{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T18:32:40Z","timestamp":1775241160359,"version":"3.50.1"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01NS099564"],"award-info":[{"award-number":["R01NS099564"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Huntington's disease (HD) is a progressive neurodegenerative disorder caused by a cytosine\u2010adenine\u2010guanine (CAG) repeat expansion in the huntingtin gene. The disease exhibits sex\u2010related differences in symptomatology and disease progression, but the effect on brain structural biomarkers and the interaction between sex and CAG\u2010age product score (CAPS), a widely used index combining the effect of CAG expansion and age, remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the interplay between sex and CAPS on clinical measures and neuroimaging biomarkers in HD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed data from Enroll\u2010HD, TRACK\u2010HD\/ON, PREDICT\u2010HD, and IMAGE\u2010HD studies, including a combined dataset of 19,738 participants with CAG\u2009\u2265\u200940. Linear mixed models were employed to evaluate the influence of sex and the sex\u2010CAPS interaction on clinical evaluations, including Unified HD Rating Scale (UHDRS) UHDRS and Problem Behaviors Assessment, and neuroimaging biomarkers (striatal volumes and cortical thickness), while controlling for covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Female participants exhibited less pronounced striatal atrophy and cortical thinning with increasing CAPS (caudate:  =\u2009\u22123.449\/\u22122.931,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.05; putamen:  =\u2009\u22124.770\/\u22123.902,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). Regarding clinical measures, females experience greater motor decline with increasing CAPS (total motor score:  =\u20093.008\/3.230,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001), greater cognitive decline (symbol digit modalities test:  =\u2009\u221234.52\/\u221238.57,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001), and greater functional decline (total functional capacity:  = \u22126.413\/\u22126.783, p\u2009&lt;\u20090.05; Independence Scale:  =\u2009\u221232.26\/\u221234.85,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The sex\u2010CAPS interaction significantly impacts both clinical and neuroimaging biomarkers of HD, underscoring the importance of incorporating sex\u2010specific considerations into the clinical staging and management of HD. \u00a9 2025 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.70064","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T08:51:26Z","timestamp":1758617486000},"page":"489-499","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Interplay Between Sex and Cytosine\u2010Adenine\u2010Guanine\u2010Age Product Score in Huntington's Disease: Clinical and Neuroimaging Perspectives"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8828-1841","authenticated-orcid":false,"given":"Jingwen","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Radiological Sciences David Geffen School of Medicine, University of California, Los Angeles  Los Angeles California USA"},{"name":"Department of Bioengineering Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grayson","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Bioengineering Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guowen","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences David Geffen School of Medicine, University of California, Los Angeles  Los Angeles California USA"},{"name":"Department of Bioengineering Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zexi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences David Geffen School of Medicine, University of California, Los Angeles  Los Angeles California USA"},{"name":"Department of Bioengineering Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5835-9831","authenticated-orcid":false,"given":"Adys","family":"Mendizabal","sequence":"additional","affiliation":[{"name":"Department of Neurology David Geffen School of Medicine, University of California, Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donatello","family":"Telesca","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of California, Los Angeles  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiying","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lola","family":"Ibragimova","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juwairia","family":"Shoaib","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie A.","family":"Morrison","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California, San Francisco  San Francisco California USA"},{"name":"UCSF\/UC Berkeley Graduate Program in Bioengineering University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janine M.","family":"Lupo","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California, San Francisco  San Francisco California USA"},{"name":"UCSF\/UC Berkeley Graduate Program in Bioengineering University of California, San Francisco  San Francisco California 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