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• Clinical Article •
Sex-specific brain morphology and network differences in Parkinson's disease patients with probable rapid eye movement sleep behavior disorder
LIU Yang  ZHANG Pengfei  LI Hao  ZHOU Liang  JIANG Jingqi  JIANG Yanli  YANG Wenxia  ZHANG Jing 

Cite this article as: LIU Y, ZHANG P F, LI H, et al. Sex-specific brain morphology and network differences in Parkinson's disease patients with probable rapid eye movement sleep behavior disorder[J]. Chin J Magn Reson Imaging, 2025, 16(3): 1-9, 17. DOI:10.12015/issn.1674-8034.2025.03.001.


[Abstract] Objective To explore gender differences in morphological change patterns among different subgroups of Parkinson's disease (PD) patients.Materials and Methods High-resolution T1-weighted magnetic resonance imaging and clinical scale data were collected from a total of 278 participants in the Parkinson's disease Progression Marker Initiative database. Using a cutoff score of 5 on the rapid eye movement sleep behavior disorder (RBD) screening questionnaire, patients were classified into PD-pRBD (≥ 5 points) and PD-nonRBD (< 5 points) groups. The final sample included 93 PD-pRBD patients, 114 PDnonRBD patients, and 71 healthy controls (HC). The Computational Anatomy Toolbox 12 (CAT12) tool was utilized to gather data on gray matter volume (GMV) and cortical morphological metrics. Subsequently, individual-level morphological similarity networks were constructed based on these cortical metrics. Finally, the topological properties of the network were analyzed using graph theoretic methods.Results In the PD-pRBD group, GMV in the frontal and temporal lobes of males was lower than that of females, while the gyrification index (GI) in the frontal lobes was lower in females than in males (P = 0.024). However, the GI of the frontal lobe in males was lower than that in females within the PDnonRBD group (P = 0.009). Network analyses based on graph theory revealed that male PD-pRBD patients displayed lower network information integration compared to female patients, particularly in terms of the global properties of fractal dimension (FD) networks. Moreover, in the PD-pRBD group, male patients showed a strong correlation between morphological network metrics and cognitive performance as measured by the delayed memory score of Hopkins Verbal Learning Test-Revised (HVLT-R) memory scores and the Montreal Cognitive Assessment (MoCA) (all P < 0.05).Conclusions PD patients with and without RBD exhibit significant sex-specific patterns at both the morphological and network levels. Moreover, the sex differences between males and females in the PD-RBD group are more extensive than those in the nonRBD group, and these differences are further associated with cognitive function. This finding emphasizes the importance of considering gender differences in the diagnosis and treatment of PD-pRBD patients.
[Keywords] Parkinson's disease；rapid eye movement sleep behavior disorder；magnetic resonance imaging；sex differences；morphological brain network；cortical surface

LIU Yang1, 2, 3   ZHANG Pengfei1, 2, 3   LI Hao1, 2, 3   ZHOU Liang1, 2, 3   JIANG Jingqi1, 2, 3   JIANG Yanli1, 2, 3   YANG Wenxia1, 2, 3   ZHANG Jing1, 2, 3, 4*  

1 Second Clinical School, Lanzhou University, Lanzhou 730030, China

2 Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730030, China

3 Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China

4 Gansu Medical MRI Equipment Application Industry Technology Center, Lanzhou 730030, China

Corresponding author: ZHANG J, E-mail: ery_zhangjing@lzu.edu.cn

Conflicts of interest   None.

Received  2024-10-21
Accepted  2025-03-10
DOI: 10.12015/issn.1674-8034.2025.03.001
Cite this article as: LIU Y, ZHANG P F, LI H, et al. Sex-specific brain morphology and network differences in Parkinson's disease patients with probable rapid eye movement sleep behavior disorder[J]. Chin J Magn Reson Imaging, 2025, 16(3): 1-9, 17. DOI:10.12015/issn.1674-8034.2025.03.001.

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