Sex differences in brain atrophy in dementia with Lewy bodies

INTRODUCTIONSex influences neurodegeneration, but it has been poorly investigated in dementia with Lewy bodies (DLB). We investigated sex differences in brain atrophy in DLB using magnetic resonance imaging (MRI).METHODSWe included 436 patients from the European-DLB consortium and the Mayo Clinic. Sex differences and sex-by-age interactions were assessed through visual atrophy rating scales (n = 327; 73 +/- 8 years, 62% males) and automated estimations of regional gray matter volume and cortical thickness (n = 165; 69 +/- 9 years, 72% males).RESULTSWe found a higher likelihood of frontal atrophy and smaller volumes in six cortical regions in males and thinner olfactory cortices in females. There were significant sex-by-age interactions in volume (six regions) and cortical thickness (seven regions) across the entire cortex.DISCUSSIONWe demonstrate that males have more widespread cortical atrophy at younger ages, but differences tend to disappear with increasing age, with males and females converging around the age of 75.HighlightsMale DLB patients had higher odds for frontal atrophy on radiological visual rating scales.Male DLB patients displayed a widespread pattern of cortical gray matter alterations on automated methods.Sex differences in gray matter measures in DLB tended to disappear with increasing age.