title: Sexual dysfunction is associated with postural instability gait difficulty subtype of Parkinson's disease.
abstract: The pathophysiology of the postural instability gait difficulty (PIGD) subtype of Parkinson's disease (PD) is unclear. Information on the spectrum of non-motor symptoms (NMS) in PIGD phenotype is limited. Our objective is to compare the spectrum of NMS in PIGD subtype compared to non-PIGD subgroup in PD patients and to determine predictive factors that are associated with PIGD phenotype. A total of 432 PD patients comprising 158 PIGD and 274 non-PIGD patients were recruited. NMS burden (frequency and severity) was assessed using non-motor symptom scale (NMSS). In the univariable analysis, NMSS total score (P = 0.0132), NMSS domain 3 (mood/apathy) score (P = 0.0108), NMSS domain 5 (attention/memory) score (P = 0.0048) and NMSS domain 8 (sexual function) score (P = 0.0052) were significantly higher in the PIGD group than in the non-PIGD group. Using multivariable logistic regression, UPDRS tremor score, UPDRS PIGD score, H&Y staging score and NMSS domain 8 (sexual function) score were found to be significantly different in the PIGD group compared to the non-PIGD group. We disclosed for the first time that PIGD patients demonstrated a greater overall NMS burden and sexual dysfunction and was an independent predictor of PIGD phenotype. Early intervention of sexual dysfunction symptoms in PIGD patients may improve their clinical management.
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, 169608, Singapore.|Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, 530021, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Deng
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, 169608, Singapore.|Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, 530021, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Xiao
authors.affiliation: Department of Clinical Research, Singapore General Hospital, Singapore, 169608, Singapore.
authors.forename: Hui-Hua
authors.initials: HH
authors.lastname: Li
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, 169608, Singapore.|Duke-NUS Graduate Medical School, Singapore, 169857, Singapore.
authors.forename: Yew-Long
authors.initials: YL
authors.lastname: Lo
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, 169608, Singapore.
authors.forename: Lai-Mun
authors.initials: LM
authors.lastname: Chew
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, 169608, Singapore.|Duke-NUS Graduate Medical School, Singapore, 169857, Singapore.
authors.forename: Kumar M
authors.initials: KM
authors.lastname: Prakash
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, 169608, Singapore. gnrtek@sgh.com.sg.|Duke-NUS Graduate Medical School, Singapore, 169857, Singapore. gnrtek@sgh.com.sg.
authors.forename: Eng-King
authors.initials: EK
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D020233:Gait Disorders, Neurologic / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology*; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*
keywords: Non-motor symptoms; Parkinson’s disease; Postural instability gait difficulty