Department of Psychiatry, Division of Geriatric Psychiatry, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.
Division of Geriatric Psychiatry, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.
Mov Disord Clin Pract. 2024 Nov;11(11):1335-1344. doi: 10.1002/mdc3.14227. Epub 2024 Oct 9.
Alpha-synucleinopathies, such as Parkinson's disease (PD), Parkinson's disease dementia (PDD), and dementia with Lewy bodies (DLB), demonstrate sex differences with regard to prevalence, age of onset, and motor manifestations. Neuropsychiatric symptoms (NPS) are common early and late manifestations of these disorders.
We aimed to describe sex differences in NPS across alpha-synucleinopathies.
We searched Web of Science Core collection databases to identify observational studies published between January 1, 2000, and June 1, 2022, reporting the prevalence or severity of NPS among individuals with a diagnosis of PD, PDD, or DLB. Prevalence and severity were pooled for each NPS according to sex using random-effects models.
Two-hundred-and-forty studies, representing 796,026 participants (45% females), were included in the meta-analysis. Female sex was associated with a higher prevalence of anxiety (OR = 1.60 [95% CI: 1.40, 1.82]), depression (OR = 1.56 [1.45, 1.67]), fatigue (OR = 1.21 [1.02, 1.43]), and psychotic symptoms (OR = 1.26 [1.14, 1.40]) and more severe anxiety (g = 1.35 [95% CI: 0.58, 2.13]), depression (g = 1.57 [1.05, 2.08]), and fatigue (g = 0.86 [0.41, 1.32]), while male sex was associated with a higher prevalence of apathy (OR = 0.77 [0.63, 0.93]), impulse control disorders (OR = 0.67 [0.55, 0.82]), REM sleep behavior disorder (OR = 0.54 [0.42, 0.70]), hypersomnolence (OR = 0.67 [0.56, 0.80]), and suicide (OR = 0.30 [0.20, 0.44]).
NPS have different prevalences and severities in alpha-synucleinopathies according to sex. These findings support consideration of sex in the elaboration of clinical tools.
α-突触核蛋白病，如帕金森病（PD）、帕金森病痴呆（PDD）和路易体痴呆（DLB），在患病率、发病年龄和运动表现方面存在性别差异。神经精神症状（NPS）是这些疾病的常见早期和晚期表现。
我们旨在描述 α-突触核蛋白病中 NPS 的性别差异。
我们检索了 Web of Science 核心合集数据库，以确定 2000 年 1 月 1 日至 2022 年 6 月 1 日期间发表的关于 PD、PDD 或 DLB 诊断个体中 NPS 患病率或严重程度的观察性研究。根据性别，使用随机效应模型汇总了每种 NPS 的患病率和严重程度。
共有 240 项研究，代表 796026 名参与者（45%为女性）纳入荟萃分析。女性性别与焦虑症（OR=1.60 [95%CI：1.40，1.82]）、抑郁症（OR=1.56 [1.45，1.67]）、疲劳（OR=1.21 [1.02，1.43]）和精神病症状（OR=1.26 [1.14，1.40]）的患病率较高，焦虑症（g=1.35 [95%CI：0.58，2.13]）、抑郁症（g=1.57 [1.05，2.08]）和疲劳（g=0.86 [0.41，1.32]）的严重程度较高相关，而男性性别与淡漠（OR=0.77 [0.63，0.93]）、冲动控制障碍（OR=0.67 [0.55，0.82]）、快速眼动睡眠行为障碍（OR=0.54 [0.42，0.70]）、过度嗜睡（OR=0.67 [0.56，0.80]）和自杀（OR=0.30 [0.20，0.44]）的患病率较高相关。
根据性别，α-突触核蛋白病中的 NPS 具有不同的患病率和严重程度。这些发现支持在制定临床工具时考虑性别因素。
