Georgiev D, Hamberg K, Hariz M, Forsgren L, Hariz G-M
Department of Neurology, University Clinical Centre Ljubljana, Ljubljana, Slovenia.
Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK.
Acta Neurol Scand. 2017 Dec;136(6):570-584. doi: 10.1111/ane.12796. Epub 2017 Jul 2.
Available data indicate that there are gender differences in many features of Parkinson's disease (PD). Precise identification of the gender differences is important to tailor treatment, predict outcomes, and meet other individual and social needs in women and men with PD. The aim of this study was to review the available clinical data on gender differences in PD. Original articles and meta-analyses published between 1990 and 2016 systematically exploring gender differences in PD were reviewed. There is slight male preponderance in incidence and prevalence of PD. PD starts earlier in men. Women tend to be more prone to develop tremor-dominant PD but are less rigid than men. Motor improvement after deep brain stimulation is equal in both sexes, but women tend to show better improvement in activities of daily living. Furthermore, women with PD show better results on tests for general cognitive abilities, outperform men in verbal cognitive tasks, show more pain symptoms, and score higher on depression scales. It seems, however, that the differences in cognition, mood, and pain perception are not disease specific as similar gender differences can be found in healthy subjects and in other neurological conditions. Despite PD being the most frequently studied movement disorder, studies investigating gender differences in PD are still scarce with most of the studies being cross-sectional. Good-quality, prospective, longitudinal studies analyzing gender differences in PD and comparing them to matched healthy controls are needed in order to properly address the issues of gender differences in PD.
现有数据表明，帕金森病（PD）的许多特征存在性别差异。准确识别这些性别差异对于为患有PD的女性和男性量身定制治疗方案、预测预后以及满足其他个人和社会需求至关重要。本研究的目的是回顾有关PD性别差异的现有临床数据。对1990年至2016年间发表的系统探讨PD性别差异的原始文章和荟萃分析进行了回顾。PD的发病率和患病率男性略占优势。男性PD发病更早。女性更容易患震颤为主型PD，但比男性僵硬程度轻。深部脑刺激术后的运动改善在两性中相当，但女性在日常生活活动方面往往改善得更好。此外，患有PD的女性在一般认知能力测试中表现更好，在言语认知任务中优于男性，疼痛症状更多，在抑郁量表上得分更高。然而，认知、情绪和疼痛感知方面的差异似乎并非PD所特有，因为在健康受试者和其他神经系统疾病中也能发现类似的性别差异。尽管PD是研究最频繁的运动障碍，但调查PD性别差异的研究仍然很少，大多数研究都是横断面研究。需要高质量的前瞻性纵向研究来分析PD中的性别差异，并将其与匹配的健康对照进行比较，以便正确解决PD中的性别差异问题。
