Sex-Specific Regional Brain Morphometric Correlates of Neighborhood Socioeconomic Disadvantage in Clinical Neuroimaging
BACKGROUND AND PURPOSENeighborhood-level socioeconomic disadvantage is associated with adverse brain morphometry, yet whether these associations differ by biological sex remain opaque. Here, we investigated sex-specific associations between the area deprivation index and brain morphometry derived from routine clinical MRI in a real-world clinical population. MATERIALS AND METHODSIntracranial volume-normalized regional brain volumes were extracted from T1-weighted MRI examinations performed in 2,863 consecutive clinical patients (median age 54 years [IQR 38-68]; 61.2% female) at a single academic medical center and associated community partners using an automated atlas-based segmentation pipeline. Exploratory factor analysis was applied to 131 regional brain volumes to identify latent neuroanatomical morphometric networks. Sex-stratified linear regression models examined associations between area deprivation index national percentile rank and each factor score, adjusting for age, with correction for multiple comparisons. RESULTSFactor analysis identified five neuroanatomical morphometric networks: cerebellar (ML1), frontal/executive (ML2), subcortical-ventricular (ML3), medial temporal/limbic (ML4), and posterior cortical/visual (ML5). In male patients (n = 1,112), linear regressions revealed that greater neighborhood-level socioeconomic disadvantage was significantly associated with lower factor scores on the cerebellar ({beta} = -0.006, 95% CI [-0.009, -0.003], P < .001), medial temporal/limbic ({beta} = -0.004, 95% CI [-0.007, -0.001], P = .01), and frontal/executive ({beta} = -0.004, 95% CI [-0.007, -0.0004], P = .04) networks. No significant associations were observed in female patients (all Ps [≥] .61). CONCLUSIONSIn a real-world clinical population, neighborhood-level socioeconomic disadvantage was associated with lower regional brain volumes across cerebellar, frontal/executive, and medial temporal/limbic neuroanatomical morphometric networks in male but not female patients. These findings suggest that the neuroanatomical correlates of neighborhood disadvantage may be sex-specific, and that sex-stratified analyses may be necessary to fully characterize the relationship between the social exposome and brain morphometry in clinical neuroimaging research.