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Gender-related differences in MS: a study of conventional and nonconventional MRI measures

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA; Department of Radiology, Clinical Hospital Centre Rijeka, Rijeka, Croatia

B Weinstock-Guttman

The Jacobs Neurological Institute, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

JL Cox

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

S Hussein

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

J Durfee

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

C Caiola

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

MG Dwyer

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

N Bergsland

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

N Abdelrahman

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

M Stosic

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

D Hojnacki

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA; The Jacobs Neurological Institute, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

FE Munschauer

The Jacobs Neurological Institute, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA

D Miletic

Department of Radiology, Clinical Hospital Centre Rijeka, Rijeka, Croatia

R Zivadinov

Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA; The Jacobs Neurological Institute, Department of Neurology, State University of New York at Buffalo, Buffalo, New York, USA rzivadinov{at}bnac.net

Background

Studies showed gender-associated differences in multiple sclerosis (MS) disease evolution and in the evolution of conventional magnetic resonance imaging (MRI) findings.

Objective

The aim of this study was to investigate gender differences according to a number of conventional and nonconventional MRI measures in patients with MS.

Methods

We examined 763 consecutive patients with MS [499 (19.2% men) relapsing-remitting (RR), 230 (24.8% men) secondary-progressive, and 34 (44.1% men) primary-progressive], 32 (21.9% men) patients with clinically isolated syndrome (CIS), and 101 (30.7% men) normal controls (NC). Patients were assessed using conventional and nonconventional MRI measures. Gender-related MRI differences were investigated using general linear model analysis, corrected for MS disease type.

Results

In the total MS group, male patients showed lower normalized peripheral gray matter (GM) (P < 0.001) and normalized GM (P = 0.011) volumes than female patients. Female patients presented lower normalized white matter (WM) volumes (P = 0.011). These gender effects were not observed in NC. Male patients also showed more advanced central atrophy (P = 0.022). In RRMS male patients, there was also a higher lateral ventricle volume (P = 0.001). The GM-WM normalized ratio was lower for male patients with MS compared with male NC (0.97 vs. 1.09, P < 0.001) but not in patients with CIS compared with NC.

Conclusions

There were no significant gender-related differences regarding nonconventional MRI measures. GM and central atrophy are more advanced in male patients, whereas WM atrophy is more advanced in female patients. These gender-related MRI differences may be explained by the effect of sex hormones on brain damage and repair mechanisms.

Key Words: gender • gray matter atrophy • multiple sclerosis • sex hormones • white matter atrophy

This version was published on March 1, 2009

Multiple Sclerosis, Vol. 15, No. 3, 345-354 (2009)
DOI: 10.1177/1352458508099479


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