ArticleInternational journal of stroke : official journal of the International Stroke Society2024
Sex differences in histopathological markers of cerebral amyloid angiopathy and related hemorrhage.
Article in International journal of stroke : official journal of the International Stroke Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The causative role of amyloidosis in the cardiac complications of Alzheimer's disease: a comprehensive systematic review.The Journal of physiology · 2026Pooled it
- Sex differences in dementia pathology and cognitive performance in a population-based, ethnically diverse Brazilian autopsy study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- APOE-mediated sex differences in microvascular pathology and AD-associated proteinopathies in the medial temporal lobe.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Sex differences in imaging features including cerebral amyloid angiopathy markers in intracerebral hemorrhage.Frontiers in stroke · 2026Article
- Exploring the origins of frequent tau-PET signal in vermal and adjacent regions.European journal of nuclear medicine and molecular imaging · 2025Article
- Sex differences in age-associated neurological diseases-A roadmap for reliable and high-yield research.Science advances · 2025Review
- Vascular cognitive impairment and dementia: Mechanisms, treatment, and future directions.International journal of stroke : official journal of the International Stroke Society · 2024Review
- Higher cerebellum florbetapir uptake in cerebral amyloid angiopathy compared to Alzheimer's disease: A dual florbetapir and FDG PET study.Journal of Alzheimer's disease reportsArticle
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Abstract
backgroundMen with cerebral amyloid angiopathy (CAA) may have an earlier onset of intracerebral hemorrhage and a more hemorrhagic disease course compared to women. In this cohort study, we investigated sex differences in histopathological markers associated with amyloid-β burden and hemorrhage in cognitively impaired individuals and patients with CAA, using neuropathological data from two autopsy databases.
methodsFirst, we investigated presence of parenchymal (Thal score) and vascular amyloid-β (CAA severity score) in cognitively impaired individuals from the National Alzheimer's Coordinating Center (NACC) neuropathology database. Next, we examined sex differences in hemorrhagic ex vivo magnetic resonance imaging (MRI) markers and local cortical iron burden and the interaction of sex on factors associated with cortical iron burden (CAA percentage area and vessel remodeling) in patients with pathologically confirmed clinical CAA from the Massachusetts General Hospital (MGH) CAA neuropathology database.
resultsIn 6120 individuals from the NACC database (45% women, mean age 80 years), the presence of parenchymal amyloid-β (odds ratio (OR) (95% confidence interval (CI)) =0.68 (0.53-0.88)) but not vascular amyloid-β was less in men compared to women. In 19 patients with definite CAA from the MGH CAA database (35% women, mean age 75 years), a lower microbleed count (p < 0.001) but a higher proportion of cortical superficial siderosis and a higher local cortical iron burden was found in men (p < 0.001) compared to women. CAA percentage area was comparable in men and women (p = 0.732). Exploratory analyses demonstrated a possible stronger negative relation between cortical CAA percentage area and cortical iron density in men compared to women (p = 0.03).
conclusionPreviously observed sex differences in hemorrhage onset and progression in CAA patients are likely not due to differences in global CAA severity between men and women. Other factors, such as vascular remodeling, may contribute, but future studies are necessary to replicate our findings in larger data sets and to further investigate the underlying mechanisms behind these complex sex differences.
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