Key result
Female sex is linked to greater age-related cerebral pulsatility, particularly in proximal anterior arteries.
Why the study?
Little is understood regarding sex differences in cerebral pulsatility with age, particularly within different cerebral arteries, or how cerebral damping blunts pulsatility across the adult lifespan.
Are there sex differences in age-related changes in cerebral pulsatility and damping across the adult lifespan?
Cross-Sectional (n=164)
Single-blind (outcome assessors)
No
Are there sex differences in age-related changes in cerebral pulsatility and damping across the adult lifespan?
Females experience a steeper age-related increase in cerebral pulsatility compared to males, particularly in the proximal anterior circulation, which may contribute to sex-specific cerebrovascular risk profiles.
Cerebral pulsatility is a potential marker of cerebrovascular health, yet little is understood about sex differences in cerebral pulsatility with age, especially within different cerebral arteries. Additionally, cerebral damping can blunt cerebral pulsatility and might decline with age. Therefore, we aimed to identify sex differences in cerebral pulsatility and damping across the adult lifespan. Forty-three young, 67 middle-aged and 54 older adults had cerebral haemodynamics measured in the internal carotid arteries (ICAs), middle cerebral arteries (MCAs) and basilar artery using 4D flow MRI. Cerebral pulsatility index (PI) and damping factor (DF) were calculated. Young females had lower PI than young males in the ICAs (p < 0.05 for both), and middle-aged females had lower PI than middle-aged males in the right ICA (p < 0.01). In contrast, older females had greater PI than older males in the right ICA (p < 0.01) and in the right MCA (p < 0.05). Only the DF between the right ICA and MCA was lower in young females than in young males (p < 0.001). Taken together, females experience greater age-related elevations in cerebral pulsatility in comparison to males, especially within the proximal arteries of the anterior circulation. Damping was not different between males and females within the proximal arteries of anterior circulation, suggesting a different underlying mechanism. Overall, our findings suggest sex-specific trends in cerebral pulsatility with age, although the mechanisms driving this require further exploration.
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Gaynor‐Metzinger et al. (2025) conducted a cross-sectional in Healthy adults (n=164). Female sex vs. Male sex was evaluated on Cerebral pulsatility index (PI) in the right internal carotid artery among older adults (p=<0.01). Females experience greater age-related elevations in cerebral pulsatility compared to males, particularly within the proximal arteries of the anterior circulation.
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