Sex difference in cerebral blood flow and cerebral glucose metabolism: an activation-likelihood estimation meta-analysis

Nucl Med Commun. 2021 Apr 1;42(4):410-415. doi: 10.1097/MNM.0000000000001343.


Objectives: Sex differences exist in a variety of aspects including neurochemicals as well as behavioral traits of cognition, language, and aggression. We performed a meta-analysis of studies using a coordinate-based technique of activation-likelihood estimation (ALE) to identify the pooled estimated effect of sex difference.

Methods: We performed a systematic search of MEDLINE and EMBASE for English-language publications using the keywords of 'positron emission tomography (PET)', 'single-photon emission computed tomography (SPECT)', and 'sex'. A threshold of uncorrected P < 0.001 (minimum volume of 200 mm3) was applied to the resulting ALE map.

Results: Cerebral blood flow (CBF) in right precuneus, left superior temporal gyrus, left inferior temporal, left inferior frontal gyrus, right cerebellar tonsil, and right middle temporal gyrus was higher in females than males. CBF in left anterior cingulate was higher in males than females. Whereas, the cerebral metabolic rate for glucose (CMRglu) in left thalamus, left cingulate gyrus, right inferior parietal lobule, left medial frontal gyrus, right middle frontal gyrus, right midbrain, and left inferior parietal lobule was higher in females than males. However, there was no brain region that showed higher CMRglu in males than females.

Conclusion: Regional CBF and CMRglu from PET and SPECT showed the difference between males and females.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Algorithms
  • Brain / diagnostic imaging*
  • Brain Chemistry / physiology*
  • Cerebrovascular Circulation / physiology*
  • Female
  • Glucose / metabolism*
  • Humans
  • Likelihood Functions
  • Male
  • Positron-Emission Tomography
  • Sex Characteristics
  • Tomography, Emission-Computed, Single-Photon


  • Glucose