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Differences in the Presentation and Progression of Parkinson's Disease by Sex.
Authors
Guido Alves
Ninad Amondikar
+46 more
Ole A Andreassen
Peggy Auinger
Roger A Barker
Cornelis Blauwendraat
Bastiaan R Bloem
David P Breen
Alexis Brice
Jean-Christophe Corvol
Fabrice Danjou
Aaron G Day-Williams
Shirley Eberly
Karol Estrada
Jonathan R Evans
Faraz Faghri
Mark Frasier
Raphael J Gibbs
Dena G Hernandez
Peter Heutink
Samantha J Hutten
Hirotaka Iwaki
Jonggeol J Kim
Hampton L Leonard
Ganqiang Liu
Mary B Makarious
Jodi Maple-Grødem
Mike A Nalls
Khanh-Dung H Nguyen
Alastair J Noyce
Lasse Pihlstrøm
Bernard Ravina
Jacqueline Rick
Clemens R Scherzer
Kirsten M Scott
David K Simon
Andrew B Singleton
Luba Smolensky
Mathias Toft
Ole-Bjørn Tysnes
Bart P van de Warrenburg
Vivianna M Van Deerlin
Jacobus J Van Hilten
Marlies van Nimwegen
Claire E Wegel
Daniel Weintraub
Ruwani Wijeyekoon
Caroline H Williams-Gray
Publication date
11 April 2020
Publisher
Mov Disord
Doi
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on
PubMed
Abstract
BACKGROUND: Previous studies reported various symptoms of Parkinson's disease (PD) associated with sex. Some were conflicting or confirmed in only one study. OBJECTIVES: We examined sex associations to PD phenotypes cross-sectionally and longitudinally in large-scale data. METHODS: We tested 40 clinical phenotypes, using longitudinal, clinic-based patient cohorts, consisting of 5946 patients, with a median follow-up of 3.1 years. For continuous outcomes, we used linear regressions at baseline to test sex-associated differences in presentation, and linear mixed-effects models to test sex-associated differences in progression. For binomial outcomes, we used logistic regression models at baseline and Cox regression models for survival analyses. We adjusted for age, disease duration, and medication use. In the secondary analyses, data from 17 719 PD patients and 7588 non-PD participants from an online-only, self-assessment PD cohort were cross-sectionally evaluated to determine whether the sex-associated differences identified in the primary analyses were consistent and unique to PD. RESULTS: Female PD patients had a higher risk of developing dyskinesia early during the follow-up period, with a slower progression in activities of daily living difficulties, and a lower risk of developing cognitive impairments compared with male patients. The findings in the longitudinal, clinic-based cohorts were mostly consistent with the results of the online-only cohort. CONCLUSIONS: We observed sex-associated contributions to PD heterogeneity. These results highlight the necessity of future research to determine the underlying mechanisms and importance of personalized clinical management. © 2020 International Parkinson and Movement Disorder Society.This study was supported by the Intramural Research Program the National Institute on Aging (NIA, Z01-AG000949-02), Biogen Idec, and the Michael J Fox Foundation for Parkinson’s Research
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