Gender Differences in Age-Related Striatal Dopamine Depletion in Parkinson’s Disease

Abstract

ObjectiveGender differences are a well-known clinical characteristic of Parkinson’s disease (PD). In-vivo imaging studies demonstrated that women have greater striatal dopamine transporter (DAT) activity than do men, both in the normal population and in PD patients. We hypothesize that women exhibit more rapid aging-related striatal DAT reduction than do men, as the potential neuroprotective effect of estrogen wanes with age.MethodsThis study included 307 de novo PD patients (152 men and 155 women) who underwent DAT scans for an initial diagnostic work-up. Gender differences in age-related DAT decline were assessed in striatal sub-regions using linear regression analysis.ResultsFemale patients exhibited greater DAT activity compared with male patients in all striatal sub-regions. The linear regression analysis revealed that age-related DAT decline was greater in the anterior and posterior caudate, and the anterior putamen in women compared with men; we did not observe this difference in other sub-regions.ConclusionsThis study demonstrated the presence of gender differences in age-related DAT decline in striatal sub-regions, particularly in the antero-dorsal striatum, in patients with PD, presumably due to aging-related decrease in estrogen. Because this difference was not observed in the sensorimotor striatum, this finding also suggests that women may not have a greater capacity to tolerate PD pathogenesis than do men.

Predictive clinical factors for penetration and aspiration in Parkinson's disease

“…Because the MOCA survey is more time consuming than age determination, age was retained and MOCA excluded. Finally, nine factors described as possible dysphagia risk factors were included in the analysis, the scale and coding of which are given in brackets: age (years), gender (male = 0, female = 1), BMI (metric), affirmed subjective aspiration signs ("no" = 0, "yes" = 1), NMS‐Quest 3 ("no" = 0, "yes" = 1), MDS‐UPDRS III score (metric), BDI‐II score (metric), DBS (absent = 0, present = 1), and disease duration (years). The binary logistic regression analysis showed that affirmed subjective aspiration signs, gender, and higher age were significantly associated with the risk of critical aspiration (Table ).…”

“…Therefore, numerous studies have tried to identify clinical findings associated with significant dysphagia. Clinical features that were found to be linked to significant dysphagia included age, gender, BMI, disease duration, disease severity, DBS, depression, and cognitive function . To assess the relative value of these clinical features, a regression analysis was performed in this study and suggested that the three parameters "affirmed subjective aspiration signs," "high age," and "gender" represent the strongest clinical criteria for predicting the risk of severe dysphagia.…”

“…The gender differences in aspiration risk observed in our study are in line with the study by Akbar et al who described for men a 2‐fold increased risk of aspiration pneumonia. As a pathophysiological basis, estrogen‐related increase in the physiological striatal dopamine levels is suspected . It was also described that male gender was associated with higher mortality in PD patients with a disease duration over 20 years .…”

“…4,5 Depending on the examined patient cohort and the survey procedure, the prevalence rates for dysphagia in PD patients vary between 11% and 95%. 1,2 Several clinical factors, such as age, 6,7 gender, [8][9][10] Body Mass Index (BMI), 11 disease duration, 12 disease severity, 11,13 drooling, 14,15 deep brain stimulation (DBS), 16 depression, 17 and cognitive function 14,18 are considered risk factors for clinically relevant dysphagia. Many patients are not aware of their swallowing dysfunction and do not report dysphagia unless asked.…”

The relationship between subcortical brain volume and striatal dopamine D2/3 receptor availability in healthy humans assessed with [11C]‐raclopride and [11C]‐(+)‐PHNO PET

“…Moreover, some studies suggest that DA transporter availability may not differ between gender, nor across the menstrual cycle [Best et al, ]. However, other studies suggests that women may have greater DA transporter functioning in the dorsal striatum [Andersen et al, ; Kaasinen et al, ; Lee et al, ; Wong et al, ], as well as greater DA synthesis capacity in the caudate [Laakso et al, ]. While we used sex as a covariate in our main analyses, there may be important sex differences between D 2/3 R availability and brain morphology.…”