Varlıbaş Hatice, Erdoğan Hacı Ali, Acir Ibrahim, Yayla Vildan
Kırıkhan State Hospital, Hatay, Türkiye.
Bakırköy Sadi Konuk Training and Research Hospital, Istanbul, Türkiye.
Front Aging Neurosci. 2025 Mar 12;17:1562003. doi: 10.3389/fnagi.2025.1562003. eCollection 2025.
Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms. Autonomic dysfunction, one of the non-motor symptoms, affects various systems such as the gastrointestinal, cardiovascular, genitourinary, and thermoregulatory systems. Sexual dysfunction (SD), however, is a frequently neglected issue in Parkinson's patients. This study aimed to investigate the relationship between SD, findings of autonomic dysfunction in other systems, and the severity of PD.
The study included 41 male and 35 female patients diagnosed with definitive idiopathic PD, with Hoehn and Yahr stages between 1 and 3, and without a diagnosis of diabetes or cognitive impairment. Demographic characteristics and disease duration of the patients were recorded. The following assessments were administered to the patients: Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr Scale, Beck Depression Inventory (BDI), SCOPA-AUT questionnaire (Scales for Outcomes in Parkinson's Disease Autonomic Dysfunction), short version of the QUIP (Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease), and ASEX (Arizona Sexual Experiences Scale).
The patients were divided into two groups: those with SD (53.9%) and those without SD (46.1%). Patients with SD had significantly higher age, PD stage, total SCOPA-AUT scores, and subdomain scores related to the cardiovascular, urinary, and gastrointestinal systems compared to those without SD ( < 0.001). The prevalence of hypertension was also significantly higher in the SD group ( = 0.001). An increase in UPDRS scores and depression severity, as measured by the Beck Depression Inventory, was associated with higher ASEX scores ( < 0.001). The frequency of impulse control disorder (ICD) was 6.5%; no significant differences were observed between patients with and without ICD in terms of equivalent levodopa dose or age ( = 0.58, = 0.76).
Although the presence of sexual dysfunction in Parkinson's disease and its negative impact on quality of life have been recognized for many years, it is often overlooked for various reasons. The significant relationship identified in our study between SD, the severity of autonomic dysfunction, and disease stage may raise awareness of the early recognition of SD in PD patients. This could help prevent the neglect of this important non-motor symptom in disease management.
帕金森病（PD）是一种以运动和非运动症状为特征的神经退行性疾病。自主神经功能障碍作为非运动症状之一，会影响多个系统，如胃肠、心血管、泌尿生殖和体温调节系统。然而，性功能障碍（SD）在帕金森病患者中是一个常被忽视的问题。本研究旨在探讨性功能障碍、其他系统自主神经功能障碍的表现与帕金森病严重程度之间的关系。
本研究纳入了41例男性和35例女性确诊为特发性帕金森病的患者，Hoehn和Yahr分期为1至3期，且未诊断出糖尿病或认知障碍。记录患者的人口统计学特征和病程。对患者进行了以下评估：统一帕金森病评定量表（UPDRS）、Hoehn和Yahr量表、贝克抑郁量表（BDI）、帕金森病自主神经功能障碍结局量表（SCOPA - AUT问卷）、帕金森病冲动控制障碍问卷（QUIP）简版以及亚利桑那性体验量表（ASEX）。
患者被分为两组：性功能障碍组（53.9%）和无性功能障碍组（46.1%）。与无性功能障碍的患者相比，性功能障碍患者的年龄、帕金森病分期、SCOPA - AUT总分以及与心血管、泌尿和胃肠系统相关的子域得分显著更高（<0.001）。性功能障碍组的高血压患病率也显著更高（=0.001）。统一帕金森病评定量表得分的增加以及贝克抑郁量表所测量的抑郁严重程度与亚利桑那性体验量表得分更高相关（<0.001）。冲动控制障碍（ICD）的发生率为6.5%；有冲动控制障碍和无冲动控制障碍的患者在等效左旋多巴剂量或年龄方面未观察到显著差异（=0.58，=0.76）。
尽管帕金森病中性功能障碍的存在及其对生活质量的负面影响多年来已得到认可，但由于各种原因它常常被忽视。我们的研究中确定的性功能障碍、自主神经功能障碍严重程度和疾病分期之间的显著关系可能会提高对帕金森病患者早期识别性功能障碍的认识。这有助于在疾病管理中避免忽视这一重要的非运动症状。
