Sex-Specific Brain Morphological and Network Differences in Parkinson's Disease Parkinson’s with Rapid Eye Movement Sleep Behavior Disorder

Motivation: It remains unclear whether there exists a sex-specific pattern of altered brain morphology in Parkinson's disease (PD) patients with rapid eye movement sleep behavior disorder Goal(s): Investigate sex differences in male and female patients with PD-RBD in terms of cortical morphology and individual structural covariant networks. Approach: gray matter volume (GMV) and cortical morphology metrics were obtained, Idividual-level morphological similarity networks were constructed. Results: In the PD-pRBD group, males showed lower GMV in frontal and temporal lobes than females, while females had lower gyrification index (GI) in these regions. Graph-based analysis indicated lower network integration in males, especially in fractal dimension (FD) networks. Impact: By examining the distinct stages of disease progression in PD patients alongside sex-specific differences, this research aims to identify resultant variations as potential targets for non-pharmacological interventions, such as transcranial magnetic stimulation (TMS), to support individualized treatment strategies.