Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy.
J Neurol. 2024 Jun;271(6):3610-3615. doi: 10.1007/s00415-024-12258-8. Epub 2024 Mar 16.
Menopause increases the risk for Parkinson's disease (PD), although the underlying biological mechanisms have not been established in patients. Here, we aimed to understand the basis of menopause-related vulnerability to PD. Main motor and non-motor scores, blood levels of estradiol, testosterone, follicle-stimulating hormone, and luteinizing hormone, CSF levels of total α-synuclein, amyloid-β-42, amyloid-β-40, total tau, and phosphorylated-181-tau were examined in 45 women with postmenopausal-onset PD and 40 age-matched controls. PD patients had higher testosterone and lower estradiol levels than controls, and the residual estradiol production was associated with milder motor disturbances and lower dopaminergic requirements. In PD but not in controls, follicle-stimulating hormone levels correlated with worse cognitive scores and CSF markers of amyloidopathy and neuronal loss. In conclusion, menopause-related hormonal changes might differentially contribute to clinical-pathological trajectories of PD, accounting for the peculiar vulnerability to the disease.
绝经增加了帕金森病 (PD) 的风险，尽管患者中尚未确定潜在的生物学机制。在这里，我们旨在了解与绝经相关的 PD 易感性的基础。主要运动和非运动评分、雌二醇、睾酮、卵泡刺激素和黄体生成素的血液水平、总α-突触核蛋白、淀粉样蛋白-β-42、淀粉样蛋白-β-40、总 tau 和磷酸化-181-tau 的 CSF 水平在 45 名绝经后 PD 女性患者和 40 名年龄匹配的对照组中进行了检查。PD 患者的睾酮水平高于对照组，雌二醇水平较低，残余雌二醇的产生与较轻的运动障碍和较低的多巴胺需求相关。在 PD 中，但在对照组中没有，卵泡刺激素水平与较差的认知评分以及 CSF 淀粉样蛋白病和神经元丢失标志物相关。总之，与绝经相关的激素变化可能会对 PD 的临床病理轨迹产生不同的影响，从而导致对该疾病的特殊易感性。
