  PD is linked to faster brain aging. Sex is recognized as an important factor
in PD, such that males are twice as likely as females to have the disease and
have more severe symptoms and a faster progression rate. Despite previous
research, there remains a significant gap in understanding the function of sex
in the process of brain aging in PD patients. The T1-weighted MRI-driven
brain-predicted age difference was computed in a group of 373 PD patients from
the PPMI database using a robust brain-age estimation framework that was
trained on 949 healthy subjects. Linear regression models were used to
investigate the association between brain-PAD and clinical variables in PD,
stratified by sex. All female PD patients were used in the correlational
analysis while the same number of males were selected based on propensity score
matching method considering age, education level, age of symptom onset, and
clinical symptom severity. Despite both patient groups being matched for
demographics, motor and non-motor symptoms, it was observed that males with
Parkinson's disease exhibited a significantly higher mean brain age-delta than
their female counterparts . In the propensity score-matched PD male group,
brain-PAD was found to be associated with a decline in general cognition, a
worse degree of sleep behavior disorder, reduced visuospatial acuity, and
caudate atrophy. Conversely, no significant links were observed between these
factors and brain-PAD in the PD female group.
