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Related Experiment Video

Updated: Jul 14, 2026

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Sex differences in brain atrophy in multiple sclerosis.

Rhonda R Voskuhl1, Kevin Patel2, Friedemann Paul3,4

  • 1Department of Neurology, University of California, Los Angeles, 635 Charles E. Young Drive South, Gordon Neuroscience Research Building, Los Angeles, CA, 90095, USA. rvoskuhl@mednet.ucla.edu.

Biology of Sex Differences
|August 30, 2020
PubMed
Summary

Men with multiple sclerosis (MS) experience greater gray matter atrophy in specific brain regions compared to women. This regional neurodegeneration in males correlates with poorer performance on motor function tests, indicating sex-based differences in MS progression.

Keywords:
Disability progressionMultiple sclerosisNeurodegenerationNeuroimagingSex differences

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Area of Science:

  • Neuroscience
  • Neurology
  • Radiology

Background:

  • Multiple sclerosis (MS) affects women more frequently than men (3:1 ratio).
  • Male sex is identified as a risk factor for more severe disability progression in MS.
  • Sex may differentially influence inflammation and neurodegeneration in MS.

Purpose of the Study:

  • To investigate sex differences in neurodegeneration in multiple sclerosis (MS).
  • To compare regional gray matter (GM) atrophy between men and women with MS and healthy controls.

Main Methods:

  • Voxel-based morphometry (VBM) was employed to analyze regional GM atrophy.
  • Deep GM substructure volumetry and cortical thinning analyses were conducted.
  • Performance on the 9-hole peg test (9HPT) was assessed to evaluate motor function.

Main Results:

  • VBM revealed GM atrophy in the thalamus for both sexes, with additional atrophy in the putamen and specific cortical regions in men.
  • Volumetric and cortical thinning analyses confirmed GM loss in deep and cortical structures.
  • Men with MS showed worse 9HPT performance than women, with thalamic volume strongly correlating with 9HPT scores in males.

Conclusions:

  • Men with MS exhibit more extensive regional GM atrophy than women.
  • These findings align with male sex being a predictor of worse disease progression in MS.
  • Sex-specific patterns of neurodegeneration may underlie differential disability progression in MS.