Women with Parkinson's show more amyloid plaques at autopsy

Researchers at Mayo Clinic examined 230 autopsy-confirmed cases of Parkinson's disease and found that women had a greater burden of amyloid plaques than men, according to the paper on pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov. The difference was present regardless of whether a co-occurring Alzheimer's disease diagnosis had been made pmc.ncbi.nlm.nih.gov. The work was published in the Journal of Parkinson's Disease and used data from the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND) and the Brain and Body Donation Program (BBDP).

Amyloid plaque burden in women and men

Females with Parkinson's disease had a higher mean cortical total plaque score than males: 6.5 out of 15 versus 4.9 out of 15 (p = 0.045) pmc.ncbi.nlm.nih.gov. The mean CERAD neuritic plaque density was 1.7 out of 3 in females and 1.3 out of 3 in males (p = 0.035) pmc.ncbi.nlm.nih.gov. A cortical plaque total of 5 or more was found in 56.8% of females and 39.7% of males (p = 0.015) pmc.ncbi.nlm.nih.gov.

In multivariable logistic regression, controlling for ApoE ε4 status, Lewy body density score and age at death, female sex was associated with more than twice the odds of a plaque total of 5 or more (OR = 2.18; 95% CI 1.17–4.06; p = 0.014) pmc.ncbi.nlm.nih.gov. The authors conclude that the association is independent of ApoE ε4 status. According to the Mayo Clinic release, the researchers found no difference between women and men in tau pathology or in the level of cognitive impairment.

Cohort and background

All participants were enrolled at Banner Sun Health Research Institute. Recruitment mainly targeted independently living retirees in Maricopa County, Arizona, so the cohort is predominantly Caucasian and of middle to high income pmc.ncbi.nlm.nih.gov. Participants had annual standardized assessments by neuropsychologists and by behavioral and movement disorders neurologists, and comprehensive neuropathological examination after death pmc.ncbi.nlm.nih.gov.

The authors note that earlier BBDP data showed significant comorbid Alzheimer's pathology, both amyloid and tau, in over half of Parkinson's disease dementia cases pmc.ncbi.nlm.nih.gov. Men are more often affected by Parkinson's disease, while women are more likely to develop Alzheimer's disease, yet few studies had examined sex differences in Alzheimer's pathology within Parkinson's disease pmc.ncbi.nlm.nih.gov.

Erika Driver-Dunckley, a movement disorder neurologist at Mayo Clinic and one of the lead researchers, said that mixed pathologies are not unusual in the brain bank and that the sex difference was what interested the team. She noted that anti-amyloid medications are already approved for certain patients with Alzheimer's disease, and that the findings raise the possibility of studying whether they could benefit certain patients with Parkinson's disease dementia and increased amyloid pathology.

Mayo Clinic: women with Parkinson's have more amyloid plaques than men in autopsy study of 230 brains

Amyloid plaque burden in women and men

Cohort and background

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