Abstract:Disability proved to be the main variable related to the presence of sexual dysfunction. Patients with ALS had the worst rates of sexual dysfunction. Patients with MS were similar to the control group. As for the PD group, no patient had normal sexuality. Finally, in stroke patients, the presence of comorbidities and their treatment may have negatively influenced sexuality. These findings showed that patients with chronic neurological diseases have sexual dysfunction and underscore the need for neurologists to… Show more
“…The prevalence of SD after stroke ranges from 20 to 95%, occurring in either gender ( 12 , 13 ). Nasimbera et al ( 14 ) reported that SD in both sexes was present in 75% of post-stroke patients, whereas the prevalence of SD in the healthy controls was only 22.5%. A national population-based study including both genders showed that sexual activity was significantly lower in patients with stroke than in those without stroke (60 vs. 30.8%) ( 15 ).…”
Men with erectile dysfunction (ED) are considered to be at risk from stroke events. Conversely, post-stroke patients are also at high risk of ED, whereas a quantitative result from all the relevant studies has not been previously addressed. Therefore, we have performed a comprehensive review and meta-analysis on this issue. This study was registered on PROSPERO (ID No. CRD42021226618). Twenty studies with a total of 3,382 stroke events were included, of which six studies were included for quantitative analysis, and the remaining 14 studies were calculated for the ratio of ED. Synthetic results from four eligible studies providing the ED cases showed that stroke patients were associated with a significantly higher risk of ED than the general population [pooled relative risk (RR) = 3.32, 95% confidence interval (CI): 1.25–8.82, P = 0.016]. Men with stroke were also found to be associated with a significant decline in International Index of Erectile Function −5 (IIEF-5) score as compared with the healthy controls [three studies, standard mean differences (SMD) = −1.8, 95% CI: −2.94 to −0.67, P = 0.002]. The prevalence of ED in post-stroke patients among 14 studies ranged from 32.1 to 77.8%, which was dramatically higher than that of the general population. The result of the GRADE-pro revealed that the quality of the evidence in this study was moderate. The present study has confirmed the high prevalence of ED in men with stroke. ED in stroke patients is a result of both neurological and psychological factors. Rehabilitative interventions rather than phosphodiesterase-5 (PDE-5) inhibitors are recommended to improve the erectile function for those survivors with ED.
“…The prevalence of SD after stroke ranges from 20 to 95%, occurring in either gender ( 12 , 13 ). Nasimbera et al ( 14 ) reported that SD in both sexes was present in 75% of post-stroke patients, whereas the prevalence of SD in the healthy controls was only 22.5%. A national population-based study including both genders showed that sexual activity was significantly lower in patients with stroke than in those without stroke (60 vs. 30.8%) ( 15 ).…”
Men with erectile dysfunction (ED) are considered to be at risk from stroke events. Conversely, post-stroke patients are also at high risk of ED, whereas a quantitative result from all the relevant studies has not been previously addressed. Therefore, we have performed a comprehensive review and meta-analysis on this issue. This study was registered on PROSPERO (ID No. CRD42021226618). Twenty studies with a total of 3,382 stroke events were included, of which six studies were included for quantitative analysis, and the remaining 14 studies were calculated for the ratio of ED. Synthetic results from four eligible studies providing the ED cases showed that stroke patients were associated with a significantly higher risk of ED than the general population [pooled relative risk (RR) = 3.32, 95% confidence interval (CI): 1.25–8.82, P = 0.016]. Men with stroke were also found to be associated with a significant decline in International Index of Erectile Function −5 (IIEF-5) score as compared with the healthy controls [three studies, standard mean differences (SMD) = −1.8, 95% CI: −2.94 to −0.67, P = 0.002]. The prevalence of ED in post-stroke patients among 14 studies ranged from 32.1 to 77.8%, which was dramatically higher than that of the general population. The result of the GRADE-pro revealed that the quality of the evidence in this study was moderate. The present study has confirmed the high prevalence of ED in men with stroke. ED in stroke patients is a result of both neurological and psychological factors. Rehabilitative interventions rather than phosphodiesterase-5 (PDE-5) inhibitors are recommended to improve the erectile function for those survivors with ED.
“…173 However, it can still be considered a "hidden" symptom of MS, with estimates of prevalence ranging up to almost 80% of MS patients. 112,113,114,115,116 Sexual dysfunction may be underreported as neurologists do not address it with even a general question in half of cases, and patients may not independently address the topic with their neurologists if not asked. Therefore, assessment of sexual dysfunction primarily involves a semi-structured clinical interview, with focus on identification followed by assessment of severity and impact on quality of life.…”
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that is characterized by recurrent bouts of acute neuroinflammation and chronic neurodegeneration. Treatments for MS are aimed at prevention of disability in the future or restoring function in the present. Prevention treatments disrupt the underlying disease pathology, whereas restorative treatments address not only the disease’s primary effects on the central nervous system, but also secondary effects on other parts of the body and tertiary effects on each patient’s psychosocial functioning. MS symptoms can have primary, secondary, and tertiary components, which can interlock and reinforce each other. Restorative treatment should tease apart these components and address them separately. In this article on symptom management, we focus on treatments that aim to maximize each component of function.
“…Amyotrophic lateral sclerosis (ALS) is a progressive disorder of motor neurons in the brain and spinal cord [33]. ALS patients were found to have problems with their sexual relationship due to impaired sexual function such as decreased libido [34], with studies indicating that ALS had the worst rates of SD when compared with other NLDs [35]. Shahbazi et al [36] reported that although SD affected the QoL in ALS patients, 75% of their clinicians were not familiar with any strategies or interventions to help the patients.…”
Epidemiological studies illustrate that sexual dysfunction (SD) is common among the majority of patients suffering from neurological disorders (NLDs). However, our understanding of the SD in NLDs is in its infancy. Our effort in this review article reveals how the clinical studies illustrate different phenotypes relating to SD in both men and women suffering from NLDs, with special reference to PD, and how the development of animal models will provide a fantastic opportunity to decipher mechanistic insights into the biological and molecular processes of SD, understanding of which is critical to figure out the causes of SD and to develop therapeutic strategies either by targeting molecular players or altering and/or regulating the profiles of involved genetic targets. Specific emphasis is placed on dopamine-dependent and independent mechanism(s) of SD among PD patients, which is important because certain critical dopamine-independent phenotypes are yet to be characterized and understood in order to decipher the comprehensive pathophysiology of PD. Synergic efforts of both clinicians and bench scientists in this critical direction would significantly improve the quality of life of sufferers of NLDs who are already burdened. This knowledge relating to SD will help us to make one more step in reducing the burden of disease.
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