Non-motor symptoms are more frequent in women than in men with Parkinson’s disease

Abstract

Purpose: Sex differences in Parkinson's disease (PD) still remain poorly understood. The aim of our study was to examine potential sex differences in specific domains of PD clinical picture: clinical subtype of the disease, motor status, severity of dyskinesia and motor fluctuations, occurrence of gastrointestinal disturbances (anorexia, nausea, vomiting), sleep disturbance and orthostatic hypotension. Methods: Seventy six PD patients (40 women and 36 men) on antiparkinsonian treatment were included. The levodopa equivalent daily dose (LEDD) was calculated. The motor symptoms severity was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) part III and complications of therapy-using UPDRS IV A (dyskinesia), B (motor fluctuations), C (other complications, i.e. anorexia, nausea, vomiting, sleep disturbance, symptomatic orthostasis). Results: No sex related differences were found regarding age, age of PD onset, PD duration, UPDRS III, IVA and IVB scores, LEDD, duration of levodopa and dopamine agonist treatments, the predominant symptom at PD onset and the clinical PD subtype. UPDRS IVC score were significantly higher in women than in men (0.67 vs 0.26, p < 0.05) and women showed a higher frequency of gastrointestinal disturbances (anorexia, nausea, vomiting), sleep disturbance and symptomatic orthostasis. Conclusions: Our study evidenced that female PD patients on dopaminergic treatment are at higher risk of certain non-motor symptoms (NMS) than male. Further research is needed to evaluate the influence of male or female sex on various NMS and use of dopaminergic medication in different PD stage.