Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, Italy.
Department of Biostatistics, The University of Iowa, Iowa City, IA, USA.
J Parkinsons Dis. 2022;12(1):421-436. doi: 10.3233/JPD-212892.
Investigation of sex-related motor and non-motor differences and biological markers in Parkinson's disease (PD) may improve precision medicine approach.
To examine sex-related longitudinal changes in motor and non-motor features and biologic biomarkers in early PD.
We compared 5-year longitudinal changes in de novo, untreated PD men and women (at baseline N = 423; 65.5%male) of the Parkinson's Progression Markers Initiative (PPMI), assessing motor and non-motor manifestations of disease; and biologic measures in cerebrospinal fluid (CSF) and dopamine transporter deficit on DaTscanTM uptake.
Men experienced greater longitudinal decline in self-reported motor (p < 0.001) and non-motor (p = 0.009) aspects of experiences of daily living, such that men had a yearly increase in MDS-UPDRS part II by a multiplicative factor of 1.27 compared to women at 0.7, while men had a yearly increase in MDS-UPDRS part I by a multiplicative factor of 0.98, compared to women at 0.67. Compared to women, men had more longitudinal progression in clinician-assessed motor features in the ON medication state (p = 0.010) and required higher dopaminergic medication dosages over time (p = 0.014). Time to reach specific disease milestones and longitudinal changes in CSF biomarkers and DaTscanTM uptake were not different by sex.
Men showed higher self-assessed motor and non-motor burden of disease, with possible contributions from suboptimal dopaminergic therapeutic response in men. However, motor features of disease evaluated with clinician-based scales in the OFF medication state, as well as biological biomarkers do not show specific sex-related progression patterns.
研究帕金森病（PD）中与性别相关的运动和非运动差异及生物学标志物，可能会改善精准医学方法。
探讨早期 PD 中与性别相关的运动和非运动特征及生物标志物的纵向变化。
我们比较了帕金森进展标志物倡议（PPMI）中 5 年的纵向变化，包括新发、未经治疗的 PD 男性和女性（基线 N=423；65.5%为男性），评估疾病的运动和非运动表现；以及脑脊液（CSF）中的生物标志物和 DaTscanTM摄取的多巴胺转运体缺陷。
男性在自我报告的运动（p<0.001）和非运动（p=0.009）方面的日常生活体验中经历了更大的纵向下降，以至于男性每年的 MDS-UPDRS 第二部分增加了 1.27 倍，而女性为 0.7 倍，而男性每年的 MDS-UPDRS 第一部分增加了 0.98 倍，而女性为 0.67 倍。与女性相比，男性在 ON 药物状态下的临床评估运动特征有更多的纵向进展（p=0.010），并且随着时间的推移需要更高的多巴胺能药物剂量（p=0.014）。性别之间到达特定疾病里程碑的时间和 CSF 生物标志物和 DaTscanTM摄取的纵向变化没有差异。
男性表现出更高的自我评估运动和非运动疾病负担，可能与男性多巴胺能治疗反应不佳有关。然而，OFF 药物状态下基于临床医生评估的运动特征，以及生物标志物并没有显示出特定的与性别相关的进展模式。
