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The extent of myelin changes in HF and variations within sexes are unclear. Our aim was to examine regional brain subcortical and white matter myelin integrity in HF patients over control subjects, as well as differences between sexes using T1\u2010 and T2\u2010weighted clinical images. We acquired T1\u2010 and T2\u2010weighted images from 63 HF patients and 129 controls using a 3.0\u2010Tesla MRI scanner. Using T1\u2010 and T2\u2010weighted images, ratio maps were computed, normalized to a common space, smoothed, and compared between groups (ANCOVA; covariates: age and sex; SPM12, false discovery rate, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.010), as well as between male versus female HF (ANCOVA; covariate: age; SPM12, uncorrected <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.005). Multiple brain areas in HF showed decreased myelin integrity, including the amygdala, hippocampus, cingulate, insula, cerebellum, prefrontal cortices, and multiple white matter areas, compared to controls. Female HF patients showed more brain injuries in the parietal, prefrontal and frontal, hippocampus, amygdala, pons, cerebellar, insula, and corpus callosum compared to male HF patients. HF subjects showed compromised subcortical and white matter myelin integrity, especially in sites regulating autonomic, respiratory, mood, and cognition, with more changes in females over males. These findings provide a structural basis for the enhanced symptoms identified in female over male HF patients with similar disease severity.<\/jats:p>","DOI":"10.1002\/jnr.25229","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T09:35:18Z","timestamp":1689586518000},"page":"1662-1674","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Heart failure\u2010induced brain myelin changes and differences between sexes"],"prefix":"10.1002","volume":"101","author":[{"given":"Bhaswati","family":"Roy","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine University of California Los Angeles  Los Angeles California 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