Abstract Details

Title Subcortical brain volumes are sexually dimorphic and related to neurofunctional outcomes in MS

Topic Multiple Sclerosis

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 12-009

Background Differences in regional and whole brain volumes between women and men with MS have been described; however, relationships of sexually dimorphic patterns of neurodegeneration to neurofunctional outcomes remain unknown.

Objective To evaluate neurofunctional reserve in men and women with multiple sclerosis (MS).

Design/Methods Participants were scanned using 3T MRI. Normalized brain volumes were calculated using Sienax and FIRST. A comprehensive neuropsychological battery was administered. Associations of brain metrics and outcomes were evaluated in sex stratified samples with analysis of variance, followed by mediation analysis of significant relationships. Hierarchical linear regression tested the interaction of sex and brain metrics on neurofunctional outcomes.

Results In 245 patients (170 women), no sex differences were shown in demographic / clinical variables: age, disability (EDSS), disease duration, race/ethnicity, estimated premorbid IQ, employment status, education, body mass index. Regarding brain volumetric differences, no whole brain, gray, or white matter differences were shown. Women had larger left and right hippocampus (p<.001, p=.010), right thalamus (trend, p=.063), and left caudate (p=.045). Regarding neurofunctional outcomes, women performed better than men on a cognitive screener (SDMT, p=.026), verbal memory (learning, p=.020, delayed recall, p=.002), and motor speed (Nine Hole Peg, p=.001). No sex differences were found for fatigue, depression, anxiety, social support, or subjective cognitive status. In a subset of patients within 5 years of diagnosis (n=183, 113 women), women had higher white matter volume (p=.021) and whole brain volume (p=.034) and performed better on verbal memory and naming efficiency tests. Left hippocampal volume mediated the relationship of sex to memory performance (delayed recall) explaining 41.9% of the variance; and on naming efficiency, explaining 22.3% of the variance. The interaction of sex and brain metrics on neurofunctional outcomes was not significant.

Conclusions

Women and men with multiple sclerosis show different patterns of neurofunctional consequences of neurodegeneration, suggesting possible sex differences in neurofunctional reserve.

Authors/Disclosures
Victoria Leavitt, PhD, FAAN (Columbia University Irving Medical Center) PRESENTER	Dr. Leavitt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Leavitt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Leavitt has received research support from National Institutes of Health. The institution of Dr. Leavitt has received research support from National Multiple Sclerosis Society. The institution of Dr. Leavitt has received research support from Department of Defense. Dr. Leavitt has received intellectual property interests from a discovery or technology relating to health care.
Claire Riley, MD, FAAN (Columbia University Medical Center)	Dr. Riley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Viracta. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics.
James F. Sumowski (Icahn School of Medicine At Mount Sinai)	Mr. Sumowski has nothing to disclose.
Korhan Buyukturkoglu, PhD (Columbia University)	Dr. Buyukturkoglu has nothing to disclose.