Sex-Related Reserve Hypothesis in Alzheimer’s Disease: Changes in Cortical Thickness with a Five-Year Longitudinal Follow-Up

Article type: Research Article

Authors: Lee, Juyoun^{a; b} | Cho, Hanna^c | Jeon, Seun^d | Kim, Hee Jin^a | Kim, Yeo Jin^e | Lee, Jeongmin^a | Kim, Sung Tae^f | Lee, Jong-Min^d | Chin, Juhee^a | Lockhart, Samuel N.^g | Lee, Ae Young^b | Na, Duk L.^a | Seo, Sang Won^{a; *}

Affiliations: [a] Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea | [b] Department of Neurology, Chungnam National University Hospital, Jung-gu, Daejeon, Korea | [c] Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Korea | [d] Department of Biomedical Engineering, Hanyang University, Seongdong-gu, Seoul, Korea | [e] Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Korea | [f] Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea | [g] Department of Internal Medicine, Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA

Correspondence: [*] Correspondence to: Sang Won Seo, MD, PhD, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, Korea. Tel.: +82 2 3410 1233; Fax: &82 2 3410 0052; E-mail: sangwonseo@empal.com.

Abstract: Background:Sex effects on the progression of Alzheimer’s disease (AD) have received less attention than other demographic factors, including onset age and education. Objective:The aim of this study was to investigate whether sex affected cortical thinning in the disease progression of AD. Methods:We prospectively recruited 36 patients with early-stage AD and 14 people with normal cognition. All subjects were assessed with magnetic resonance imaging at baseline, Year 1, Year 3, and Year 5. We performed cortical thickness analyses using surface-based morphometry on magnetic resonance imaging. Results:Women with AD showed more rapid cortical thinning in the left dorsolateral frontal cortex, left superior temporal gyrus, bilateral temporo-parietal association cortices, bilateral anterior cingulate gyri, bilateral medial frontal cortices, and bilateral occipital cortices over 5 years than men with AD, even though there was no difference in cortical thickness at baseline. In contrast, there were no regions of significantly more rapid atrophy in men with AD. Conclusions:Our findings suggest that women deteriorate faster than men in the progression of AD.

Keywords: Alzheimer’s disease, cognitive reserve, cortical thickness, longitudinal study, sex

DOI: 10.3233/JAD-180049

Journal: Journal of Alzheimer's Disease, vol. 65, no. 2, pp. 641-649, 2018