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Open Access 08-06-2022 | Frontotemporal Dementia | Original Article

Sex influences clinical phenotype in frontotemporal dementia

Authors: Marta Pengo, Antonella Alberici, Ilenia Libri, Alberto Benussi, Yasmine Gadola, Nicholas J. Ashton, Henrik Zetterberg, Kaj Blennow, Barbara Borroni

Published in: Neurological Sciences | Issue 9/2022

Abstract

Introduction

Frontotemporal dementia (FTD) encompasses a wide spectrum of genetic, clinical, and histological findings. Sex is emerging as a potential biological variable influencing FTD heterogeneity; however, only a few studies explored this issue with nonconclusive results.

Objective

To estimate the role of sex in a single-center large cohort of FTD patients.

Methods

Five hundred thirty-one FTD patients were consecutively enrolled. Demographic, clinical, and neuropsychological features, survival rate, and serum neurofilament light (NfL) concentration were determined and compared between sex.

Results

The behavioral variant of FTD was more common in men, whereas primary progressive aphasia was overrepresented in women (p < 0.001). While global cognitive impairment was comparable, females had a more severe cognitive impairment, namely in Trail Making Test parts A and B (p = 0.003), semantic fluency (p = 0.03), Short Story Recall Test (p = 0.003), and the copy of Rey Complex Figure (p = 0.005). On the other hand, men exhibited more personality/behavioral symptoms (Frontal Behavior Inventory [FBI] AB, p = 0.003), displaying higher scores in positive FBI subscales (FBI B, p < 0.001). In particular, apathy (p = 0.02), irritability (p = 0.006), poor judgment (p = 0.033), aggressivity (p = 0.008), and hypersexuality (p = 0.006) were more common in men, after correction for disease severity. NfL concentration and survival were not statistically different between men and women (p = 0.167 and p = 0.645, respectively).

Discussion

The present study demonstrated that sex is a potential factor in determining FTD phenotype, while it does not influence survival. Although the pathophysiological contribution of sex in neurodegeneration is not well characterized yet, our findings highlight its role as deserving biological variable in FTD.

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Title: Sex influences clinical phenotype in frontotemporal dementia
Authors: Marta Pengo
Antonella Alberici
Ilenia Libri
Alberto Benussi
Yasmine Gadola
Nicholas J. Ashton
Henrik Zetterberg
Kaj Blennow
Barbara Borroni
Publication date: 08-06-2022
Publisher: Springer International Publishing
Keywords: Frontotemporal Dementia
Frontotemporal Dementia
Dementia
Dementia
Published in: Neurological Sciences / Issue 9/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-022-06185-7

At a glance: The STEP trials

Springer Medicine

Sex influences clinical phenotype in frontotemporal dementia

Abstract

Introduction

Objective

Methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Objective

Methods

Results

Discussion

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