Neurobiology of Aging
Volume 30, Issue 6 , Pages 946-956, June 2009

Sex differences in the causes and consequences of white matter hyperintensities

  • P.S. Sachdev

      Affiliations

    • School of Psychiatry, University of New South Wales, Australia
    • Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
    • Corresponding Author InformationCorresponding author at: NPI, Euroa Centre, Prince of Wales Hospital, Barker Street, Randwick, NSW 2031, Australia. Tel.: +61 2 9382 3763; fax: +61 2 9382 3774.
    • ,
  • R. Parslow

      Affiliations

    • Orygen Research Centre, University of Melbourne, Melbourne, Australia
    • ,
  • W. Wen

      Affiliations

    • School of Psychiatry, University of New South Wales, Australia
    • Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
    • ,
  • K.J. Anstey

      Affiliations

    • Centre for Mental Health Research, Australian National University, Canberra, Australia
    • ,
  • S. Easteal

      Affiliations

    • John Curtin School of Medical Research, Australian National University, Canberra, Australia

Received 11 April 2007; received in revised form 6 August 2007; accepted 31 August 2007. published online 22 October 2007.

Abstract 

Objective

To examine sex differences in white matter hyperintensities (WMHs) on T2-weighted magnetic resonance imaging (MRI), reported to be more severe in older women.

Methods

A random community sample of 228 men and 204 women, aged 60–64, underwent brain MRI scans. WMHs on T2-weighted FLAIR MRI scans were measured using an automated procedure. Subjects were assessed for physical health, cognitive function, vascular risk factors and Apolipoprotein E (APOE) genotyping.

Results

Women had more WMHs in both deep and periventricular regions. Hypertension, heart disease and high homocysteine were significant determinants in men and current smoking in women. Hormone replacement therapy and APOE*E4 allele did not have an association with WMHs. WMHs were related to reduced processing speed in men, and had an association with poor physical health and lowered grip strength in both sexes.

Conclusion

WMHs are more common in women, with somewhat different putative causes and consequences than men, but >80% of the variance in their causation remains unexplained. The focus in the investigation of WMHs should move beyond the examination for cerebrovascular disease.

Keywords: MRI, White matter hyperintensities, Sex differences, Small vessel disease

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PII: S0197-4580(07)00354-5

doi:10.1016/j.neurobiolaging.2007.08.023

Neurobiology of Aging
Volume 30, Issue 6 , Pages 946-956, June 2009

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