模式。
总体而言，在这102例左半球中风患者队列中，失用症缺陷与顶叶、颞叶和额叶区域的病变有关。年龄匹配的队列由30名女性和30名男性组成，在人口统计学和临床特征方面没有显著差异。在实践功能的行为层面，男性和女性之间没有表现差异。相比之下，VLSM显示了按性别划分的差异病变模式。与女性失用性中风患者相比，男性更常出现影响左侧额下回的病变。
数据表明男性和女性的实践系统组织存在差异，值得进一步探索。
