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Arenaza-Urquijo EM, Boyle R, Casaletto K, Anstey KJ, Vila-Castelar C, Colverson A, Palpatzis E, Eissman JM, Kheng Siang Ng T, Raghavan S, Akinci M, Vonk JMJ, Machado LS, Zanwar PP, Shrestha HL, Wagner M, Tamburin S, Sohrabi HR, Loi S, Bartrés-Faz D, Dubal DB, Prashanthi V, Okonkwo O, Hohman TJ, Ewers M, Buckley RF. Sex and gender differences in cognitive resilience to aging and Alzheimer's disease. Alzheimers Dement 2024. [PMID: 38967222 DOI: 10.1002/alz.13844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/08/2024] [Accepted: 03/21/2024] [Indexed: 07/06/2024]
Abstract
Sex and gender-biological and social constructs-significantly impact the prevalence of protective and risk factors, influencing the burden of Alzheimer's disease (AD; amyloid beta and tau) and other pathologies (e.g., cerebrovascular disease) which ultimately shape cognitive trajectories. Understanding the interplay of these factors is central to understanding resilience and resistance mechanisms explaining maintained cognitive function and reduced pathology accumulation in aging and AD. In this narrative review, the ADDRESS! Special Interest Group (Alzheimer's Association) adopted a multidisciplinary approach to provide the foundations and recommendations for future research into sex- and gender-specific drivers of resilience, including a sex/gender-oriented review of risk factors, genetics, AD and non-AD pathologies, brain structure and function, and animal research. We urge the field to adopt a sex/gender-aware approach to resilience to advance our understanding of the intricate interplay of biological and social determinants and consider sex/gender-specific resilience throughout disease stages. HIGHLIGHTS: Sex differences in resilience to cognitive decline vary by age and cognitive status. Initial evidence supports sex-specific distinctions in brain pathology. Findings suggest sex differences in the impact of pathology on cognition. There is a sex-specific change in resilience in the transition to clinical stages. Gender and sex factors warrant study: modifiable, immune, inflammatory, and vascular.
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Affiliation(s)
- Eider M Arenaza-Urquijo
- Environment and Health Over the Life Course Programme, Climate, Air Pollution, Nature and Urban Health Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- University of Pompeu Fabra, Barcelona, Barcelona, Spain
| | - Rory Boyle
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kaitlin Casaletto
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Kaarin J Anstey
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Psychology, University of New South Wales, Sidney, New South Wales, Australia
| | - Clara Vila-Castelar
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Aaron Colverson
- University of Florida Center for Arts in Medicine Interdisciplinary Research Lab, University of Florida, Center of Arts in Medicine, Gainesville, Florida, USA
| | - Eleni Palpatzis
- Environment and Health Over the Life Course Programme, Climate, Air Pollution, Nature and Urban Health Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- University of Pompeu Fabra, Barcelona, Barcelona, Spain
| | - Jaclyn M Eissman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ted Kheng Siang Ng
- Rush Institute for Healthy Aging and Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Muge Akinci
- Environment and Health Over the Life Course Programme, Climate, Air Pollution, Nature and Urban Health Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- University of Pompeu Fabra, Barcelona, Barcelona, Spain
| | - Jet M J Vonk
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Luiza S Machado
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal Do Rio Grande Do Sul, Farroupilha, Porto Alegre, Brazil
| | - Preeti P Zanwar
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- The Network on Life Course and Health Dynamics and Disparities, University of Southern California, Los Angeles, California, USA
| | | | - Maude Wagner
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Hamid R Sohrabi
- Centre for Healthy Ageing, Health Future Institute, Murdoch University, Murdoch, Western Australia, Australia
- School of Psychology, Murdoch University, Murdoch, Western Australia, Australia
| | - Samantha Loi
- Neuropsychiatry Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences & Institut de Neurociències, University of Barcelona, Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques (IDIBAPS), Barcelona, Barcelona, Spain
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de Barcelona, Badalona, Barcelona, Spain
| | - Dena B Dubal
- Department of Neurology and Weill Institute of Neurosciences, University of California, San Francisco, San Francisco, California, USA
- Biomedical and Neurosciences Graduate Programs, University of California, San Francisco, San Francisco, California, USA
| | | | - Ozioma Okonkwo
- Alzheimer's Disease Research Center and Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig Maximilians Universität (LMU), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
| | - Rachel F Buckley
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Gu Y, Maria-Stauffer E, Bedford SA, Romero-Garcia R, Grove J, Børglum AD, Martin H, Baron-Cohen S, Bethlehem RA, Warrier V. Polygenic scores for autism are associated with neurite density in adults and children from the general population. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.10.24305539. [PMID: 38645251 PMCID: PMC11030520 DOI: 10.1101/2024.04.10.24305539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Genetic variants linked to autism are thought to change cognition and behaviour by altering the structure and function of the brain. Although a substantial body of literature has identified structural brain differences in autism, it is unknown whether autism-associated common genetic variants are linked to changes in cortical macro- and micro-structure. We investigated this using neuroimaging and genetic data from adults (UK Biobank, N = 31,748) and children (ABCD, N = 4,928). Using polygenic scores and genetic correlations we observe a robust negative association between common variants for autism and a magnetic resonance imaging derived phenotype for neurite density (intracellular volume fraction) in the general population. This result is consistent across both children and adults, in both the cortex and in white matter tracts, and confirmed using polygenic scores and genetic correlations. There were no sex differences in this association. Mendelian randomisation analyses provide no evidence for a causal relationship between autism and intracellular volume fraction, although this should be revisited using better powered instruments. Overall, this study provides evidence for shared common variant genetics between autism and cortical neurite density.
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Affiliation(s)
- Yuanjun Gu
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, UK
| | | | - Saashi A. Bedford
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, UK
| | | | | | - Rafael Romero-Garcia
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH
- Department of Medical Physiology and Biophysics, Instituto de Biomedicina de Sevilla (IBiS), HUVR/CSIC/Universidad de Sevilla/CIBERSAM, ISCIII, 41013, Sevilla, Spain, 41013
| | - Jakob Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, 8210, Denmark
- Center for Genomics and Personalized Medicine (CGPM), Aarhus University, Aarhus, 8000, Denmark
- Department of Biomedicine (Human Genetics) and iSEQ Center, Aarhus University, Aarhus, 8000, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark, 8000
| | - Anders D. Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, 8210, Denmark
- Center for Genomics and Personalized Medicine (CGPM), Aarhus University, Aarhus, 8000, Denmark
- Department of Biomedicine (Human Genetics) and iSEQ Center, Aarhus University, Aarhus, 8000, Denmark
| | - Hilary Martin
- Human Genetics Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, UK
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
| | | | - Varun Warrier
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH
- Human Genetics Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
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Inui K, Takeuchi N, Borgil B, Shingaki M, Sugiyama S, Taniguchi T, Nishihara M, Watanabe T, Suzuki D, Motomura E, Kida T. Age and sex effects on paired-pulse suppression and prepulse inhibition of auditory evoked potentials. Front Neurosci 2024; 18:1378619. [PMID: 38655109 PMCID: PMC11035799 DOI: 10.3389/fnins.2024.1378619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
Responses to a sensory stimulus are inhibited by a preceding stimulus; if the two stimuli are identical, paired-pulse suppression (PPS) occurs; if the preceding stimulus is too weak to reliably elicit the target response, prepulse inhibition (PPI) occurs. PPS and PPI represent excitability changes in neural circuits induced by the first stimulus, but involve different mechanisms and are impaired in different diseases, e.g., impaired PPS in schizophrenia and Alzheimer's disease and impaired PPI in schizophrenia and movement disorders. Therefore, these measures provide information on several inhibitory mechanisms that may have roles in clinical conditions. In the present study, PPS and PPI of the auditory change-related cortical response were examined to establish normative data on healthy subjects (35 females and 32 males, aged 19-70 years). We also investigated the effects of age and sex on PPS and PPI to clarify whether these variables need to be considered as biases. The test response was elicited by an abrupt increase in sound pressure in a continuous sound and was recorded by electroencephalography. In the PPS experiment, the two change stimuli to elicit the cortical response were a 15-dB increase from the background of 65 dB separated by 600 ms. In the PPI experiment, the prepulse and test stimuli were 2- and 10-dB increases, respectively, with an interval of 50 ms. The results obtained showed that sex exerted similar effects on the two measures, with females having stronger test responses and weaker inhibition. On the other hand, age exerted different effects: aging correlated with stronger test responses and weaker inhibition in the PPS experiment, but had no effects in the PPI experiment. The present results suggest age and sex biases in addition to normative data on PPS and PPI of auditory change-related potentials. PPS and PPI, as well as other similar paradigms, such as P50 gating, may have different and common mechanisms. Collectively, they may provide insights into the pathophysiologies of diseases with impaired inhibitory function.
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Affiliation(s)
- Koji Inui
- Department of Functioning and Disability, Institute for Developmental Research, Aichi Developmental Disability Center, Kasugai, Japan
- Section of Brain Function Information, National Institute for Physiological Sciences, Okazaki, Japan
| | | | - Bayasgalan Borgil
- Department of Functioning and Disability, Institute for Developmental Research, Aichi Developmental Disability Center, Kasugai, Japan
| | - Megumi Shingaki
- Department of Functioning and Disability, Institute for Developmental Research, Aichi Developmental Disability Center, Kasugai, Japan
| | - Shunsuke Sugiyama
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tomoya Taniguchi
- Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Makoto Nishihara
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
| | - Takayasu Watanabe
- Department of Clinical Laboratory, Mie University Hospital, Tsu, Japan
| | - Dai Suzuki
- Department of Neuropsychiatry, Mie University Graduate School of Medicine, Tsu, Japan
| | - Eishi Motomura
- Department of Neuropsychiatry, Mie University Graduate School of Medicine, Tsu, Japan
| | - Tetsuo Kida
- Department of Functioning and Disability, Institute for Developmental Research, Aichi Developmental Disability Center, Kasugai, Japan
- Section of Brain Function Information, National Institute for Physiological Sciences, Okazaki, Japan
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Kung KTF, Louie K, Spencer D, Hines M. Prenatal androgen exposure and sex-typical play behaviour: A meta-analysis of classic congenital adrenal hyperplasia studies. Neurosci Biobehav Rev 2024; 159:105616. [PMID: 38447820 DOI: 10.1016/j.neubiorev.2024.105616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/08/2024]
Abstract
Thousands of non-human mammal experiments have demonstrated that early androgen exposure exerts long-lasting effects on neurobehavioural sexual differentiation. In humans, females with classic congenital adrenal hyperplasia (CAH) are exposed to unusually high concentrations of androgens prenatally, whereas prenatal concentrations of androgens in males with CAH are largely normal. The current meta-analysis included 20 independent samples and employed multi-level meta-analytic models. Consistently across all 7 male-typical and female-typical play outcomes, in the expected directions, the present study found significant and large average differences between control males and control females (gs = 0.83-2.78) as well as between females with CAH and control females (gs = 0.95-1.08), but differences between males with CAH and control males were mostly negligible and were non-significant for 6 of the 7 outcomes (gs = 0.04-0.27). These meta-analytic findings suggest that prenatal androgen exposure masculinises and defeminises play behaviour in humans. Broader implications in relation to sex chromosomes, brain development, oestrogens, socio-cognitive influences, other aspects of sex-related behavioural development, and gender nonconformity are discussed.
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Affiliation(s)
- Karson T F Kung
- Department of Psychology, Jockey Club Tower, Centennial Campus, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region.
| | - Krisya Louie
- Department of Psychology, Jockey Club Tower, Centennial Campus, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region
| | - Debra Spencer
- Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, United Kingdom
| | - Melissa Hines
- Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, United Kingdom
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Schultz V, Hedderich DM, Schmitz-Koep B, Schinz D, Zimmer C, Yakushev I, Apostolova I, Özden C, Opfer R, Buchert R. Removing outliers from the normative database improves regional atrophy detection in single-subject voxel-based morphometry. Neuroradiology 2024; 66:507-519. [PMID: 38378906 PMCID: PMC10937771 DOI: 10.1007/s00234-024-03304-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/03/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE Single-subject voxel-based morphometry (VBM) compares an individual T1-weighted MRI to a sample of normal MRI in a normative database (NDB) to detect regional atrophy. Outliers in the NDB might result in reduced sensitivity of VBM. The primary aim of the current study was to propose a method for outlier removal ("NDB cleaning") and to test its impact on the performance of VBM for detection of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD). METHODS T1-weighted MRI of 81 patients with biomarker-confirmed AD (n = 51) or FTLD (n = 30) and 37 healthy subjects with simultaneous FDG-PET/MRI were included as test dataset. Two different NDBs were used: a scanner-specific NDB (37 healthy controls from the test dataset) and a non-scanner-specific NDB comprising 164 normal T1-weighted MRI from 164 different MRI scanners. Three different quality metrics based on leave-one-out testing of the scans in the NDB were implemented. A scan was removed if it was an outlier with respect to one or more quality metrics. VBM maps generated with and without NDB cleaning were assessed visually for the presence of AD or FTLD. RESULTS Specificity of visual interpretation of the VBM maps for detection of AD or FTLD was 100% in all settings. Sensitivity was increased by NDB cleaning with both NDBs. The effect was statistically significant for the multiple-scanner NDB (from 0.47 [95%-CI 0.36-0.58] to 0.61 [0.49-0.71]). CONCLUSION NDB cleaning has the potential to improve the sensitivity of VBM for the detection of AD or FTLD without increasing the risk of false positive findings.
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Affiliation(s)
- Vivian Schultz
- Department of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Dennis M Hedderich
- Department of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany
| | - Benita Schmitz-Koep
- Department of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany
| | - David Schinz
- Department of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen (FAU), Nürnberg, Germany
| | - Claus Zimmer
- Department of Neuroradiology, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany
| | - Ivayla Apostolova
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Cansu Özden
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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6
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Vosberg DE. Sex and Gender in Population Neuroscience. Curr Top Behav Neurosci 2024. [PMID: 38509404 DOI: 10.1007/7854_2024_468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
To understand psychiatric and neurological disorders and the structural and functional properties of the human brain, it is essential to consider the roles of sex and gender. In this chapter, I first define sex and gender and describe studies of sex differences in non-human animals. In humans, I describe the sex differences in behavioral and clinical phenotypes and neuroimaging-derived phenotypes, including whole-brain measures, regional subcortical and cortical measures, and structural and functional connectivity. Although structural whole-brain sex differences are large, regional effects (adjusting for whole-brain volumes) are typically much smaller and often fail to replicate. Nevertheless, while an individual neuroimaging feature may have a small effect size, aggregating them in a "maleness/femaleness" score or machine learning multivariate paradigm may prove to be predictive and informative of sex- and gender-related traits. Finally, I conclude by summarizing emerging investigations of gender norms and gender identity and provide methodological recommendations to incorporate sex and gender in population neuroscience research.
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Affiliation(s)
- Daniel E Vosberg
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada.
- Department of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
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Eliot L. Remembering the null hypothesis when searching for brain sex differences. Biol Sex Differ 2024; 15:14. [PMID: 38336816 PMCID: PMC10854110 DOI: 10.1186/s13293-024-00585-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
Human brain sex differences have fascinated scholars for centuries and become a key focus of neuroscientists since the dawn of MRI. We recently published a major review in Neuroscience and Biobehavioral Reviews showing that most male-female brain differences in humans are small and few have been reliably replicated. Although widely cited, this work was the target of a critical Commentary by DeCasien et al. (Biol Sex Differ 13:43, 2022). In this response, I update our findings and confirm the small effect sizes and pronounced scatter across recent large neuroimaging studies of human sex/gender difference. Based on the sum of data, neuroscientists would be well-advised to take the null hypothesis seriously: that men and women's brains are fundamentally similar, or "monomorphic". This perspective has important implications for how we study the genesis of behavioral and neuropsychiatric gender disparities.
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Affiliation(s)
- Lise Eliot
- Stanson Toshok Center for Brain Function and Repair, Chicago Medical School, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA.
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Levitis E, Liu S, Whitman ET, Warling A, Torres E, Clasen LS, Lalonde FM, Sarlls J, Alexander DC, Raznahan A. The Variegation of Human Brain Vulnerability to Rare Genetic Disorders and Convergence With Behaviorally Defined Disorders. Biol Psychiatry 2024; 95:136-146. [PMID: 37480975 PMCID: PMC10799187 DOI: 10.1016/j.biopsych.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/16/2023] [Accepted: 07/10/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Diverse gene dosage disorders (GDDs) increase risk for psychiatric impairment, but characterization of GDD effects on the human brain has so far been piecemeal, with few simultaneous analyses of multiple brain features across different GDDs. METHODS Here, through multimodal neuroimaging of 3 aneuploidy syndromes (XXY [total n = 191, 92 control participants], XYY [total n = 81, 47 control participants], and trisomy 21 [total n = 69, 41 control participants]), we systematically mapped the effects of supernumerary X, Y, and chromosome 21 dosage across a breadth of 15 different macrostructural, microstructural, and functional imaging-derived phenotypes (IDPs). RESULTS The results revealed considerable diversity in cortical changes across GDDs and IDPs. This variegation of IDP change underlines the limitations of studying GDD effects unimodally. Integration across all IDP change maps revealed highly distinct architectures of cortical change in each GDD along with partial coalescence onto a common spatial axis of cortical vulnerability that is evident in all 3 GDDs. This common axis shows strong alignment with shared cortical changes in behaviorally defined psychiatric disorders and is enriched for specific molecular and cellular signatures. CONCLUSIONS Use of multimodal neuroimaging data in 3 aneuploidies indicates that different GDDs impose unique fingerprints of change in the human brain that differ widely depending on the imaging modality that is being considered. Embedded in this variegation is a spatial axis of shared multimodal change that aligns with shared brain changes across psychiatric disorders and therefore represents a major high-priority target for future translational research in neuroscience.
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Affiliation(s)
- Elizabeth Levitis
- Section on Developmental Neurogenomics, National Institute of Mental Health, Bethesda, Maryland; Center for Medical Image Computing, Department of Computer Science, UCL, London, UK.
| | - Siyuan Liu
- Section on Developmental Neurogenomics, National Institute of Mental Health, Bethesda, Maryland
| | - Ethan T Whitman
- Section on Developmental Neurogenomics, National Institute of Mental Health, Bethesda, Maryland
| | - Allysa Warling
- Section on Developmental Neurogenomics, National Institute of Mental Health, Bethesda, Maryland
| | - Erin Torres
- Section on Developmental Neurogenomics, National Institute of Mental Health, Bethesda, Maryland
| | - Liv S Clasen
- Section on Developmental Neurogenomics, National Institute of Mental Health, Bethesda, Maryland
| | - François M Lalonde
- Section on Developmental Neurogenomics, National Institute of Mental Health, Bethesda, Maryland
| | - Joelle Sarlls
- National Institutes of Health MRI Research Facility, National Institute of Mental Health, Bethesda, Maryland
| | - Daniel C Alexander
- Center for Medical Image Computing, Department of Computer Science, UCL, London, UK
| | - Armin Raznahan
- Section on Developmental Neurogenomics, National Institute of Mental Health, Bethesda, Maryland.
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9
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Sanchis-Segura C, Wilcox RR, Cruz-Gómez AJ, Félix-Esbrí S, Sebastián-Tirado A, Forn C. Univariate and multivariate sex differences and similarities in gray matter volume within essential language-processing areas. Biol Sex Differ 2023; 14:90. [PMID: 38129916 PMCID: PMC10740309 DOI: 10.1186/s13293-023-00575-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Sex differences in language-related abilities have been reported. It is generally assumed that these differences stem from a different organization of language in the brains of females and males. However, research in this area has been relatively scarce, methodologically heterogeneous and has yielded conflicting results. METHODS Univariate and multivariate sex differences and similarities in gray matter volume (GMVOL) within 18 essential language-processing brain areas were assessed in a sex-balanced sample (N = 588) of right-handed young adults. Univariate analyses involved location, spread, and shape comparisons of the females' and males' distributions and were conducted with several robust statistical methods able to quantify the size of sex differences and similarities in a complementary way. Multivariate sex differences and similarities were estimated by the same methods in the continuous scores provided by two distinct multivariate procedures (logistic regression and a multivariate analog of the Wilcoxon-Mann-Whitney test). Additional analyses were addressed to compare the outcomes of these two multivariate analytical strategies and described their structure (that is, the relative contribution of each brain area to the multivariate effects). RESULTS When not adjusted for total intracranial volume (TIV) variation, "large" univariate sex differences (males > females) were found in all 18 brain areas considered. In contrast, "small" differences (females > males) in just two of these brain areas were found when controlling for TIV. The two multivariate methods tested provided very similar results. Multivariate sex differences surpassed univariate differences, yielding "large" differences indicative of larger volumes in males when calculated from raw GMVOL estimates. Conversely, when calculated from TIV-adjusted GMVOL, multivariate differences were "medium" and indicative of larger volumes in females. Despite their distinct size and direction, multivariate sex differences in raw and TIV-adjusted GMVOL shared a similar structure and allowed us to identify the components of the SENT_CORE network which more likely contribute to the observed effects. CONCLUSIONS Our results confirm and extend previous findings about univariate sex differences in language-processing areas, offering unprecedented evidence at the multivariate level. We also observed that the size and direction of these differences vary quite substantially depending on whether they are estimated from raw or TIV-adjusted GMVOL measurements.
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Affiliation(s)
- Carla Sanchis-Segura
- Departament de Psicologia Bàsica Clinica I Psicobiología, Facultat de Ciències de La Salut, Universitat Jaume I, Avda Sos Baynat, SN, 12071, Castelló, Spain.
| | - Rand R Wilcox
- Department of Psychology, University of Southern California, Los Angeles, USA
| | | | - Sonia Félix-Esbrí
- Departament de Psicologia Bàsica Clinica I Psicobiología, Facultat de Ciències de La Salut, Universitat Jaume I, Avda Sos Baynat, SN, 12071, Castelló, Spain
| | - Alba Sebastián-Tirado
- Departament de Psicologia Bàsica Clinica I Psicobiología, Facultat de Ciències de La Salut, Universitat Jaume I, Avda Sos Baynat, SN, 12071, Castelló, Spain
| | - Cristina Forn
- Departament de Psicologia Bàsica Clinica I Psicobiología, Facultat de Ciències de La Salut, Universitat Jaume I, Avda Sos Baynat, SN, 12071, Castelló, Spain
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10
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Weller S, Derntl B, Plewnia C. Sex matters for the enhancement of cognitive training with transcranial direct current stimulation (tDCS). Biol Sex Differ 2023; 14:78. [PMID: 37919761 PMCID: PMC10623760 DOI: 10.1186/s13293-023-00561-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) can influence brain network activity and associated cognitive and behavioural functions. In addition to the extensive variety in stimulation parameters, numerous biological factors drive these effects, however these are yet poorly understood. Here, we investigate one of the major biological factors by focusing on sex-dependent effects of tDCS on a challenging cognitive control task (adaptive paced auditory serial addition task [PASAT]) in healthy humans. METHODS This sex-specific re-analysis was performed on data of 163 subjects who underwent a 2-week cognitive control training (6 sessions in total). Subjects received either verum (anodal/cathodal) or sham tDCS. Electrodes were placed over the left or right dorsolateral prefrontal cortex and the respective contralateral deltoid muscle. Cognitive control was measured as performance in the PASAT and was analysed in respect to stimulation conditions (sham, anodal, cathodal) and sex. RESULTS Regardless of stimulation condition, performance gains between the sexes were higher in females compared to males (p = 0.0038). Female's performance during anodal tDCS exceeded male's (p = 0.0070), yet no effects were found for cathodal or sham tDCS. Moreover, in females we found a superior effect for anodal tDCS over sham stimulation (fanodal: p = 0.0354; fcathodal: p = 0.6181), but no such effect in males (manodal: p = 0.6882; mcathodal: p = 0.4822). CONCLUSIONS This study highlights the relevance of biological sex for the effects of tDCS on cognitive training. Thus, an increased attention to biological sex is advisable in future brain stimulation research to highlight and in consequence better understand potentially underlying sex-specific mechanisms. Considering biological sex will further advance customisation and individualisation of tDCS interventions. Trial registration ClinicalTrials.gov, NCT04108663.
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Affiliation(s)
- Simone Weller
- Department of Psychiatry and Psychotherapy, Neurophysiology and Interventional Neuropsychiatry, University of Tübingen, Calwerstraße 14, 72076, Tübingen, Germany
- German Center for Mental Health (DZPG), partner site Tübingen, Germany
| | - Birgit Derntl
- German Center for Mental Health (DZPG), partner site Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, University of Tübingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, Neurophysiology and Interventional Neuropsychiatry, University of Tübingen, Calwerstraße 14, 72076, Tübingen, Germany.
- German Center for Mental Health (DZPG), partner site Tübingen, Germany.
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11
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Man C, Gilissen E, Michaud M. Sexual dimorphism in the cranium and endocast of the eastern lowland gorillas (Gorilla beringei graueri). J Hum Evol 2023; 184:103439. [PMID: 37804559 DOI: 10.1016/j.jhevol.2023.103439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 10/09/2023]
Abstract
Sexual dimorphism of the nervous system has been reported for a wide range of vertebrates. However, understanding of sexual dimorphism in primate cranial structures and soft tissues, and more particularly the brain, remains limited. In this study, we aimed to investigate the external and internal (i.e., endocast) cranial differences between male and female eastern lowland gorillas (Gorilla beringei graueri). We examined the differences in the size, shape, and disparity with the aim to compare how sexual dimorphism can impact these two structures distinctively, with a particular focus on the endocranium. To do so, we reconstructed gorilla external crania and endocasts from CT scans and used 3D geometric morphometric techniques combined with multivariate analyses to assess the cranial and endocranial differences between the sexes. Our results highlighted sexual dimorphism for the external cranium and endocast with regard to both size and shape. In particular, males display an elongated face accompanied by a pronounced sagittal crest and an elongated endocast along the rostroposterior axis, in contrast to females who are identified by a more rounded brain case and endocast. Males also show a significantly larger external cranium and endocast size than females. In addition, we described important differences for the posterior cranial fossae (i.e., the position of the cerebellum within the brain case) and olfactory bulb between the two sexes. Particularly, our results highlighted that, relatively to males, females have larger posterior cranial fossae, whereas males have been characterized by a larger and rostrally oriented olfactory bulb.
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Affiliation(s)
- Caitlin Man
- Laboratory of Ecology, Evolution and Biodiversity Conservation, Katholieke Universiteit Leuven, Charles Deberiotstraat 32 Bus 2439, 3000 Leuven, Belgium; Department of African Zoology, Royal Museum for Central Africa, Leuvensesteenweg 13, 3080 Tervuren, Belgium.
| | - Emmanuel Gilissen
- Department of African Zoology, Royal Museum for Central Africa, Leuvensesteenweg 13, 3080 Tervuren, Belgium; Laboratory of Histology and Neuropathology, Université Libre de Bruxelles, CP620 - Route de Lennik 808, 1070 Brussels, Belgium
| | - Margot Michaud
- Department of African Zoology, Royal Museum for Central Africa, Leuvensesteenweg 13, 3080 Tervuren, Belgium
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12
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Eliot L, Beery AK, Jacobs EG, LeBlanc HF, Maney DL, McCarthy MM. Why and How to Account for Sex and Gender in Brain and Behavioral Research. J Neurosci 2023; 43:6344-6356. [PMID: 37704386 PMCID: PMC10500996 DOI: 10.1523/jneurosci.0020-23.2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 09/15/2023] Open
Abstract
Long overlooked in neuroscience research, sex and gender are increasingly included as key variables potentially impacting all levels of neurobehavioral analysis. Still, many neuroscientists do not understand the difference between the terms "sex" and "gender," the complexity and nuance of each, or how to best include them as variables in research designs. This TechSights article outlines rationales for considering the influence of sex and gender across taxa, and provides technical guidance for strengthening the rigor and reproducibility of such analyses. This guidance includes the use of appropriate statistical methods for comparing groups as well as controls for key covariates of sex (e.g., total intracranial volume) and gender (e.g., income, caregiver stress, bias). We also recommend approaches for interpreting and communicating sex- and gender-related findings about the brain, which have often been misconstrued by neuroscientists and the lay public alike.
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Affiliation(s)
- Lise Eliot
- Stanson Toshok Center for Brain Function and Repair, Chicago Medical School, Rosalind Franklin University of Medicine & Science, North Chicago, Illinois 60064
| | - Annaliese K Beery
- Department of Integrative Biology, University of California-Berkeley, Berkeley, California 94720
| | - Emily G Jacobs
- Department of Psychological & Brain Sciences, University of California-Santa Barbara, Santa Barbara, California 93106
| | - Hannah F LeBlanc
- Division of the Humanities & Social Sciences, California Institute of Technology, Pasadena, California 91125
| | - Donna L Maney
- Department of Psychology, Emory University, Atlanta, Georgia 30322
| | - Margaret M McCarthy
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, Maryland 21201
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13
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Shafee R, Moraczewski D, Liu S, Mallard T, Thomas A, Raznahan A. A sex-stratified analysis of the genetic architecture of human brain anatomy. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.09.23293881. [PMID: 37609186 PMCID: PMC10441503 DOI: 10.1101/2023.08.09.23293881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Large biobanks have dramatically advanced our understanding of genetic influences on human brain anatomy. However, most studies have combined rather than compared males and females - despite theoretical grounds for potential sex differences. By systematically screening for sex differences in the common genetic architecture of > 1000 neuroanatomical phenotypes in the UK Biobank, we establish a general concordance between males and females in heritability estimates, genetic correlations and variant-level effects. Notable exceptions include: higher mean h 2 in females for regional volume and surface area phenotypes; between-sex genetic correlations that are significantly below 1 in the insula and parietal cortex; and, a male-specific effect common variant mapping to RBFOX1 - a gene linked to multiple male-biased neuropsychiatric disorders. This work suggests that common variant influences on human brain anatomy are largely consistent between males and females, with a few exceptions that will guide future research as biobanks continue to grow in size.
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14
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Sauty B, Durrleman S. Impact of sex and APOE- ε4 genotype on patterns of regional brain atrophy in Alzheimer's disease and healthy aging. Front Neurol 2023; 14:1161527. [PMID: 37333001 PMCID: PMC10272760 DOI: 10.3389/fneur.2023.1161527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/19/2023] [Indexed: 06/20/2023] Open
Abstract
Alzheimer's Disease (AD) is a heterogeneous disease that disproportionately affects women and people with the APOE-ε4 susceptibility gene. We aim to describe the not-well-understood influence of both risk factors on the dynamics of brain atrophy in AD and healthy aging. Regional cortical thinning and brain atrophy were modeled over time using non-linear mixed-effect models and the FreeSurfer software with t1-MRI scans from the Alzheimer's Disease Neuroimaging Initiative (N = 1,502 subjects, 6,728 images in total). Covariance analysis was used to disentangle the effect of sex and APOE genotype on the regional onset age and pace of atrophy, while correcting for educational level. A map of the regions mostly affected by neurodegeneration is provided. Results were confirmed on gray matter density data from the SPM software. Women experience faster atrophic rates in the temporal, frontal, parietal lobes and limbic system and earlier onset in the amygdalas, but slightly later onset in the postcentral and cingulate gyri as well as all regions of the basal ganglia and thalamus. APOE-ε4 genotypes leads to earlier and faster atrophy in the temporal, frontal, parietal lobes, and limbic system in AD patients, but not in healthy patients. Higher education was found to slightly delay atrophy in healthy patients, but not for AD patients. A cohort of amyloid positive patients with MCI showed a similar impact of sex as in the healthy cohort, while APOE-ε4 showed similar associations as in the AD cohort. Female sex is as strong a risk factor for AD as APOE-ε4 genotype regarding neurodegeneration. Women experience a sharper atrophy in the later stages of the disease, although not a significantly earlier onset. These findings may have important implications for the development of targeted intervention.
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15
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Fan J, Zhu Z, Chen Y, Yang C, Li X, Chen K, Chen X, Zhang Z. SORL1 rs1699102 Moderates the Effect of Sex on Language Network. J Alzheimers Dis 2023:JAD221133. [PMID: 37212098 DOI: 10.3233/jad-221133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Language ability differs between the sexes. However, it is unclear how this sex difference is moderated by genetic factors and how the brain interacts with genetics to support this specific language capacity. Previous studies have demonstrated that the sorting protein-related receptor (SORL1) polymorphism influences cognitive function and brain structure differently in males and females and is associated with Alzheimer's disease risk. OBJECTIVE The aim of this study was to investigate the effects of sex and the SORL1 rs1699102 (CC versus T carriers) genotype on language. METHODS 103 non-demented Chinese older adults from Beijing Aging Brain Rejuvenation Initiative (BABRI) database were included in this study. Participants completed language tests, T1-weighted structural magnetic resonance imaging (MRI) and resting-state functional MRI. Language test performance, gray matter volume, and network connections were compared between genotype and sex groups. RESULTS The rs1699102 polymorphism moderated the effects of sex on language performance, with the female having reversed language advantages in T carriers. The T allele carriers had lower gray matter volume in the left precentral gyrus. The effect of sex on language network connections was moderated by rs1699102; male CC homozygotes and female T carriers had higher internetwork connections, which were negatively correlated with language performance. CONCLUSION These results suggest that SORL1 moderates the effects of sex on language, with T being a risk allele, especially in females. Our findings underscore the importance of considering the influence of genetic factors when examining sex effects.
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Affiliation(s)
- Jialing Fan
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Zhibao Zhu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
- Fujian Key Laboratory of Molecular Neurology, Institute of Neuroscience, Fujian Medical University, Fuzhou, Fujian, China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Caishui Yang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
| | - Kewei Chen
- BABRI Centre, Beijing Normal University, Beijing, China
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Xiaochun Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
- Fujian Key Laboratory of Molecular Neurology, Institute of Neuroscience, Fujian Medical University, Fuzhou, Fujian, China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- BABRI Centre, Beijing Normal University, Beijing, China
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16
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Williams CM, Labouret G, Wolfram T, Peyre H, Ramus F. A General Cognitive Ability Factor for the UK Biobank. Behav Genet 2023; 53:85-100. [PMID: 36378351 DOI: 10.1007/s10519-022-10127-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/30/2022] [Indexed: 11/16/2022]
Abstract
UK Biobank participants do not have a high-quality measure of intelligence or polygenic scores (PGSs) of intelligence to simultaneously examine the genetic and neural underpinnings of intelligence. We created a standardized measure of general intelligence (g factor) relative to the UK population and estimated its quality. After running a GWAS of g on UK Biobank participants with a g factor of good quality and without neuroimaging data (N = 187,288), we derived a g PGS for UK Biobank participants with neuroimaging data. For individuals with at least one cognitive test, the g factor from eight cognitive tests (N = 501,650) explained 29% of the variance in cognitive test performance. The PGS for British individuals with neuroimaging data (N = 27,174) explained 7.6% of the variance in g. We provided high-quality g factor estimates for most UK Biobank participants and g factor PGSs for UK Biobank participants with neuroimaging data.
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Affiliation(s)
- Camille Michèle Williams
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 75005, Paris, France. .,LSCP, Département d'Etudes Cognitives, École Normale Supérieure, 29 rue d'Ulm, 75005, Paris, France.
| | - Ghislaine Labouret
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 75005, Paris, France
| | - Tobias Wolfram
- Faculty of Sociology, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| | - Hugo Peyre
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 75005, Paris, France.,INSERM UMR 1141, Paris Diderot University, Paris, France.,Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France
| | - Franck Ramus
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 75005, Paris, France
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17
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Lista S, Vergallo A, Teipel SJ, Lemercier P, Giorgi FS, Gabelle A, Garaci F, Mercuri NB, Babiloni C, Gaire BP, Koronyo Y, Koronyo-Hamaoui M, Hampel H, Nisticò R. Determinants of approved acetylcholinesterase inhibitor response outcomes in Alzheimer's disease: relevance for precision medicine in neurodegenerative diseases. Ageing Res Rev 2023; 84:101819. [PMID: 36526257 DOI: 10.1016/j.arr.2022.101819] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/11/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
Acetylcholinesterase inhibitors (ChEI) are the global standard of care for the symptomatic treatment of Alzheimer's disease (AD) and show significant positive effects in neurodegenerative diseases with cognitive and behavioral symptoms. Although experimental and large-scale clinical evidence indicates the potential long-term efficacy of ChEI, primary outcomes are generally heterogeneous across outpatient clinics and regional healthcare systems. Sub-optimal dosing or slow tapering, heterogeneous guidelines about the timing for therapy initiation (prodromal versus dementia stages), healthcare providers' ambivalence to treatment, lack of disease awareness, delayed medical consultation, prescription of ChEI in non-AD cognitive disorders, contribute to the negative outcomes. We present an evidence-based overview of determinants, spanning genetic, molecular, and large-scale networks, involved in the response to ChEI in patients with AD and other neurodegenerative diseases. A comprehensive understanding of cerebral and retinal cholinergic system dysfunctions along with ChEI response predictors in AD is crucial since disease-modifying therapies will frequently be prescribed in combination with ChEI. Therapeutic algorithms tailored to genetic, biological, clinical (endo)phenotypes, and disease stages will help leverage inter-drug synergy and attain optimal combined response outcomes, in line with the precision medicine model.
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Affiliation(s)
- Simone Lista
- Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, Montpellier, France; School of Pharmacy, University of Rome "Tor Vergata", Rome, Italy.
| | - Andrea Vergallo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Pablo Lemercier
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Filippo Sean Giorgi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Audrey Gabelle
- Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, Montpellier, France
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; Casa di Cura "San Raffaele Cassino", Cassino, Italy
| | - Nicola B Mercuri
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; IRCCS Santa Lucia Foundation, Rome, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele Cassino, Cassino, Italy
| | - Bhakta Prasad Gaire
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Biomedical Sciences, Division of Applied Cell Biology and Physiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Harald Hampel
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Robert Nisticò
- School of Pharmacy, University of Rome "Tor Vergata", Rome, Italy; Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, Rome, Italy.
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18
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Weber KA, Teplin ZM, Wager TD, Law CSW, Prabhakar NK, Ashar YK, Gilam G, Banerjee S, Delp SL, Glover GH, Hastie TJ, Mackey S. Confounds in neuroimaging: A clear case of sex as a confound in brain-based prediction. Front Neurol 2022; 13:960760. [PMID: 36601297 PMCID: PMC9806266 DOI: 10.3389/fneur.2022.960760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
Muscle weakness is common in many neurological, neuromuscular, and musculoskeletal conditions. Muscle size only partially explains muscle strength as adaptions within the nervous system also contribute to strength. Brain-based biomarkers of neuromuscular function could provide diagnostic, prognostic, and predictive value in treating these disorders. Therefore, we sought to characterize and quantify the brain's contribution to strength by developing multimodal MRI pipelines to predict grip strength. However, the prediction of strength was not straightforward, and we present a case of sex being a clear confound in brain decoding analyses. While each MRI modality-structural MRI (i.e., gray matter morphometry), diffusion MRI (i.e., white matter fractional anisotropy), resting state functional MRI (i.e., functional connectivity), and task-evoked functional MRI (i.e., left or right hand motor task activation)-and a multimodal prediction pipeline demonstrated significant predictive power for strength (R 2 = 0.108-0.536, p ≤ 0.001), after correcting for sex, the predictive power was substantially reduced (R 2 = -0.038-0.075). Next, we flipped the analysis and demonstrated that each MRI modality and a multimodal prediction pipeline could significantly predict sex (accuracy = 68.0%-93.3%, AUC = 0.780-0.982, p < 0.001). However, correcting the brain features for strength reduced the accuracy for predicting sex (accuracy = 57.3%-69.3%, AUC = 0.615-0.780). Here we demonstrate the effects of sex-correlated confounds in brain-based predictive models across multiple brain MRI modalities for both regression and classification models. We discuss implications of confounds in predictive modeling and the development of brain-based MRI biomarkers, as well as possible strategies to overcome these barriers.
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Affiliation(s)
- Kenneth A. Weber
- Systems Neuroscience and Pain Lab, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States,*Correspondence: Kenneth A. Weber II
| | - Zachary M. Teplin
- Systems Neuroscience and Pain Lab, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Tor D. Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Christine S. W. Law
- Systems Neuroscience and Pain Lab, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Nitin K. Prabhakar
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Yoni K. Ashar
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States
| | - Gadi Gilam
- Systems Neuroscience and Pain Lab, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States,The Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Scott L. Delp
- Department of Bioengineering and Mechanical Engineering, Stanford University, Palo Alto, CA, United States
| | - Gary H. Glover
- Radiological Sciences Laboratory, Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Trevor J. Hastie
- Department of Statistics, Stanford University, Palo Alto, CA, United States
| | - Sean Mackey
- Systems Neuroscience and Pain Lab, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
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19
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Williams CM, Peyre H, Ramus F. Brain volumes, thicknesses, and surface areas as mediators of genetic factors and childhood adversity on intelligence. Cereb Cortex 2022; 33:5885-5895. [PMID: 36533516 DOI: 10.1093/cercor/bhac468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022] Open
Abstract
Although genetic and environmental factors influence general intelligence (g-factor), few studies examined the neuroanatomical measures mediating environmental and genetic effects on intelligence. Here, we investigate the brain volumes, cortical mean thicknesses, and cortical surface areas mediating the effects of the g-factor polygenic score (gPGS) and childhood adversity on the g-factor in the UK Biobank. We first examined the global and regional brain measures that contribute to the g-factor. Most regions contributed to the g-factor through global brain size. Parieto-frontal integration theory (P-FIT) regions were not more associated with the g-factor than non-PFIT regions. After adjusting for global brain size and regional associations, only a few regions predicted intelligence and were included in the mediation analyses. We conducted mediation analyses on global measures, regional volumes, mean thicknesses, and surface areas, separately. Total brain volume mediated 7.04% of the gPGS' effect on the g-factor and 2.50% of childhood adversity's effect on the g-factor. In comparison, the fraction of the gPGS and childhood adversity's effects mediated by individual regional volumes, surfaces, and mean thicknesses was 10-15 times smaller. Therefore, genetic and environmental effects on intelligence may be mediated to a larger extent by other brain properties.
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Affiliation(s)
- Camille M Williams
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 29 rue d'ulm, 75005, Paris, France
| | - Hugo Peyre
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 29 rue d'ulm, 75005, Paris, France
- INSERM UMR 1141, Paris Diderot University, 48 Bd Sérurier, 75019, Paris, France
- Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, 48 Bd Sérurier, 75019, Paris, France
| | - Franck Ramus
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 29 rue d'ulm, 75005, Paris, France
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20
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Colby AE, DeCasien AR, Cooper EB, Higham JP. Greater variability in rhesus macaque ( Macaca mulatta) endocranial volume among males than females. Proc Biol Sci 2022; 289:20220728. [PMID: 36350207 PMCID: PMC9653222 DOI: 10.1098/rspb.2022.0728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/05/2022] [Indexed: 11/11/2023] Open
Abstract
The greater male variability (GMV) hypothesis proposes that traits are more variable among males than females, and is supported by numerous empirical studies. Interestingly, GMV is also observed for human brain size and internal brain structure, a pattern which may have implications for sex-biased neurological and psychiatric conditions. A better understanding of neuroanatomical variability in non-human primates may illuminate whether certain species are appropriate models for these conditions. Here, we tested for sex differences in the variability of endocranial volume (ECV, a proxy for brain size) in a sample of 542 rhesus macaques (Macaca mulatta) from a large pedigreed free-ranging population. We also examined the components of phenotypic variance (additive genetic and residual variance) to tease apart the potential drivers of sex differences in variability. Our results suggest that males exhibit more variable ECVs, and that this pattern reflects either balancing/disruptive selection on male behaviour (associated with alternative male mating strategies) or sex chromosome effects (associated with mosaic patterns of X chromosome gene expression in females), rather than extended neurodevelopment among males. This represents evidence of GMV for brain size in a non-human primate species and highlights the potential of rhesus macaques as a model for sex-biased brain-based disorders.
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Affiliation(s)
- Abigail E. Colby
- Department of Anthropology, New York University, New York, NY, USA
- Department of Anthropology and Archaeology, University of Calgary, Calgary, AB, Canada
| | - Alex R. DeCasien
- Department of Anthropology, New York University, New York, NY, USA
- New York Consortium in Evolutionary Primatology, New York, NY, USA
- Section on Developmental Neurogenomics, National Institutes of Health, Bethesda, MD, USA
| | - Eve B. Cooper
- Department of Anthropology, New York University, New York, NY, USA
- New York Consortium in Evolutionary Primatology, New York, NY, USA
| | - James P. Higham
- Department of Anthropology, New York University, New York, NY, USA
- New York Consortium in Evolutionary Primatology, New York, NY, USA
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21
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Herman D, Andrea V, Pablo L, Simone L, Andrea B, Nicholas A, Enrica C, Henrik Z, Kaj B, Eugeen V, Harald H. Menopause hormone therapy significantly alters pathophysiological biomarkers of Alzheimer's disease. Alzheimers Dement 2022; 19:1320-1330. [PMID: 36218064 DOI: 10.1002/alz.12759] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/01/2022] [Accepted: 06/14/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION This increasing body of literature indicates that menopause hormonal replacement therapy (MHT) may substantially mitigate the risk of developing late-life cognitive decline due to progressive Alzheimer's disease (AD) pathophysiology. For the first time, we investigated the question whether MHT impacts AD biomarker-informed pathophysiological dynamics in de-novo diagnosed menopausal women. METHODS We analyzed baseline and longitudinal differences between MHT-taking and -not women in terms of concentrations of core pathophysiological AD plasma biomarkers, validated in symptomatic and cognitively healthy individuals, including biomarkers of (1) the amyloid-β (Aβ) pathway, (2) tau pathophysiology, (3) neuronal loss, and (4) axonal damage and neurodegeneration. RESULTS We report a prominent and significant treatment response at the Aβ pathway biomarker level. Women at genetic risk for AD (APOE e4 allele carriers) have particularly shown favorable results from treatment. DISCUSSION To our knowledge, we present first prospective clinical evidence on effects of MHT on AD pathophysiology during menopause.
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Affiliation(s)
- Depypere Herman
- Department of Gynecology, Breast and Menopause Clinic University Hospital, Coupure Menopause Centre Ghent Belgium
| | - Vergallo Andrea
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Boulevard de l'hôpital Paris France
| | - Lemercier Pablo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Boulevard de l'hôpital Paris France
| | - Lista Simone
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Boulevard de l'hôpital Paris France
| | - Benedet Andrea
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology the Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
| | - Ashton Nicholas
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology the Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Wallenberg Centre for Molecular and Translational Medicine, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology the Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- King's College London, Institute of Psychiatry, Psychology & Neuroscience Maurice Wohl Clinical Neuroscience Institute London UK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation London UK
| | - Cavedo Enrica
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Boulevard de l'hôpital Paris France
| | - Zetterberg Henrik
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology the Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology Queen Square London UK
- UK Dementia Research Institute at UCL London UK
- Hong Kong Center for Neurodegenerative Diseases Hong Kong China
| | - Blennow Kaj
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology the Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
| | | | - Hampel Harald
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Boulevard de l'hôpital Paris France
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22
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Sanchis-Segura C, Aguirre N, Cruz-Gómez ÁJ, Félix S, Forn C. Beyond "sex prediction": Estimating and interpreting multivariate sex differences and similarities in the brain. Neuroimage 2022; 257:119343. [PMID: 35654377 DOI: 10.1016/j.neuroimage.2022.119343] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 12/31/2022] Open
Abstract
Previous studies have shown that machine-learning (ML) algorithms can "predict" sex based on brain anatomical/ functional features. The high classification accuracy achieved by ML algorithms is often interpreted as revealing large differences between the brains of males and females and as confirming the existence of "male/female brains". However, classification and estimation are different concepts, and using classification metrics as surrogate estimates of between-group differences may result in major statistical and interpretative distortions. The present study avoids these distortions and provides a novel and detailed assessment of multivariate sex differences in gray matter volume (GMVOL) that does not rely on classification metrics. Moreover, appropriate regression methods were used to identify the brain areas that contribute the most to these multivariate differences, and clustering techniques and analyses of similarities (ANOSIM) were employed to empirically assess whether they assemble into two sex-typical profiles. Results revealed that multivariate sex differences in GMVOL: (1) are "large" if not adjusted for total intracranial volume (TIV) variation, but "small" when controlling for this variable; (2) differ in size between individuals and also depends on the ML algorithm used for their calculation (3) do not stem from two sex-typical profiles, and so describing them in terms of "male/female brains" is misleading.
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Affiliation(s)
- Carla Sanchis-Segura
- Departament de Psicologia Bàsica, Clínica i Psicobiologia, Universitat Jaume I, Avda. Sos Baynat, SN., Castelló 12071, Spain.
| | - Naiara Aguirre
- Departament de Psicologia Bàsica, Clínica i Psicobiologia, Universitat Jaume I, Avda. Sos Baynat, SN., Castelló 12071, Spain
| | - Álvaro Javier Cruz-Gómez
- Departament de Psicologia Bàsica, Clínica i Psicobiologia, Universitat Jaume I, Avda. Sos Baynat, SN., Castelló 12071, Spain
| | - Sonia Félix
- Departament de Psicologia Bàsica, Clínica i Psicobiologia, Universitat Jaume I, Avda. Sos Baynat, SN., Castelló 12071, Spain
| | - Cristina Forn
- Departament de Psicologia Bàsica, Clínica i Psicobiologia, Universitat Jaume I, Avda. Sos Baynat, SN., Castelló 12071, Spain
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23
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Sex differences in the human brain: a roadmap for more careful analysis and interpretation of a biological reality. Biol Sex Differ 2022; 13:43. [PMID: 35883159 PMCID: PMC9327177 DOI: 10.1186/s13293-022-00448-w] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/23/2022] [Indexed: 12/15/2022] Open
Abstract
The presence, magnitude, and significance of sex differences in the human brain are hotly debated topics in the scientific community and popular media. This debate is largely fueled by studies containing strong, opposing conclusions: either little to no evidence exists for sex differences in human neuroanatomy, or there are small-to-moderate differences in the size of certain brain regions that are highly reproducible across cohorts (even after controlling for sex differences in average brain size). Our Commentary uses the specific comparison between two recent large-scale studies that adopt these opposing views-namely the review by Eliot and colleagues (2021) and the direct analysis of ~ 40k brains by Williams and colleagues (2021)-in an effort to clarify this controversy and provide a framework for conducting this research. First, we review observations that motivate research on sex differences in human neuroanatomy, including potential causes (evolutionary, genetic, and environmental) and effects (epidemiological and clinical evidence for sex-biased brain disorders). We also summarize methodological and empirical support for using structural MRI to investigate such patterns. Next, we outline how researchers focused on sex differences can better specify their study design (e.g., how sex was defined, if and how brain size was adjusted for) and results (by e.g., distinguishing sexual dimorphisms from sex differences). We then compare the different approaches available for studying sex differences across a large number of individuals: direct analysis, meta-analysis, and review. We stress that reviews do not account for methodological differences across studies, and that this variation explains many of the apparent inconsistencies reported throughout recent reviews (including the work by Eliot and colleagues). For instance, we show that amygdala volume is consistently reported as male-biased in studies with sufficient sample sizes and appropriate methods for brain size correction. In fact, comparing the results from multiple large direct analyses highlights small, highly reproducible sex differences in the volume of many brain regions (controlling for brain size). Finally, we describe best practices for the presentation and interpretation of these findings. Care in interpretation is important for all domains of science, but especially so for research on sex differences in the human brain, given the existence of broad societal gender-biases and a history of biological data being used justify sexist ideas. As such, we urge researchers to discuss their results from simultaneously scientific and anti-sexist viewpoints.
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24
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Comparing brain asymmetries independently of brain size. Neuroimage 2022; 254:119118. [PMID: 35318151 DOI: 10.1016/j.neuroimage.2022.119118] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 01/16/2023] Open
Abstract
Studies examining cerebral asymmetries typically divide the l-R Measure (e.g., Left-Right Volume) by the L + R Measure to obtain an Asymmetry Index (AI). However, contrary to widespread belief, such a division fails to render the AI independent from the L + R Measure and/or from total brain size. As a result, variations in brain size may bias correlation estimates with the AI or group differences in AI. We investigated how to analyze brain asymmetries in to distinguish global from regional effects, and report unbiased group differences in cerebral asymmetries in the UK Biobank (N = 40, 028). We used 306 global and regional brain measures provided by the UK Biobank. Global gray and white matter volumes were taken from Freesurfer ASEG, subcortical gray matter volumes from Freesurfer ASEG and subsegmentation, cortical gray matter volumes, mean thicknesses, and surface areas from the Destrieux atlas applied on T1-and T2-weighted images, cerebellar gray matter volumes from FAST FSL, and regional white matter volumes from Freesurfer ASEG. We analyzed the extent to which the L + R Measure, Total Cerebral Measure (TCM, e.g., Total Brain Volume), and l-R TCM predict regional asymmetries. As a case study, we assessed the consequences of omitting each of these predictors on the magnitude and significance of sex differences in asymmetries. We found that the L + R Measure, the TCM, and the l-R TCM predicted the AI of more than 89% of regions and that their relationships were generally linear. Removing any of these predictors changed the significance of sex differences in 33% of regions and the magnitude of sex differences across 13-42% of regions. Although we generally report similar sex and age effects on cerebral asymmetries to those of previous large-scale studies, properly adjusting for regional and global brain size revealed additional sex and age effects on brain asymmetry.
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25
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Lohner V, Pehlivan G, Sanroma G, Miloschewski A, Schirmer MD, Stöcker T, Reuter M, Breteler MMB. The Relation Between Sex, Menopause, and White Matter Hyperintensities: The Rhineland Study. Neurology 2022; 99:e935-e943. [PMID: 35768207 DOI: 10.1212/wnl.0000000000200782] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 04/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Mounting evidence implies that there are sex differences in white matter hyperintensity (WMH) burden in the elderly. Questions remain regarding possible differences in WMH burden between men and women of younger age, sex-specific age trajectories and effects of (un)controlled hypertension, and the effect of menopause on WMH. Therefore, our aim is to investigate these sex differences and age-dependencies in WMH load across the adult life span, and to examine the effect of menopause. METHODS This cross-sectional analysis was based on participants of the population-based Rhineland Study (30 - 95 years) who underwent brain MRI. We automatically quantified WMH using T1-weighted, T2-weighted and FLAIR images. Menopausal status was self-reported. We examined associations of sex and menopause with WMH load (logit-transformed and z-standardised) using linear regression models, while adjusting for age, age-squared, and vascular risk factors. We checked for an age*sex and (un)controlled hypertension*sex interaction and stratified for menopausal status comparing men with premenopausal women (persons aged ≤ 59 years), men with postmenopausal women (persons aged ≥ 45 years), and pre- with postmenopausal women (age range 45 - 59 years). RESULTS Of 3410 participants with a mean age of 54.3 years (SD = 13.7), 1973 (57.9%) were women, of which 1167 (59.1%) were postmenopausal. We found that the increase in WMH load accelerates with age and in a sex-dependent way. Premenopausal women and men of similar age did not differ in WMH burden. WMH burden was higher and accelerated faster in postmenopausal women compared to men of similar age. Additionally, we observed changes related to menopause, in that postmenopausal women had more WMH than premenopausal women of similar age.. Women with uncontrolled hypertension had a higher WMH burden compared to men, which was unrelated to menopausal status. DISCUSSION After menopause, women displayed a higher burden of WMH than contemporary premenopausal women and men, and an accelerated increase in WMH. Sex-specific effects of uncontrolled hypertension on WMH were not related to menopause. Further studies are warranted to investigate menopause-related physiological changes, that may inform on causal mechanisms involved in cerebral small vessel disease progression.
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Affiliation(s)
- Valerie Lohner
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Gökhan Pehlivan
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Gerard Sanroma
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anne Miloschewski
- Statistics and Machine Learning, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Markus D Schirmer
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston.,Clinic for Neuroradiology, University Hospital Bonn, Germany
| | - Tony Stöcker
- MR Physics, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Physics and Astronomy, University of Bonn, Bonn, Germany
| | - Martin Reuter
- Image Analysis, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts.,Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany .,Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany
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26
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Opfer R, Krüger J, Spies L, Kitzler HH, Schippling S, Buchert R. Single-subject analysis of regional brain volumetric measures can be strongly influenced by the method for head size adjustment. Neuroradiology 2022; 64:2001-2009. [PMID: 35462574 PMCID: PMC9474386 DOI: 10.1007/s00234-022-02961-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/14/2022] [Indexed: 12/03/2022]
Abstract
Purpose
Total intracranial volume (TIV) is often a nuisance covariate in MRI-based brain volumetry. This study compared two TIV adjustment methods with respect to their impact on z-scores in single subject analyses of regional brain volume estimates. Methods Brain parenchyma, hippocampus, thalamus, and TIV were segmented in a normal database comprising 5059 T1w images. Regional volume estimates were adjusted for TIV using the residual method or the proportion method. Age was taken into account by regression with both methods. TIV- and age-adjusted regional volumes were transformed to z-scores and then compared between the two adjustment methods. Their impact on the detection of thalamus atrophy was tested in 127 patients with multiple sclerosis. Results The residual method removed the association with TIV in all regions. The proportion method resulted in a switch of the direction without relevant change of the strength of the association. The reduction of physiological between-subject variability was larger with the residual method than with the proportion method. The difference between z-scores obtained with the residual method versus the proportion method was strongly correlated with TIV. It was larger than one z-score point in 5% of the subjects. The area under the ROC curve of the TIV- and age-adjusted thalamus volume for identification of multiple sclerosis patients was larger with the residual method than with the proportion method (0.84 versus 0.79). Conclusion The residual method should be preferred for TIV and age adjustments of T1w-MRI-based brain volume estimates in single subject analyses. Supplementary Information The online version contains supplementary material available at 10.1007/s00234-022-02961-6.
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Affiliation(s)
| | | | | | - Hagen H Kitzler
- Institute of Diagnostic and Interventional Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Sven Schippling
- Center for Neuroscience Zurich (ZNZ), Federal Institute of Technology (ETH), Multimodal Imaging in Neuroimmunological Diseases (MINDS), University of Zurich, Zurich, Switzerland
| | - Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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27
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Cox SR, Deary IJ. Brain and cognitive ageing: The present, and some predictions (…about the future). AGING BRAIN 2022; 2:100032. [PMID: 36908875 PMCID: PMC9997131 DOI: 10.1016/j.nbas.2022.100032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/18/2022] [Accepted: 01/31/2022] [Indexed: 11/26/2022] Open
Abstract
Experiencing decline in one's cognitive abilities is among the most feared aspects of growing old [53]. Age-related cognitive decline carries a huge personal, societal, and financial cost both in pathological ageing (such as dementias) and also within the non-clinical majority of the population. A projected 152 million people worldwide will suffer from dementia by 2050 [3]. The early stages of cognitive decline are much more prevalent than dementia, and can still impose serious limitations of performance on everyday activities, independence, and quality of life in older age [5], [60], [80]. Cognitive decline also predicts poorer health, adherence to medical regimens, and financial decision-making, and can herald dementia, illness, and death [6], [40]. Of course, when seeking to understand why some people experience more severe cognitive ageing than others, researchers have turned to the organ of thinking for clues about the nature, possible mechanisms, and determinants that might underpin more and less successful cognitive agers. However, that organ is relatively inaccessible, a limitation partly alleviated by advances in neuroimaging. Here we discuss lessons for cognitive and brain ageing that have come from neuroimaging research (especially structural brain imaging), what neuroimaging still has left to teach us, and our views on possible ways forward in this multidisciplinary field.
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Affiliation(s)
- Simon R Cox
- Lothian Birth Cohorts, Department of Psychology, The University of Edinburgh, UK.,Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK
| | - Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, The University of Edinburgh, UK
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28
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Williams CM, Peyre H, Toro R, Ramus F. Sex differences in the brain are not reduced to differences in body size. Neurosci Biobehav Rev 2021; 130:509-511. [PMID: 34520800 DOI: 10.1016/j.neubiorev.2021.09.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/02/2021] [Accepted: 09/06/2021] [Indexed: 11/18/2022]
Abstract
In their comprehensive review of sex differences in the brain, Eliot et al. (2021) conclude that (1) men and women significantly differ in global brain size, but this "mostly parallels the divergence of male/female body size during development" and that (2) "once we account for individual differences in brain size, there is almost no difference in the volume of specific cortical or subcortical structures between men and women". In sum, almost all brain differences would directly or indirectly follow from differences in body size. In a recent study that does not have the same limitations as most studies reviewed by Eliot et al., we find that sex differences in total brain volume are not accounted for by sex differences in height and weight, and that once global brain size is taken into account, there remain numerous regional sex differences in both directions (Williams et al., 2021).
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Affiliation(s)
- Camille Michèle Williams
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 75005, Paris, France
| | - Hugo Peyre
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 75005, Paris, France; INSERM UMR 1141, Paris Diderot University, Paris, France; Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France
| | - Roberto Toro
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR 3571 CNRS, France; Center for Research and Interdisciplinarity (CRI), INSERM U1284, France; Université de Paris, Paris, France
| | - Franck Ramus
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, 75005, Paris, France.
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29
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Williams CM, Peyre H, Toro R, Ramus F. Neuroanatomical norms in the UK Biobank: The impact of allometric scaling, sex, and age. Hum Brain Mapp 2021; 42:4623-4642. [PMID: 34268815 PMCID: PMC8410561 DOI: 10.1002/hbm.25572] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 12/18/2022] Open
Abstract
Few neuroimaging studies are sufficiently large to adequately describe population‐wide variations. This study's primary aim was to generate neuroanatomical norms and individual markers that consider age, sex, and brain size, from 629 cerebral measures in the UK Biobank (N = 40,028). The secondary aim was to examine the effects and interactions of sex, age, and brain allometry—the nonlinear scaling relationship between a region and brain size (e.g., total brain volume)—across cerebral measures. Allometry was a common property of brain volumes, thicknesses, and surface areas (83%) and was largely stable across age and sex. Sex differences occurred in 67% of cerebral measures (median |β| = .13): 37% of regions were larger in males and 30% in females. Brain measures (49%) generally decreased with age, although aging effects varied across regions and sexes. While models with an allometric or linear covariate adjustment for brain size yielded similar significant effects, omitting brain allometry influenced reported sex differences in variance. Finally, we contribute to the reproducibility of research on sex differences in the brain by replicating previous studies examining cerebral sex differences. This large‐scale study advances our understanding of age, sex, and brain allometry's impact on brain structure and provides data for future UK Biobank studies to identify the cerebral regions that covary with specific phenotypes, independently of sex, age, and brain size.
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Affiliation(s)
- Camille Michèle Williams
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, Paris, France
| | - Hugo Peyre
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, Paris, France.,INSERM UMR 1141, Paris Diderot University, Paris, France.,Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France
| | - Roberto Toro
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR 3571 CNRS, Paris, France.,Center for Research and Interdisciplinarity (CRI), INSERM U1284, Paris, France.,Université de Paris, Paris, France
| | - Franck Ramus
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, École Normale Supérieure, EHESS, CNRS, PSL University, Paris, France
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