Age-related gender-specific changes in the brain metabolism and morphology

With a large database, we aimed to evaluate gender-specific distinctive changes of brain glucose metabolism and morphology during normal aging using Magnetic resonance imaging (MRI) and ¹⁸F-FDG positron emission tomography (PET). Methods: A total of 963 cognitively healthy adults were included in this study. All subjects underwent medical questionnaire, mini mental state examination (MMSE) and whole-body examinations including brain MRI and whole-body ¹⁸F-FDG PET. We performed statistical analysis of the MR and PET images using three-dimensional stereotactic surface projection (3D-SSP). All images were corrected by whole brain pixel value to identify the brain regions with significant changes and regions of interest (ROI) were set up with reference to the Brodmann Area (BA). We evaluated morphological and glucose metabolic changes by the cross-sectional analysis. The baseline database consisted of the subjects from 30 to 40 years old and the age-step for comparison was each 5 years. We also compared gender-specific differences of MR and PET images in each generation. Results: In age-related changes, the brain atrophy was observed in the lateral frontal and parietal regions, and the glucose hypometabolism was observed in the medial frontal regions in both genders. Between-gender comparison revealed significant sex differences in these parameters, showing that parallel changes in volume and metabolism were manifested in the medial frontal cortex in men and in the lateral and medial temporal cortex in women. By contrast, metabolism-dominant reductions were manifested in the lateral and medial parietal cortex in men and in the ventrolateral prefrontal cortex, including the Broca area, in women. These differences became insignificant in individuals aged 66 years and older. Conclusion: Our brain mapping study with a large number of normal human brain data demonstrates age-related, parallel changes between morphology and metabolism in the medial frontal regions, and gender-specific hypometabolism in the parietal (male) and the ventrolateral prefrontal (female) cortices. These findings may suggest a presence of aging vulnerability of gender-specific brain regions; the parietal cortex for the visuospatial ability in men and the Broca area for speech communication in women.

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