Gender differences in brain reserve

BackgroundNeuropathological studies suggest that the association between neurodegenerative brain damage and clinical symptoms may be stronger in women than in men.ObjectiveTo test the hypothesis that cerebral metabolic deficits due to neurodegeneration are more pronounced in men than in women at the same level of clinical disease severity.Methods93 patients with mild Alzheimer's disease (AD; 50 men, 43 women) underwent an extensive clinical and neuropsychological examination and 18F-FDG PET imaging at a university-based outpatient unit for cognitive disorders. An analysis of covariance (with age, total score of the CERAD neuropsychological battery, and years of school education as covariates) was conducted in each study group to identify gender differences in glucose metabolism.ResultsControlling for age, education, and clinical severity, cortical regions were identified,where glucose metabolism was significantly reduced in men as compared with women. These regions were located in areas typically affected by AD pathology (right inferior frontal, superior temporal and insular cortex, and hippocampus).ConclusionsThese data suggest that the same clinical severity of dementia is associated with greater reductions in cerebral metabolism in men than in women suggesting a greater degree of brain reserve in men.