Evidence mapPaperPMID 41546373Full record

SynthesisThe British journal of radiology2026

Sex differences in Alzheimer's disease: a systematic review of two decades of neuroimaging research.

Parinaz Massoumzadeh, Savannah Tiemann Powles, Mahshid Naghashzadeh, Jacqueline Rizzo, Jessica Hu, Lauren Yaeger, Hiba Alkelani, Qing Wang, Gengsheng Chen, Mahsa Dolatshahi and 2 more

Abstract readSystematic Review
In one paragraph

Synthesis in The British journal of radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Parinaz MassoumzadehMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.ORCID 0000-0001-7510-7273
Savannah Tiemann PowlesMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Mahshid NaghashzadehMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Jacqueline RizzoMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Jessica HuMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Lauren YaegerMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Hiba AlkelaniMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Qing WangMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Gengsheng ChenMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Mahsa DolatshahiMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Nelly Joseph-MathurinMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.
Tammie L S BenzingerMallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63110, United States.

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
Smartphone-Based "Burst" Cognitive AssessmentsP01AG003991 · NIA · WASHINGTON UNIVERSITY · PI JOHN MORRIS, Suzanne Elizabeth Schindler · 1985 to 2026
$69.5M
Imaging CoreU19AG032438 · NIA · WASHINGTON UNIVERSITY · PI BATEMAN, RANDALL J · 2010 to 2025
$53.9M
The natural history of AB accumulation in preclinical ADP01AG026276 · NIA · WASHINGTON UNIVERSITY · PI ANCES, BEAU M · 2005 to 2025
$49.5M
Research Education ComponentP30AG066444 · NIA · WASHINGTON UNIVERSITY · PI Susan Lynn Stark · 2020 to 2026
$28.7M
Dominantly Inherited Alzheimer NetworkUF1AG032438 · NIA · WASHINGTON UNIVERSITY · PI BATEMAN, RANDALL J · 2014 to 2017
$21.6M
Quantitative Endogenous MRI Imaging of Neuroinflammation in ADR01AG074909 · NIA · WASHINGTON UNIVERSITY · PI QING WANG · 2022 to 2026
$3.7M
Quantification of Neuroinflammation inAlzheimer's Disease Using Diffusion BasisSpectrum ImagingR01AG054567 · NIA · WASHINGTON UNIVERSITY · PI BENZINGER, TAMMIE LEE SMITH, WANG, YONG · 2017 to 2021
$3.6M
Imaging Tauopathy in the Dominanatly Inherited Alzheimer Network (DIAN)R01AG052550 · NIA · WASHINGTON UNIVERSITY · PI ANCES, BEAU M, BENZINGER, TAMMIE LEE SMITH · 2018 to 2022
$3.6M
Evaluation of the neurovascular unit in the setting of pathogenesis and treatment of autosomal dominant Alzheimer diseaseK01AG080123 · NIA · WASHINGTON UNIVERSITY · PI Nelly Cecile Joseph-Mathurin · 2023 to 2026
$376k
NCATS NIH HHS UL1 TR002345NCATS NIH HHS UL1TR002345NIA NIH HHS K01 AG080123NIA NIH HHS K01AG080123NIA NIH HHS P01 AG003991NIA NIH HHS P01 AG026276NIA NIH HHS P30 AG066444NIA NIH HHS R01 AG052550NIA NIH HHS R01 AG054567NIA NIH HHS R01 AG074909NIA NIH HHS R01AG074909NIA NIH HHS U19 AG032438NIA NIH HHS UF1 AG032438NIH HHS
6 · The paper itself

Abstract

objectivesGiven the heterogeneous nature of Alzheimer's disease (AD) and its higher prevalence in females, it is crucial to understand sex-related differences in AD presentation and changes in the brain.

methodsThis systematic review investigates sex differences in AD and summarizes key findings from neuroimaging studies over the past two decades to examine how genetics, hormones, and lifestyle factors influence neuroimaging biomarkers and their correlation with cognitive decline and AD progression. A comprehensive literature search was conducted across several databases for human studies from 2004 to 2024 related to AD, biological sex differences, and neuroimaging.

resultsAfter a 3-step review process, the final extraction included 120 peer-reviewed studies using various neuroimaging modalities, such as MRI, amyloid-beta PET, tau-PET, and fluorodeoxyglucose (FDG) PET, to investigate sex as a biological predictor variable in adults with or at risk for AD. Over 90% of the reviewed studies identified clear sex-specific patterns of imaging biomarkers related to cognitive reserve, hormonal changes, APOE-ɛ4 genotype, inflammation, vascular health, and lifestyle factors. Machine learning studies increasingly incorporate sex as a key variable, revealing sex-specific biomarkers and improving model performance in predicting disease status and progression.

conclusionsConsidering biological sex in AD research is essential for improving diagnostic accuracy, tailoring interventions, and health outcomes. ADVANCES IN KNOWLEDGE: This systematic review identifies sex-specific patterns in neuroimaging biomarkers of AD, influenced by cognitive reserve, hormones, APOE-ɛ4 genotype, inflammation, vascular health, and lifestyle. Recognizing these differences is crucial for understanding, diagnosis, and treatment efficacy.

Indexed as

Alzheimer DiseaseNeuroimagingBiomarkersBrainDisease ProgressionFemaleHumansMalePositron-Emission TomographySex FactorsBiomarkersADRDAlzheimer’s diseaseamyloid-beta PETcognitive reservedementiaMRIneuroimagingsex differencestau-PET

Identifiers

PMID41546373
PMCPMC13070646

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.