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Sex Differences in the Adult Human Brain: Evidence from 5216 UK Biobank Participants
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Abstract
Sex differences in the human brain are of interest for many reasons: for example, there are sex differences in the observed prevalence of psychiatric disorders and in some psychological traits that brain differences might help to explain. We report the largest single-sample study of structural and functional sex differences in the human brain (2750 female, 2466 male participants; mean age 61.7 years, range 44-77 years). Males had higher raw volumes, raw surface areas, and white matter fractional anisotropy; females had higher raw cortical thickness and higher white matter tract complexity. There was considerable distributional overlap between the sexes. Subregional differences were not fully attributable to differences in total volume, total surface area, mean cortical thickness, or height. There was generally greater male variance across the raw structural measures. Functional connectome organization showed stronger connectivity for males in unimodal sensorimotor cortices, and stronger connectivity for females in the default mode network. This large-scale study provides a foundation for attempts to understand the causes and consequences of sex differences in adult brain structure and function.
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“Sex-related differences in brain structure and function have been consistently reported across large-scale neuroimaging studies, involving both global and regional measures such as total brain volume, cortical thickness, white matter microstructure, and functional connectivity [29,30,31,32].”
From Benchmarking Multimodal Deep Fusion Strategies for Heterogeneous Neuroimaging and Cognitive Data Using a Controlled Sex Classification Task (2026) · cites this paper as [31]
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“As sex differences exist in brain morphology,33”
From Sex Differences in the Association of Global Amyloid and Regional Tau Deposition Measured by Positron Emission Tomography in Clinically Normal Older Adults (2019) · cites this paper as [33]
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“Memory impairment is similarly found among patients with Cushing disease and Cushing syndrome (694).”
From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [694]
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“However, the specific locations and patterns of these identified differences can vary across studies ( Ritchie et al., 2018; Scheinost et al., 2015).”
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A multi-site study on sex differences in cortical thickness in non-demented Parkinson’s disease
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Friedrichs, K., & Kellmeyer, P. (2022) · European Journal of Neuroscience · doi:10.1111/ejn.15834 · Cited by 13
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“When considering neuroanatomical sex differences in humans, volumetric distributions are largely overlapping with relatively small mean difference (Ritchie et al. 2018).”
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“…potential confounding factors affecting the complexity analysis of rsfMRI signals, including age (Dosenbach et al. 2010), years of education (Shen et al. 2018), depression (Mulders et al. 2015), site for data collection sites (Nair et al. 2018), global signal (Li et al. 2019), and brain…”
A sex-stratified analysis of the genetic architecture of human brain anatomy
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“…in line with existing research that underscores sex-specific patterns in brain connectivity, such as enhanced connectivity within the Default Mode Network (DMN) observed in females (Ingalhalikar et al., 2014; Ritchie et al., 2018), with cingulum playing a pivotal role in linking key DMN components.”
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Self-citationThe Impact of Stress Within and Across Generations: Neuroscientific and Epigenetic Considerations
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“According to current science, little is known about sex differences in RSFC (41, 42).”
BackgroundSex and gender differences in genetic and lifestyle risk and protective factors for dementia
Sindi, S., Toopchiani, S. T., Barbera, M., Håkansson, K., Lehtisalo, J., Rosenberg, A., Stephen, R., Udeh‐Momoh, C. T., & Kivipelto, M. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-819344-0.00013-2 · Cited by 11
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The fMRI correlates of visuo-spatial abilities: sex differences and gender dysphoria
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“, 2016) and because it was reported to have a different connectivity in males and females (Adesnik et al. 2010; Ritchie et al., 2018).”
BackgroundWhole‐brain dynamics differentiate among cisgender and transgender individuals
Uribe, C., Escrichs, A., Filippi, E. D., Perl, Y. S., Junqué, C., Gómez‐Gil, E., Kringelbach, M. L., Guillamón, A., & Deco, G. (2022) · Human Brain Mapping · doi:10.1002/hbm.25905 · Cited by 10
“Higher functional connectivity in default mode regions has been reported in cis women in contrast to cis men (Biswal et al., 2010; de Lacy et al., 2019; Ritchie et al., 2018).”
BackgroundResultHome alone: A population neuroscience investigation of brain morphology substrates
Noonan, M. P., Zajner, C., & Bzdok, D. (2023) · NeuroImage · doi:10.1016/j.neuroimage.2023.119936 · Cited by 11
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The Not So Subtle and Status Quo Maintaining Nature of Everyday Sexism
Vescio, T. K., & Kosakowska‐Berezecka, N. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108561716.019 · Cited by 10
Krishnamurthy, L. C., Champion, G., McGregor, K., Krishnamurthy, V., Turabi, A., Roberts, S. R., Nocera, J. R., Borich, M. R., Rodriguez, A. D., Belagaje, S. R., et al. (2020) · Scientific Reports · doi:10.1038/s41598-020-76382-x · Cited by 10
Shin, S., Kim, K., Nam, H., Kim, I. J., & Pak, K. (2020) · Nuclear Medicine Communications · doi:10.1097/mnm.0000000000001343 · Cited by 10
A slower rate of sulcal widening in the brains of the nondemented oldest old
Tang, H., Liu, T., Liu, H., Jiang, J., Cheng, J., Niu, H., Li, S., Brodaty, H., Sachdev, P. S., & Wen, W. X. (2021) · NeuroImage · doi:10.1016/j.neuroimage.2021.117740 · Cited by 11
Multimodal Image Analysis of Sexual Dimorphism in Developing Childhood Brain
Yang, X., Li, A., Li, L., Li, T., Li, P., & Liu, M. (2021) · Brain Topography · doi:10.1007/s10548-021-00823-7 · Cited by 10
Resting state functional brain imaging in obsessive-compulsive disorder across genders
Ma, Y., Zhao, Q., Xu, T., Wang, P., Gu, Q., & Wang, Z. (2021) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2021.1938669 · Cited by 10
“A large sample study of 5216 healthy people showed that there were gender differences in approximately 54% of brain functional images (Ritchie et al. 2018).”
BackgroundBilleci, L., Calderoni, S., Conti, E., Lagomarsini, A., Narzisi, A., Gesi, C., Carmassi, C., Dell’Osso, L., Cioni, G., Muratori, F., et al. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8040487 · Cited by 10
“We restricted our investigation to male subjects with ASD and their fathers, as fathers have higher rates of BAP than mothers [22], and gender can impact on neuroanatomical findings, both in typical [56] and ASD subjects [57].”
BackgroundHeritability of Structural Patterning in the Human Cerebral Cortex
Kruggel, F., & Solodkin, A. (2020) · NeuroImage · doi:10.1016/j.neuroimage.2020.117169 · Cited by 9
“Similar values and regions were found in the larger UK Biobank cohort (Elliott et al. 2018; Ritchie et al. 2018).”
Cho, J., Jang, H., Noh, Y., Lee, S., Koh, S. B., Kim, S., & Kim, C. (2023) · Journal of Korean Medical Science · doi:10.3346/jkms.2023.38.e159 · Cited by 9
Silander, N. C., & Tarescavage, A. M. (2023) · Springer eBooks · doi:10.1007/978-3-031-29148-7_11 · Cited by 9
Gender and cytoarchitecture differences: Functional connectivity of the hippocampal sub-regions
Alahmadi, A. A. S., Alotaibi, N. O., Hakami, N. Y., Almutairi, R. S., Darwesh, A. M. F., Abdeen, R. H., Alghamdi, J., Abdulaal, O. M., Alsharif, W. M., Sultan, S. R., et al. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e20389 · Cited by 10
“Several neuroscience studies have found structural and functional differences between the brains of females and males, which may contribute to gender disparities in behavior and cognition [24,25].”
BackgroundGhiyamihoor, F., Peymani, P., Perron, J., Asemi‐Rad, A., Marzban, M., Mohite, A., Ardila, K., Aljada, B., Marzban, A., Toback, M., et al. (2025) · Human Brain Mapping · doi:10.1002/hbm.70214 · Cited by 8
“…recent studies found that males exhibit slightly more pronounced cerebellar atrophy than females in most regions, pointing to sex-specific brain aging patterns (Chen and Desmond 2005; Inano et al. 2013; King et al. 2019; Ritchie et al. 2018; Schmahmann 2019; Stoodley 2012; Wang et al. 2024).”
Moulinet, I., Landeau, B., Touron, E., Sayette, V. D. L., Desgranges, B., Vivien, D., Marchant, N. L., Poisnel, G., & Chételat, G. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.004 · Cited by 11
The Effects of Testosterone on the Brain of Transgender Men
Zubiaurre‐Elorza, L., Cerdán, S., Uribe, C., Pérez-Laso, C., Marcos, A., del Cerro, M. C. R., Fernández, R., Pásaro, E., & Guillamón, A. (2021) · Androgens Clinical Research and Therapeutics · doi:10.1089/andro.2021.0008 · Cited by 11
“Female and male cisgender subjects show sex differences in cortical thickness, with the four lobes showing a thicker cortex in females than in males.(22,24) Cortical thickness does not differ statistically between TM and cisgender females.”
BackgroundResultChien, C., Seiler, M., Eitel, F., Schmitz‐Hübsch, T., Paul, F., & Ritter, K. (2022) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/20552173221109770 · Cited by 8
“We decreased bias in the training, validation, and test sets of the data by stratifying splitting based on both the outcome variable (low and high disease activity groupings) and sex, which is often an important confounder of MRI brain data.(40) Since the Mklaren algorithm allows for flexibility in using large numbers…”
MethodReynier, K. A., Giudice, J. S., Chernyavskiy, P., Forman, J. L., & Panzer, M. B. (2022) · Annals of Biomedical Engineering · doi:10.1007/s10439-022-03084-y · Cited by 9
Tepper, Á., Núñez, J. V., Ramírez-Mahaluf, J. P., Aguirre, J. M., Barbagelata, D., Maldonado, E. M., Dellarossa, C. D., Nachar, R., González‐Valderrama, A., Undurraga, J. P., et al. (2023) · NeuroImage Clinical · doi:10.1016/j.nicl.2023.103391 · Cited by 9
Halsey, L. G., Esteves, G. P., & Dolan, E. (2023) · Royal Society Open Science · doi:10.1098/rsos.230713 · Cited by 13
Adaptor protein complex 2 in the orbitofrontal cortex predicts alcohol use disorder
Mulholland, P. J., Berto, S., Wilmarth, P. A., McMahan, C. S., Ball, L. E., & Woodward, J. J. (2023) · Molecular Psychiatry · doi:10.1038/s41380-023-02236-3 · Cited by 11
Actions developed by the Brazilian Physiological Society to promote women’s participation in science
Mello‐Carpes, P. B., Abreu, A. R. D. P., Stanisçuaski, F., Souza, M. A., Campagnole‐Santos, M. J., & Irigoyen, M. C. (2019) · AJP Advances in Physiology Education · doi:10.1152/advan.00216.2018 · Cited by 9
“Although there are different patterns associated with sex, there is a great overlap in the cerebral volume and the cortical thickness between men and women (52).”
BackgroundRzechorzek, N. M., Saunders, O. M., Hiscox, L. V., Schwarz, T., Marioni‐Henry, K., Argyle, D. J., Schoenebeck, J. J., & Freeman, T. C. (2019) · Scientific Reports · doi:10.1038/s41598-019-48446-0 · Cited by 9
Bolton, M. J., Mogil, H. M., & Ault, L. K. (2020) · Journal of Operational Meteorology · doi:10.15191/nwajom.2020.0804 · Cited by 9
Robustness of sex-differences in functional connectivity over time in middle-aged marmosets
Nephew, B., Febo, M., Cali, R., Workman, K. P., Payne, L., Moore, C., King, J., & Lacreuse, A. (2020) · Scientific Reports · doi:10.1038/s41598-020-73811-9 · Cited by 10
Kisner, M. A., Sussman, L., Manuweera, T., Grodin, E. N., Fede, S. J., Sarlls, J. E., & Momenan, R. (2021) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.14678 · Cited by 9
Moore, K. J., Moertel, C. L., & Williams, L. A. (2022) · Cancer · doi:10.1002/cncr.34120 · Cited by 9
“Anatomically, male brains are approximately 10% larger in volume than female brains, and this is fairly fixed over the life course.(6,16) As such, males begin with a higher number of cells; this increases the number of mitotic events experienced by male brains, which could increase the frequency of opportunities to ac…”
BackgroundSex differences in gene regulatory networks during mid-gestational brain development
de Toledo, V. H. C., Feltrin, A. S., Barbosa, A. D. L., Tahira, A. C., & Brentani, H. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.955607 · Cited by 12
“Total and regional volume, for example, differs between males and females, including during fetal development (Ritchie et al., 2018; Galjaard et al., 2019).”
BackgroundMijalkov, M., Veréb, D., Jamialahmadi, O., Canal-García, A., Gómez-Ruiz, E., Dídac Vidal-piñeiro, A., Romeo, S., Volpe, G., & Pereira, J. B. (2022) · Network Neuroscience · doi:10.1162/netn_a_00286 · Cited by 9
“…genes implicated in aging-related physiological processes as well as cognition, brain structure, and vascular disease, which have been previously shown to differ between men and women (McCarrey et al., 2016; Ramirez & Sullivan, 2018; Ritchie et al., 2018; Sachdev et al., 2009; Weiss et al., 2003).”
BackgroundResultInfluentialQu’est-ce que la psychologie évolutive ?
Elimari, N., & Lafargue, G. (2022) · L’Année psychologique · doi:10.3917/anpsy1.231.0173 · Cited by 10
Ju, S., Horien, C. L., Shen, X., Abuwarda, H., Trainer, A. E., Constable, R. T., & Fredericks, C. A. (2023) · Frontiers in Dementia · doi:10.3389/frdem.2023.1126016 · Cited by 10
“At rest, women have relatively higher DMN connectivity (Biswal et al., 2010; Scheinost et al., 2015; Cavedo et al., 2018; Ritchie et al., 2018; Ficek-Tani et al., 2022), with higher posterior DMN connectivity particularly during the menopausal decades (Ficek-Tani et al.”
BackgroundSelf-citationSex Differences in the Complexity of Healthy Older Adults’ Magnetoencephalograms
Shumbayawonda, E., Abásolo, D., López‐Sanz, D., Bruña, R., Maestú, F., & Fernández, A. (2019) · Entropy · doi:10.3390/e21080798 · Cited by 9
“Interestingly, a very recent MRI investigation by Ritchie and co-workers [49] reported increased tract complexity and connectivity in the DMN within females.”
BackgroundAlteration of the Intra- and Inter-Lobe Connectivity of the Brain Structural Network in Normal Aging
Jao, C., Yeh, J., Wu, Y., Lien, L.-M., Tsai, Y., Chu, K.-E., Hsiao, C., Wang, P.-S., & Lau, C. I. (2020) · Entropy · doi:10.3390/e22080826 · Cited by 9
“Moreover, the surface area method has also verified that inter-individual differences in surface area are strongly influenced by sex differences [11].”
MethodSex differences in hippocampal connectivity during spatial long‐term memory
Spets, D. S., Fritch, H. A., & Slotnick, S. D. (2021) · Hippocampus · doi:10.1002/hipo.23319 · Cited by 9
“…that investigated sex differences using resting-state fMRI data found higher functional connectivity in sensorimotor, visual, and anterior lateral prefrontal areas for males than females and higher functional connectivity within the default network for females than males (Ritchie et al., 2018).”
BackgroundInfluentialThe influence of age and sex on the absolute cell numbers of the human brain cerebral cortex
Castro-Fonseca, E., de Morais, V. A. C., da Silva, C. G., Wollner, J., Freitas, J., Neto, A. F. M., Oliveira, L. E., de Oliveira, V. C., Leite, R. E. P., Alho, A. T. D. L., et al. (2023) · Cerebral Cortex · doi:10.1093/cercor/bhad148 · Cited by 9
Gender differences in the functional language networks at birth: a resting-state fNIRS study
Hu, A., Tong, X.-Q., Yang, L., Shi, Z., Long, Q., Chen, M., & Lee, Y. (2024) · Cerebral Cortex · doi:10.1093/cercor/bhae196 · Cited by 8
Sexual and Metabolic Differences in Hippocampal Evolution: Alzheimer’s Disease Implications
Martínez-Martos, J. M., Cantón-Habas, V., Rich‐Ruiz, M., Reyes-Medina, M. J., Ramírez-Expósito, M. J., & Carrera-González, M. P. (2024) · Life · doi:10.3390/life14121547 · Cited by 8
Gómez‐Ramírez, J., & González-Rosa, J. J. (2021) · Brain Structure and Function · doi:10.1007/s00429-021-02305-9 · Cited by 8
The Impact of Gender and Culture in Consumer Behavior
Ng, S., Bharti, M., & Faust, N. T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108561716.021 · Cited by 9
Metadata
- Authors
- Ritchie, S. J., Cox, S. R., Shen, X., Lombardo, M. V., Reus, L. M., Alloza, C., Harris, M. A., Alderson, H. L., Hunter, S., Neilson, E., Liewald, D. C. M., Auyeung, B., Whalley, H. C., Lawrie, S. M., Gale, C. R., Bastin, M. E., McIntosh, A. M., & Deary, I. J.
- Affiliations
- University of Edinburgh (GB)
- University of Cambridge (GB)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Queen Margaret Hospital (GB)
- NHS Lothian (GB)
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
- Corresponding author
- Ritchie, Stuart J
- ORCID
- Venue
- Cerebral Cortex
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-05-16
- Volume
- 28
- Issue
- 8
- Pages
- 2959-2975
- ISSN
- 1047-3211 (ISSN-L)
- 1460-2199
- PMC
- PMC6041980
- OpenAlex
- W2952574438
- Cited by
- 855
- References
- 125
- Citations by year
- 2026: 75 · 2025: 86 · 2024: 101 · 2023: 110 · 2022: 105 · 2021: 130 · 2020: 138 · 2019: 68 · 2018: 35
- FWCI
- 88.29
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Cerebral Cortex (publishedVersion, cc-by)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- OSF Preprints (OSF Preprints) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- CCACE (MR/K026992/1)
- MRC (MR/M013111/1)
- Dementias Platform UK (MR/L015382/1)
- STRADL (104036/Z/14/Z)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Keywords
- sex differences, adult human brain, brain structure, brain function, brain volume, cortical thickness, white matter fractional anisotropy, functional connectome, default mode network, sensorimotor cortex, UK Biobank
- MeSH terms
- Adult, Aged, Brain, Brain Mapping, Female, United Kingdom, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Oxygen, Rest, Sex Characteristics, Biological Specimen Banks, Community Health Planning, Connectome, White Matter
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