Gender-related differences in the burden of non-motor symptoms in Parkinson’s disease

Abstract

Differences in the expression of non-motor symptoms (NMS) by Parkinson's disease (PD) patients may have important implications for their management and prognosis. Gender is a basic epidemiological variable that could influence such expression. The present study evaluated the prevalence and severity of NMS by gender in an international sample of 951 PD patients, 62.63% males, using the non-motor symptoms scale (NMSS). Assessments for motor impairment and complications, global severity, and health state were also applied. All disease stages were included. No significant gender differences were found for demographic and clinical characteristics. For the entire sample, the most prevalent symptoms were Nocturia (64.88%) and Fatigue (62.78%) and the most prevalent affected domains were Sleep/Fatigue (84.02%) and Miscellaneous (82.44%). Fatigue, feelings of nervousness, feelings of sadness, constipation, restless legs, and pain were more common and severe in women. On the contrary, daytime sleepiness, dribbling saliva, interest in sex, and problems having sex were more prevalent and severe in men. Regarding the NMSS domains, Mood/Apathy and Miscellaneous problems (pain, loss of taste or smell, weight change, and excessive sweating) were predominantly affected in women and Sexual dysfunction in men. No other significant differences by gender were observed. To conclude, in this study significant differences between men and women in prevalence and severity of fatigue, mood, sexual and digestive problems, pain, restless legs, and daytime sleepiness were found. Gender-related patterns of NMS involvement may be relevant for clinical trials in PD.

Clinical determinants of primary and secondary fatigue in patients with Parkinson’s disease

“…A recent study on fatigue in early PD found a significant correlation between higher fatigue scores and older age, but when linear regression analysis was applied, only depression and UPDRS activities of daily living subscale remained significant in their population [38]. In contrast with some previous studies, where higher prevalence of fatigue was found in women [39], we found a significant association of MFI domains mental fatigue and reduced motivation with male gender, but only in the secondary fatigue group.…”

Exploring Gender-Associated Socioeconomic Differences in Parkinson’s Disease

“…Non-orthostatic type autonomic dysfunction is an umbrella term that includes a wide variety of autonomic symptoms, including urinary and sexual dysfunction, gastrointestinal disturbances, and thermal dysregulation. Our data collection did not parse out these various symptoms; however, prior studies have demonstrated that sexual dysfunction is highly prevalent in men with PD [8] [11], which may underlie the difference in our population. However, other autonomic symptoms have been demonstrated to cluster in women with PD, such as constipation [11].…”

“…Our data collection did not parse out these various symptoms; however, prior studies have demonstrated that sexual dysfunction is highly prevalent in men with PD [8] [11], which may underlie the difference in our population. However, other autonomic symptoms have been demonstrated to cluster in women with PD, such as constipation [11]. Further study is warranted in our patient population to better characterize these differences.…”

“…Men experience sexual dysfunction [8] [11], fatigue [11], olfactory dysfunction [8] [11], and use caregivers more than women [12]. Dyskinesia has been widely reported to cluster in women [1] [13] [14], and women have been observed to experience dysphagia [15], restless legs [11], pain [11], and depressive symptoms more frequently than men [8] [11] [16].…”

Structural Brain Sex Differences in Parkinson’s Disease: A Voxel-Based Morphometry Study

“…Additionally, the slow progression of the disease in females could be the reason for the predominant tremor that presents more in females than males [27]. Additionally, according to Martinez-Martin et al [37], dyskinesia and depression symptoms in earlier stage than males [44]. Depression has been theoretically linked to the amygdala because the amygdala plays an important role in emotional memory [45].…”