Sex differences in the progression of cerebral microbleeds in patients with concomitant cerebral small vessel disease

Abstract

Background and purposeSex differences in cerebral microbleeds (CMBs) are not well-known. We aimed to assess the impact of sex on the progression of CMBs.MethodsThe CHALLENGE (Comparison Study of Cilostazol and Aspirin on Changes in Volume of Cerebral Small Vessel Disease White Matter Changes) database was analyzed. Out of 256 subjects, 189 participants with a follow-up brain scan were included in the analysis. The linear mixed-effect model was used to compare the 2-year changes in the number of CMBs between men and women.ResultsA total of 65 men and 124 women were analyzed. There were no significant differences in the prevalence (70.8 vs. 71.8%; P = 1.000) and the median [interquartile range (IQR)] number of total CMBs [1 (0–7) vs. 2 (0–7); P = 0.810] at baseline between men and women. The median (IQR) increase over 2 years in the number of CMBs was statistically higher in women than in men [1 (0–2) vs. 0 (0–1), P = 0.026]. The multivariate linear mixed-effects model showed that women had a significantly greater increase in the number of total, deep, and lobar CMBs compared to men after adjusting for age and the baseline number of CMBs [estimated log-transformed mean of difference between women and men: 0.040 (P = 0.028) for total CMBs, 0.037 (P = 0.047) for deep CMBs, and 0.047 (P = 0.009) for lobar CMBs].ConclusionThe progression of CMB over 2 years was significantly greater in women than in men.

Relationships between intracranial arterial dolichoectasia and small vessel disease in patients with ischaemic stroke: a systematic review and meta-analysis

“…This anatomical link between large and small artery pathology is consistent with either shared pathophysiological mechanisms or vulnerability rather than simply shared risk factors [ 29 , 31 , 36 , 43 ]. Importantly, results from meta-regression of gender heterogeneity on the influencing of CMBs in AIS patients with IADE showed that gender might not affect the incidence or burden of CMBs, in agreement with previous studies [ 44 , 45 ]. Even though we did not find evidence that the heterogeneity in the relationship between IADE and CMBs is driven by differences in hypertension in the meta-regression analysis, previous studies have emphasised the strong association between IADE and the presence of CMBs after adjusting for age, sex, and hypertension [ 13 ].…”

Hypoxic oligodendrocyte precursor cell-derived VEGFA is associated with blood–brain barrier impairment

“…6 C, D). However, age and sex are known to influence both VEGFA plasma levels and BBB integrity [ 9 , 53 , 62 , 68 ]. After adjustment for these covariates we found a significant the relationship between VEGFA plasma levels and BBB leakage rate (K i ) in the NAWM in patients ( p = 0.044, Table 2 ).…”

Sex and interferon gamma signaling regulate microglia migration in the adult mouse cortex in vivo

“…), our results showing sex differences in migratory responses to injury could have functional implications. Human studies are rather mixed but show that males diagnosed with cerebral amyloid angiopathy ( 87 ), mild cognitive impairment, or Alzheimer disease ( 88 ), have significantly more cerebral microbleeds than females ( 89 ), whereas females with small vessel disease have increased microbleed burden ( 90 ). In rodents, the picture appears more consistent where female mice exhibit more abundant microbleeds than males in mouse models of Alzheimer disease ( 91 ) or cerebral amyloid angiopathy ( 92 ).…”