Journal
MOVEMENT DISORDERS
Volume 36, Issue 1, Pages 106-117Publisher
WILEY
DOI: 10.1002/mds.28312
Keywords
Parkinson's disease; gender; sex; dyskinesias; cognitive impairment; activities of daily livings
Categories
Funding
- Michael J. Fox Foundation for Parkinson's Research
- AbbVie
- Allergan
- Avid Radiopharmaceuticals
- Biogen
- BioLegend
- BristolMyers Squibb
- Celgene
- Denali Incorporated
- GE Healthcare
- Genentech
- GlaxoSmithKline
- Eli Lilly and Company
- Lundbeck
- Merck Co.
- Meso Scale Discovery
- Pfizer
- Piramal
- Prevail Therapeutics
- Roche
- Sanofi Genzyme
- Servier Laboratories
- Takeda
- Teva
- UCB
- Verily
- Voyager Therapeutics
- Golub Capital
- National Institute of Neurological Disorders and Stroke (NINDS) [NS24778]
- General Clinical Research Centers Program of the National Institutes of Health at Columbia University [RR00645]
- General Clinical Research Centers Program of the National Institutes of Health at University of Virginia [RR00847]
- General Clinical Research Centers Program of the National Institutes of Health at University of Pennsylvania [RR00040]
- General Clinical Research Centers Program of the National Institutes of Health at University of Iowa [RR00059]
- General Clinical Research Centers Program of the National Institutes of Health at Ohio State University [RR00034]
- General Clinical Research Centers Program of the National Institutes of Health at Massachusetts General Hospital [RR01066]
- General Clinical Research Centers Program of the National Institutes of Health at University of Rochester [RR00044]
- General Clinical Research Centers Program of the National Institutes of Health at Brown University [RR02038]
- General Clinical Research Centers Program of the National Institutes of Health at Oregon Health Sciences University [RR00334]
- General Clinical Research Centers Program of the National Institutes of Health at Baylor College of Medicine [RR00350]
- General Clinical Research Centers Program of the National Institutes of Health at University of California [RR00827]
- General Clinical Research Centers Program of the National Institutes of Health at Johns Hopkins University [RR00035]
- General Clinical Research Centers Program of the National Institutes of Health at University of Michigan [RR00042]
- General Clinical Research Centers Program of the National Institutes of Health at Washington University [RR00036]
- Parkinson's Disease Foundation at Columbia-Presbyterian Medical Center
- National Parkinson Foundation
- Parkinson Foundation of Canada
- United Parkinson Foundation, Chicago
- American Parkinson's Disease Association, New York
- University of Rochester
- Assistance Publique Hopitaux de Paris - French Ministry of Health (PHRC 2008) [AOM08010]
- Agence Nationale pour la Securite des Medicaments (ANSM)
- Harvard NeuroDiscovery Center
- Michael J Fox Foundation
- NINDS [U01NS082157, U01NS100603, U01NS043128, 5U01NS050095-05]
- Massachusetts Alzheimer's Disease Research Center [NIA P50AG005134]
- ZonMw (Netherlands Organization for Health Research and Development) [75020012]
- Michael J Fox Foundation for Parkinson's research
- VGZ (health insurance company)
- Research Council of Norway
- Western Norway Regional Health Authority
- Stavanger University Hospital Research Funds
- Norwegian Parkinson's Disease Association
- Cure Parkinson's Trust
- Van Geest Foundation
- National Institute of Health Research Cambridge Biomedical Research Centre
- Department of Defense Neurotoxin Exposure Treatment Parkinson's Research Program [W23RRYX7022N606]
- Parkinson's Disease Foundation
- Lundbeck Pharmaceuticals
- Cephalon Inc
- Lundbeck Inc
- John Blume Foundation
- Smart Family Foundation
- RJG Foundation
- Kinetics Foundation
- Amarin Neuroscience LTD
- CHDI Foundation Inc
- National Institutes of Health (NHGRI, NINDS)
- Columbia Parkinson's Disease Research Center
- Alkemade-Keuls Foundation
- Stichting Parkinson Fonds
- Parkinson Vereniging
- Netherlands Organisation for Health Research and Development
- NINDS
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This study examined sex associations to PD phenotypes cross-sectionally and longitudinally in large-scale data. Female PD patients were found to have a higher risk of developing dyskinesia early during the follow-up period, with slower progression in daily living difficulties, and a lower risk of developing cognitive impairments compared with male patients. The findings were consistent in both longitudinal, clinic-based cohorts and an online-only cohort.
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. (c) 2020 International Parkinson and Movement Disorder Society
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