Gender influences nonmotor symptoms in early Parkinson’s
medwireNews: The predominant nonmotor symptoms (NMS) in patients with Parkinson’s disease (PD) vary between men and women, shows an analysis of the Parkinson’s Progression Markers Initiative (PPMI) study.
Men with newly diagnosed PD had more impaired olfaction than women, but were less affected by anxiety. Women, however, had overall less cognitive impairment at diagnosis, despite both genders having had PD symptoms for 18 to 20 months at study enrolment.
Of note, most of the gender differences among the patients were enlargements of differences found between the 121 healthy male and 67 healthy female controls in the study, “suggesting these are likely intrinsic sex differences that may be further exacerbated by the onset of PD”, write the researchers in Neurology.
Among the PD patients, trait anxiety was significantly higher among the 145 women than the 269 men. Global cognition was significantly better among women than men, but while women had significantly better memory function, they had significantly poorer visuospatial ability.
Men had significantly worse olfactory function than women, at a median of 21.5 versus 24.0 points on the University of Pennsylvania Smell Identification Test.
Nevertheless, impaired olfaction was the strongest predictor of PD for both genders, report Rui Liu (National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA) and study co-authors.
Global cognition also predicted PD among both women and men, while autonomic dysfunction predicted PD among men only and sleep behaviour disorder among women only. These NMS distinguished between PD patients and controls with greater than 90% accuracy.
Editorialists Marina Picillo (University of Salerno, Italy) and Alfonso Fasano (University of Toronto, Ontario, Canada) note that “future strategies aimed at identifying patients with PD in their premotor phase should take potential sex differences into account in order to increase sensitivity.”
They add: “Since diagnosing PD at prodromal stages is our next challenging mission, one of the PPMI study purposes is to find reliable and widely applicable diagnostic biomarkers. In this context, Liu et al. remind us that sex matters, even in PD.”
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