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Whoa, whoa, I mean male/female. Don't read too much between the lines. Women get it more often, but guys get it rougher. Boy, that still sounds bad. - Dave
Gender-related differences in functional connectivity in multiple sclerosis
Menno M Schoonheim m.schoonheim@vumc.nl
Dept of Radiology/Anatomy & Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
Hanneke E Hulst
Dept of Radiology/Anatomy & Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
Doriana Landi
Department of Neurology, “Campus Bio-Medico” University, Rome, Italy
Olga Ciccarelli
Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom
Stefan D Roosendaal
Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
Ernesto J Sanz-Arigita
Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
Hugo Vrenken
Department of Radiology/Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
Chris H Polman
Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
Cornelis J Stam
Department of Clinical Neurophysiology, VU University Medical Center, Amsterdam, The Netherlands
Frederik Barkhof
Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
Jeroen JG Geurts
Department of Clinical Neurophysiology, VU University Medical Center, Amsterdam, The Netherlands
Abstract
Background: Gender effects are strong in multiple sclerosis (MS), with male patients showing a worse clinical outcome than female patients. Functional reorganization of neural activity may contribute to limit disability, and possible gender differences in this process may have important clinical implications.
Objectives: The aim of this study was to explore gender-related changes in functional connectivity and network efficiency in MS patients. Additionally, we explored the association of functional changes with cognitive function.
Methods: Sixty subjects were included in the study, matched for age, education level and intelligence quotient (IQ). Male and female patients were matched for disability, disease duration and white matter lesion load. Two cognitive domains often impaired in MS, i.e. visuospatial memory and information processing speed, were evaluated in all subjects. Functional connectivity between brain regions and network efficiency was explored using resting-state functional magnetic resonance imaging and graph analysis. Differences in cognitive and functional characteristics between groups, and correlations with cognitive performance, were examined.
Results: Male patients showed worse performance on cognitive tests than female and male controls, while female patients were cognitively normal. Decreases in functional connectivity and network efficiency, observed in male patients, correlated with reduced visuospatial memory (r = −0.6 and r = −0.5, respectively). In the control group, no cognitive differences were found between genders, despite differences in functional connectivity between healthy men and women.
Conclusions: Functional connectivity differences were found in male patients only and were related to impaired visuospatial memory. These results underline the importance of gender in MS and require further investigation in larger and longitudinal studies.
Gender-related differences in functional connectivity in multiple sclerosis
Menno M Schoonheim m.schoonheim@vumc.nl
Dept of Radiology/Anatomy & Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
Hanneke E Hulst
Dept of Radiology/Anatomy & Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
Doriana Landi
Department of Neurology, “Campus Bio-Medico” University, Rome, Italy
Olga Ciccarelli
Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom
Stefan D Roosendaal
Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
Ernesto J Sanz-Arigita
Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
Hugo Vrenken
Department of Radiology/Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
Chris H Polman
Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
Cornelis J Stam
Department of Clinical Neurophysiology, VU University Medical Center, Amsterdam, The Netherlands
Frederik Barkhof
Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
Jeroen JG Geurts
Department of Clinical Neurophysiology, VU University Medical Center, Amsterdam, The Netherlands
Abstract
Background: Gender effects are strong in multiple sclerosis (MS), with male patients showing a worse clinical outcome than female patients. Functional reorganization of neural activity may contribute to limit disability, and possible gender differences in this process may have important clinical implications.
Objectives: The aim of this study was to explore gender-related changes in functional connectivity and network efficiency in MS patients. Additionally, we explored the association of functional changes with cognitive function.
Methods: Sixty subjects were included in the study, matched for age, education level and intelligence quotient (IQ). Male and female patients were matched for disability, disease duration and white matter lesion load. Two cognitive domains often impaired in MS, i.e. visuospatial memory and information processing speed, were evaluated in all subjects. Functional connectivity between brain regions and network efficiency was explored using resting-state functional magnetic resonance imaging and graph analysis. Differences in cognitive and functional characteristics between groups, and correlations with cognitive performance, were examined.
Results: Male patients showed worse performance on cognitive tests than female and male controls, while female patients were cognitively normal. Decreases in functional connectivity and network efficiency, observed in male patients, correlated with reduced visuospatial memory (r = −0.6 and r = −0.5, respectively). In the control group, no cognitive differences were found between genders, despite differences in functional connectivity between healthy men and women.
Conclusions: Functional connectivity differences were found in male patients only and were related to impaired visuospatial memory. These results underline the importance of gender in MS and require further investigation in larger and longitudinal studies.
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