Movement Disorders Center, Department of Neurology, Institute of Neurology, University of Cagliari, Cagliari, Italy.
J Neurol Sci. 2012 Dec 15;323(1-2):33-9. doi: 10.1016/j.jns.2012.07.026. Epub 2012 Aug 27.
Parkinson's disease (PD) occurs more frequently in men than in women and a higher risk for PD development in males compared with females has been hypothesized, suggesting gender may be a significant factor in the development and progression of parkinsonism. To date, gender differences in non-motor symptoms are under-reported.
To assess gender differences in motor and non-motor symptoms among Sardinian PD patients.
One hundred fifty-six (91 male and 65 female) consecutive Sardinian PD outpatients were included in this analysis. Modified Hoehn and Yahr scale and UPDRS were used to assess motor symptoms, while non-motor disturbances were evaluated with the non-motor symptoms scale (NMSS). Presence of depression, anxiety and other iatrogenic behavioral disorders was also investigated. In order to determine how gender differences could be specific to PD, 132 age-matched normal controls were assessed with the NMSS.
Women were more likely than men to present with tremor as initial symptom (p<.025) and worse UPDRS instability score (p<.02). NMSS score in females was significantly higher than that in males (p<.018). A significantly higher severity in cardiovascular (p<0.002), sleep/fatigue (p<.018) and mood/apathy (p<.001) domains was observed in female PD patients, while the sexual dysfunction domain was reported with a significantly higher score in male patients (p<.017). Fatigue (p<.03), lack of motivation (p<.015) and sadness (p<.009) were observed significantly more frequent in females, while altered interest in sex was noted as more common in males (p<.001). Frequency of depression (p<.011) and anxiety (p<.001) was significantly higher in females, while male patients had increased frequency of compulsive sexual behaviors (p<.05). There was a significantly higher frequency of non-motor symptoms in eight domains in both male and female PD patients compared with controls (p<.001, for all comparisons, with the exception of urinary disturbances in females: p<.004). Only sexual dysfunctions were not significantly higher in male and female PD patients compared with controls.
The present study highlights the role of gender differences associated with the occurrence of motor and non-motor disorders and our findings indicate that spectrum and severity of non-motor symptoms may present with different gender distribution in PD patients, suggesting a possible sex-related effect.
帕金森病（PD）在男性中比女性更为常见，且男性 PD 的发展风险高于女性，这表明性别可能是帕金森病发展和进展的重要因素。迄今为止，非运动症状的性别差异报道较少。
评估撒丁岛 PD 患者的运动和非运动症状中的性别差异。
本分析纳入了 156 名（91 名男性和 65 名女性）连续的撒丁岛 PD 门诊患者。采用改良 Hoehn 和 Yahr 量表和 UPDRS 评估运动症状，同时采用非运动症状量表（NMSS）评估非运动障碍。还调查了抑郁、焦虑和其他医源性行为障碍的存在情况。为了确定性别差异如何与 PD 有关，对 132 名年龄匹配的正常对照者进行了 NMSS 评估。
女性更可能以震颤为首发症状（p<.025）且 UPDRS 不稳定评分更差（p<.02）。女性 NMSS 评分显著高于男性（p<.018）。女性 PD 患者心血管（p<0.002）、睡眠/疲劳（p<.018）和情绪/淡漠（p<.001）方面的严重程度显著更高，而男性患者的性功能障碍方面的评分显著更高（p<.017）。女性更容易出现疲劳（p<.03）、缺乏动力（p<.015）和悲伤（p<.009），而男性更容易出现性兴趣改变（p<.001）。女性的抑郁（p<.011）和焦虑（p<.001）频率显著更高，而男性患者强迫性性行为的频率更高（p<.05）。与对照组相比，男性和女性 PD 患者在八个非运动症状领域的频率均显著更高（p<.001，所有比较均如此，女性的尿失禁除外：p<.004）。只有性功能障碍在男性和女性 PD 患者与对照组相比没有显著更高。
本研究强调了与运动和非运动障碍发生相关的性别差异的作用，我们的研究结果表明，非运动症状的范围和严重程度可能在 PD 患者中表现出不同的性别分布，提示可能存在与性别相关的影响。
