A Kind of Dementia That Affects the Brains of Men and Women Differently

Dementia That Affects the Brains of Men and Women

Dementia is a neurological condition that impairs cognitive functions such as memory, language, and the ability to recognize and deal with emotions. Dementia with Lewy bodies (DLB) is among the most common kinds of dementia.

Understanding more about the potential involvement of gender and sex in DLB has gained attention recently. Researchers at Karolinska Institutet have addressed this issue of sex differences in DLB in two recent papers.

Sex differences in dementia with lewy bodies (DLB)

Dementia care is shifting away from treating all patients in the same manner. Instead, how dementia is identified and treated depends on the distinctive characteristics of each patient, such as their age, sex, lifestyle, or past medical history. This customized approach is especially crucial in diseases that manifest differently in various patients, such as dementia with Lewy bodies (DLB).

Given the high proportion of men with DLB compared to women, it has long been assumed that sex plays a significant role in the condition. However, the reasons underlying this discovery remain unclear.

A recent study has helped to highlight that men and women with DLB have distinct symptoms. Women with DLB typically have more visual hallucinations, whereas males with DLB are more likely to have movement issues and dream sleep disturbances.

The recent study

Dr. Javier Oltra and associates in the Ferreira lab released a study in December 2023 that has contributed to our growing knowledge of the disease’s impact on the brains of male and female DLB patients. Drs. Oltra, Habich, Ferreira, and associates facilitated an extensive global collaboration between scientists at the Karolinska Institute, the University of Barcelona, the European DLB consortium, and the Mayo Clinic in Rochester, U.S.

The researchers jointly explored how a patient’s sex would impact DLB-related brain tissue loss. The journal Alzheimer’s and Dementia published the investigation’s findings [1]. The researchers examined the world’s largest DLB imaging dataset, which included 442 patients from 14 centers throughout Europe and the Mayo Clinic in the United States.

The researchers defined brain matter loss using two different methodologies. In the first approach, a specialized medical specialist visually examined images of the brain and determined whether brain matter loss happens in substantial parts of the brain. This method is straightforward but effective because it is used in clinical practice today, making it easier to translate research findings into clinical practice. The second approach evaluated the loss of brain tissue in smaller brain regions using a sophisticated, automated process.

The study found that men with DLB lose more brain matter than women with DLB in several brain regions, especially in the frontal lobe. Interestingly, these sex differences were evident in younger patients and reduced at older age, with differences between men and women with DLB diminishing at the age of 75. Additionally, the researchers demonstrated that cognitive issues and the occurrence of visual hallucinations were linked to men’s regional loss of brain matter.

Ongoing Research

Expanding upon these gender disparities in DLB brain loss, the group carried out a second study under the direction of Dr. Annegret Habich, but from a network perspective this time [2]
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By employing the network technique, rather than concentrating on a single brain region at a time, we can examine intricate patterns of brain matter loss that appear across numerous brain regions. It is crucial because the illness that causes DLB, known as the “Lewy body disease,” is thought to cause brain matter loss and spread across the brain via these brain networks rather than staying in one specific area of the brain.

According to their research, sex differences in brain networks mostly occurred between men and women in good health; however, sex differences were less pronounced in DLB patients.

Consistent with the earlier research, these results underscore the significance of sex in DLB and may account for the distinct ways in which the illness spreads throughout the brains of men and women until the point at which the sex differences vanish during the dementia phase of the condition.

The combined results of these two investigations point to an earlier onset of brain matter loss in males with DLB. In contrast, women with DLB experience a more aggressive course of brain matter loss that begins later.

As a result, while women and men with DLB eventually attain equal degrees of disease severity, their disease processes can differ dramatically.

Raising awareness about this issue will assist physicians in detecting the condition earlier and more accurately in women and men with DLB, which is the initial step toward providing patients with sufficient dementia care and treatment options.

References

  1. Oltra, J., Habich, A., Schwarz, C.G., Nedelska, Z., Przybelski, S.A., Inguanzo, A., Diaz‐Galvan, P., Lowe, V.J., Oppedal, K., Gonzalez, M.C. and Philippi, N., 2023. Sex differences in brain atrophy in dementia with Lewy bodies. Alzheimer’s & Dementia.
  2. Habich, A., Oltra, J., Schwarz, C.G., Przybelski, S.A., Oppedal, K., Inguanzo, A., Blanc, F., Lemstra, A.W., Hort, J., Westman, E. and Lowe, V.J., 2023. Sex differences in grey matter networks in dementia with Lewy bodies.
  3. A type of dementia that hits the brain of men and women differently. News from Karolinska Institutet. https://news.ki.se/a-type-of-dementia-that-hits-the-brain-of-men-and-women-differently. Published Online: 22nd January, 2024. Accessed: 9th February, 2024.
  4. A type of dementia that hits the brains of men and women differently. Medical Xpress. https://medicalxpress.com/news/2024-01-dementia-brains-men-women-differently.html. Published Online: 23rd January, 2024. Accessed: 9th February, 2024.
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