title: Gender differences in motor and non-motor symptoms among Sardinian patients with Parkinson's disease.
abstract: BACKGROUND
  Parkinson's disease (PD) occurs more frequently in men than in women and a higher risk for PD development in males compared with females has been hypothesized, suggesting gender may be a significant factor in the development and progression of parkinsonism. To date, gender differences in non-motor symptoms are under-reported.
  
  
  OBJECTIVE
  To assess gender differences in motor and non-motor symptoms among Sardinian PD patients.
  
  
  METHODS
  One hundred fifty-six (91 male and 65 female) consecutive Sardinian PD outpatients were included in this analysis. Modified Hoehn and Yahr scale and UPDRS were used to assess motor symptoms, while non-motor disturbances were evaluated with the non-motor symptoms scale (NMSS). Presence of depression, anxiety and other iatrogenic behavioral disorders was also investigated. In order to determine how gender differences could be specific to PD, 132 age-matched normal controls were assessed with the NMSS.
  
  
  RESULTS
  Women were more likely than men to present with tremor as initial symptom (p<.025) and worse UPDRS instability score (p<.02). NMSS score in females was significantly higher than that in males (p<.018). A significantly higher severity in cardiovascular (p<0.002), sleep/fatigue (p<.018) and mood/apathy (p<.001) domains was observed in female PD patients, while the sexual dysfunction domain was reported with a significantly higher score in male patients (p<.017). Fatigue (p<.03), lack of motivation (p<.015) and sadness (p<.009) were observed significantly more frequent in females, while altered interest in sex was noted as more common in males (p<.001). Frequency of depression (p<.011) and anxiety (p<.001) was significantly higher in females, while male patients had increased frequency of compulsive sexual behaviors (p<.05). There was a significantly higher frequency of non-motor symptoms in eight domains in both male and female PD patients compared with controls (p<.001, for all comparisons, with the exception of urinary disturbances in females: p<.004). Only sexual dysfunctions were not significantly higher in male and female PD patients compared with controls.
  
  
  CONCLUSIONS
  The present study highlights the role of gender differences associated with the occurrence of motor and non-motor disorders and our findings indicate that spectrum and severity of non-motor symptoms may present with different gender distribution in PD patients, suggesting a possible sex-related effect.
authors.affiliation: Movement Disorders Center, Department of Neurology, Institute of Neurology, University of Cagliari, Cagliari, Italy. paosol29@yahoo.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Solla
authors.forename: Antonino
authors.initials: A
authors.lastname: Cannas
authors.forename: Federica Carla
authors.initials: FC
authors.lastname: Ibba
authors.forename: Federico
authors.initials: F
authors.lastname: Loi
authors.forename: Marta
authors.initials: M
authors.lastname: Corona
authors.forename: Gianni
authors.initials: G
authors.lastname: Orofino
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Marrosu
authors.forename: Francesco
authors.initials: F
authors.lastname: Marrosu
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D018476:Hypokinesia / Q000453:epidemiology / Q000209:etiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology; D009043:Motor Activity; D009127:Muscle Rigidity / Q000453:epidemiology / Q000209:etiology; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology / Q000209:etiology; D012720:Severity of Illness Index; D012727:Sex Characteristics; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology; D020919:Sleep Disorders, Intrinsic / Q000453:epidemiology / Q000209:etiology; D063189:Symptom Assessment; D014202:Tremor / Q000453:epidemiology; D014555:Urination Disorders / Q000453:epidemiology / Q000209:etiology
chemical_list: D000978:Antiparkinson Agents