Chen Mei-Ling, Tan Chun-Hsiang, Su Hui-Chen, Sung Pi-Shan, Chien Chia-Yi, Yu Rwei-Ling
Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Brain Sci. 2021 Oct 9;11(10):1331. doi: 10.3390/brainsci11101331.
This study aimed to understand the impact of sex on the neurocognitive function of patients with Parkinson's disease (PD). Ninety-four participants with idiopathic PD and 167 age-matched healthy individuals as normal controls (NCs) were recruited and underwent comprehensive neuropsychological assessments. Sex differences were found in NCs, but not in patients with PD. Among male participants, patients with PD showed worse performance on the Digit Symbol Substitution (DSS) ( < 0.001) test and Symbol Search (SS) ( < 0.001) than NCs. Among female participants, patients with PD showed worse performance on the category score of the Modified Wisconsin Card Sorting Test ( < 0.001), SS ( < 0.001), and pentagon copying ( < 0.001) than NCs. After controlling for the effects of age and years of education, Hoehn and Yahr stage was found to predict the performance of the Color Trails Test part A (βA = 0.241, pA = 0.036), Stroop Color and Word Test (β = -0.245, = 0.036), and DSS (β = -0.258, = 0.035) in men with PD. These results indicate the differential effect of sex on the neurocognitive function among healthy aging and PD populations. The disappearance of sex differences, which is present in healthy aging, in patients with PD suggests a gradual loss of the neuroprotective effect of estrogen after the initiation of the neurodegenerative process. This study also found mental flexibility and visuospatial function to be the susceptible cognitive domains in women with PD, while the disease severity could predict the working memory and processing speed in men with PD.
本研究旨在了解性别对帕金森病（PD）患者神经认知功能的影响。招募了94名特发性PD患者和167名年龄匹配的健康个体作为正常对照（NCs），并对他们进行了全面的神经心理学评估。在NCs中发现了性别差异，但在PD患者中未发现。在男性参与者中，PD患者在数字符号替换（DSS）（<0.001）测试和符号搜索（SS）（<0.001）中的表现比NCs差。在女性参与者中，PD患者在改良威斯康星卡片分类测试的类别得分（<0.001）、SS（<0.001）和五边形临摹（<0.001）方面的表现比NCs差。在控制了年龄和受教育年限的影响后，发现Hoehn和Yahr分期可预测PD男性患者在颜色轨迹测试A部分（βA = 0.241，pA = 0.036）、Stroop颜色和单词测试（β = -0.245， = 0.036）以及DSS（β = -0.258， = 0.035）中的表现。这些结果表明性别对健康衰老人群和PD人群的神经认知功能有不同影响。健康衰老人群中存在的性别差异在PD患者中消失，这表明神经退行性过程开始后雌激素的神经保护作用逐渐丧失。本研究还发现，心理灵活性和视觉空间功能是PD女性患者易受影响的认知领域，而疾病严重程度可预测PD男性患者的工作记忆和处理速度。
