Gender differences in Parkinson's disease: A clinical perspective

Abstract

Available data indicate that there are gender differences in many features of Parkinson's disease (PD). Precise identification of the gender differences is important to tailor treatment, predict outcomes, and meet other individual and social needs in women and men with PD. The aim of this study was to review the available clinical data on gender differences in PD. Original articles and meta-analyses published between 1990 and 2016 systematically exploring gender differences in PD were reviewed. There is slight male preponderance in incidence and prevalence of PD. PD starts earlier in men. Women tend to be more prone to develop tremor-dominant PD but are less rigid than men. Motor improvement after deep brain stimulation is equal in both sexes, but women tend to show better improvement in activities of daily living. Furthermore, women with PD show better results on tests for general cognitive abilities, outperform men in verbal cognitive tasks, show more pain symptoms, and score higher on depression scales. It seems, however, that the differences in cognition, mood, and pain perception are not disease specific as similar gender differences can be found in healthy subjects and in other neurological conditions. Despite PD being the most frequently studied movement disorder, studies investigating gender differences in PD are still scarce with most of the studies being cross-sectional. Good-quality, prospective, longitudinal studies analyzing gender differences in PD and comparing them to matched healthy controls are needed in order to properly address the issues of gender differences in PD.

The center of olfactory bulb‐seeded α‐synucleinopathy is the limbic system and the ensuing pathology is higher in male than in female mice

“…The sex differences reported here seem consistent with clinical observations that women with PD perform better than male PD patients in the University of Pennsylvania Smell Identification Test . Other notable sex differences include greater rigidity and cognitive dysfunction in male PD patients, whereas women with PD are more likely than men to display severe tremors, postural imbalances and dyskinesias . Perhaps for the latter reasons, fibril‐infused females in the present study engaged in lower levels of spontaneous rearing behavior and made fewer forelimb contacts with the walls of a cylinder.…”

Comparison of Parkinson’s Disease Patients’ Characteristics by Indication for Deep Brain Stimulation: Men Are More Likely to Have DBS for Tremor

“…7 A review of prior studies also shows that men appear more likely to have surgical intervention for tremor in PD. A retrospective case series of 15 patients who underwent DBS for “benign tremulous parkinsonism” was 80% men, 4 and another study comparing Vim and STN DBS in PD patients with medication refractory tremor included 15 men (83%) and 3 women.…”

Serum gamma-glutamyltransferase activity and Parkinson’s disease risk in men and women

“…However, the general hypothesis could not explain the contrary predictive effects of GGT on PD risk between men and women. Although sex-dependent factors such as health behaviors, including smoking, alcohol consumption, and exercise, may have a differential influence on disease risk, estrogen has been consistently thought to be a biological factor explaining the disparity between men and women [16][17][18] . Several studies have suggested that estrogen may play a protective role in the development of PD 19,20 , and plasma GGT activities were shown to be inversely associated with estrogen in an ovariectomized mouse model 21 and in humans undergoing hormonal replacement therapy 22 .…”