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Updated: Dec 21, 2025
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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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Sex-Specific Differences in Life Span Brain Volumes in Multiple Sclerosis.
Dejan Jakimovski1, Robert Zivadinov1,2, Niels Bergsland1,3
1Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.
Summary
Male multiple sclerosis (MS) patients show greater lateral ventricular volume (LVV) and lower gray matter volume (GMV) compared to females, with these sex differences diminishing in older age groups. This highlights sex-specific brain changes throughout the MS lifespan.
Area of Science:
- Neurology
- Neuroimaging
- Sex Differences in Disease
Background:
- Multiple sclerosis (MS) exhibits numerous sex-specific differences in susceptibility, disease progression, and neurodegeneration.
- Previous magnetic resonance imaging (MRI) studies indicate structural brain volume disparities between female and male MS patients.
Purpose of the Study:
- To investigate sex-specific global and tissue-specific brain volumes across the MS lifespan using a large, real-world MRI database.
- To identify how sex and age interact to influence brain structure in MS.
Main Methods:
- Structural MRI data from 2,199 MS patients (1,651 female, 548 male) were analyzed.
- Whole brain volume (WBV), white matter, gray matter volume (GMV), and lateral ventricular volume (LVV) were quantified using SIENAX and NeuroSTREAM.
- General linear models assessed sex and age interactions, with post hoc analyses comparing sex differences.
Main Results:
- Male MS patients, despite age-matching, had lower normalized WBV and GMV, and greater LVV compared to females (P < .001).
- Significant interactions between sex and age affected LVV (P = .033) and GMV (P = .032), persisting even when accounting for disease subtype and treatment.
- Greater LVV and lower GMV in males were observed in early to mid-life but were absent in patients over 60 years old.
Conclusions:
- Distinct sex-specific differences exist in lateral ventricular volume and gray matter volume throughout the multiple sclerosis lifespan.
- These findings underscore the importance of considering sex as a biological variable in understanding MS neurodegeneration and progression.
