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早期未经药物治疗的帕金森病中非运动症状的性别差异。

Gender differences in non-motor symptoms in early, drug naïve Parkinson's disease.

机构信息

Department of Neurological Sciences, Federico II University, Naples, Italy.

出版信息

J Neurol. 2013 Nov;260(11):2849-55. doi: 10.1007/s00415-013-7085-x. Epub 2013 Aug 30.

DOI:10.1007/s00415-013-7085-x
PMID:23989344
Abstract

Gender differences in brain structure and function may lead to differences in the clinical expression of neurological diseases, including Parkinson's disease (PD). Few studies reported gender-related differences in the burden of non-motor symptoms (NMS) in treated PD patients, but this matter has not been previously explored in drug-naïve PD patients. This study is to assess gender differences in the prevalence of NMS in a large sample of early, drug-naïve PD patients compared with age and sex-matched healthy controls. Two hundred early, drug-naïve PD patients and ninety-three age and sex-matched healthy controls were included in the study. Frequency of NMS was evaluated by means of the Non-Motor Symptoms Questionnaire. The difference in gender distribution of NMS was evaluated with the χ (2) exact test; multiple comparisons were corrected with the Benjamini-Hochberg method. Male PD patients complained of problems having sex and taste/smelling difficulties significantly more frequently than female PD patients. Furthermore, men with PD complained more frequently of dribbling, sadness/blues, loss of interest, anxiety, acting during dreams, and taste/smelling difficulties as compared to healthy control men, while female PD patients reported more frequently loss of interest and anxiety as compared with healthy control women. This study shows specific sex-related patterns of NMS in drug-naïve PD. In contrast with previous data, female PD patients did not present higher prevalence of mood symptoms as compared to male PD patients. Comparison with healthy controls showed that some NMS classically present in premotor and early stage of disease (i.e., acting out during dreams, taste/smelling difficulties) are more frequent in male than in female patients.

摘要

性别差异可能导致大脑结构和功能的差异,从而影响神经疾病的临床表现,包括帕金森病(PD)。很少有研究报告过治疗后的 PD 患者中与性别相关的非运动症状(NMS)负担差异,但在未经药物治疗的 PD 患者中,这一问题尚未得到探讨。本研究旨在评估在一大组早期未经药物治疗的 PD 患者中,与年龄和性别匹配的健康对照组相比,NMS 的患病率是否存在性别差异。本研究纳入了 200 名早期未经药物治疗的 PD 患者和 93 名年龄和性别匹配的健康对照者。采用非运动症状问卷评估 NMS 的频率。采用卡方检验评估 NMS 的性别分布差异;采用 Benjamini-Hochberg 方法校正多重比较。与女性 PD 患者相比,男性 PD 患者出现性功能障碍和味觉/嗅觉障碍的频率更高。此外,与健康对照男性相比,男性 PD 患者更常出现遗尿、悲伤/忧郁、兴趣丧失、焦虑、梦境中的行为以及味觉/嗅觉障碍,而女性 PD 患者与健康对照女性相比,更常出现兴趣丧失和焦虑。本研究显示了未经药物治疗的 PD 患者中特定的与性别相关的 NMS 模式。与之前的数据不同,女性 PD 患者的情绪症状患病率并不高于男性 PD 患者。与健康对照组相比,一些在疾病前驱期和早期就出现的 NMS(如梦境中的行为、味觉/嗅觉障碍)在男性患者中比在女性患者中更为常见。

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