Sexual dimorphism of clinical and radiological characteristics in patients with multiple sclerosis

Abstract

Introduction. The neuroradiological picture of multiple sclerosis (MS) is characterized by a focal demyelinating process in the central nervous system. Gender-specific patterns of demyelination are attributed to a propensity for neurodegenerative or proinflammatory phenotypes in different sexes. The heterogeneity of studies examining the correlation between the prevalence of focal lesions and the degree of disability necessitates the assessment of the contribution of gender characteristics in MS to the rates of disability in patients. The purpose of the study is to assess gender differences in the localization of the demyelinating process and the relationship between the morphological and quantitative characteristics of the lesion and the indicators of the disability scale in multiple sclerosis. Materials and methods. A prospective analysis of magnetic resonance imaging data using goodness-of-fit tests and correlation analysis was carried out on 76 patients (47 women, 29 men; mean age 41.3±11.3) with relapsing remitting multiple sclerosis during a period of stable remission, receiving outpatient care in the Kursk Regional Multidisciplinary Clinical Hospital for the years 2019–2022. Results. The quantitative indicator of the frequency of localization of lesions in the corpus callosum is characterized by a predominance in the male population (62 %) compared to female population (42.5 %) (p<0.05). Lesions in the cerebellum and cervical spinal cord were found predominantly in men: 48.3 % versus 21.3 % in women, and 75.9 % versus 36.1 %, respectively (p<0.05; p<0.001). According to the frequency quantitative value of the periventricular localization of the demyelinating process, a prevalence was recorded in males (96.5 %) compared to females (70.2 %) (p<0.05). In the studied sample, there were significant differences in the number of lesions in different gender groups (p<0.05), which, however, did not affect the degree of disability of patients. Correlation analysis demonstrated the presence of a moderate positive relationship between the size of the leading lesion and Expanded Disability Status Scale (EDSS) scores in females (ρ=0.287; p<0.05). Conclusion. Gender-specific features of the neuroradiological picture in multiple sclerosis are characterized by the spatial predominance of the demyelinating process in men (periventricular localization, cerebellum, corpus callosum, cervical spinal cord) and the size of the leading lesion in women, comparable to the degree of disability of patients.