Sex-stratified neural connectivity patterns in Alzheimer's disease: a resting-state fMRI study unraveling distinct topological alterations

Previous studies have indicated sex differences in Alzheimer's disease (AD). There has not yet been an experiment examining the neural mechanisms and influencing factors of brain connectivity. We gathered resting-state functional magnetic resonance imaging (rs-fMRI) data from a total of 31 AD patients, including 17 females, and 50 healthy controls, comprising 28 females. We investigated brain connectivity from multiple topological variables. The small-world coefficient is significantly higher in the female subgroup than in the male subgroup, in both AD and CN groups. The probability distribution of brain connectivity degrees in males shows more pronounced changes compared to females. There are significant differences in topological variables among groups and sex. Our results demonstrate that brain connectivity exists in the sex differences between AD and CN, which provides new evidence for the existence of physiological protective mechanisms in males against AD.