Gender differences in Parkinson’s disease
Identifieur interne : 000680 ( Main/Corpus ); précédent : 000679; suivant : 000681Gender differences in Parkinson’s disease
Auteurs : Charlotte A. Haaxma ; Bastiaan R. Bloem ; George F. Borm ; Wim J G. Oyen ; Klaus L. Leenders ; Silvia Eshuis ; Jan Booij ; Dean E. Dluzen ; Martin W I M. HorstinkSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2007-08.
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- KwdEn :
Abstract
Objective: To investigate gender differences in basic disease characteristics, motor deterioration and nigrostriatal degeneration in Parkinson’s disease (PD). Methods: We studied 253 consecutive PD patients who were not receiving levodopa or dopamine agonists (disease duration ⩽10 years). We investigated the influence of gender and oestrogen status on: (1) age at onset, (2) presenting symptom, (3) severity and progression of motor symptoms (Unified Parkinson’s Disease Rating Scale III (UPDRS-III) scores) and (4) amount and progression of nigrostriatal degeneration ([123I]FP-CIT single photon emission computed tomography measurements). Results: Age at onset was 2.1 years later in women (53.4 years) than in men (51.3 years). In women, age at onset correlated positively with parity, age at menopause and fertile life span. Women more often presented with tremor (67%) than men (48%). Overall, patients presenting with tremor had a 3.6 year higher age at onset and a 38% slower UPDRS-III deterioration. Mean UPDRS-III scores at disease onset were equal for both genders, as was the rate of deterioration. Women had a 16% higher striatal [123I]FP-CIT binding than men at symptom onset and throughout the course of PD. Conclusions: Our results suggest that, in women, the development of symptomatic PD may be delayed by higher physiological striatal dopamine levels, possibly due to the activity of oestrogens. This could explain the epidemiological observations of a lower incidence and higher age at onset in women. Women also presented more often with tremor which, in turn, is associated with milder motor deterioration and striatal degeneration. Taken together, these findings suggest a more benign phenotype in women with PD.
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DOI: 10.1136/jnnp.2006.103788
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Haaxma</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R" last="Bloem">Bastiaan R. Bloem</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Borm, George F" sort="Borm, George F" uniqKey="Borm G" first="George F" last="Borm">George F. Borm</name><affiliation><mods:affiliation>Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Oyen, Wim J G" sort="Oyen, Wim J G" uniqKey="Oyen W" first="Wim J G" last="Oyen">Wim J G. 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Leenders</name><affiliation><mods:affiliation>Department of Neurology, Groningen University Medical Centre, Groningen, the Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Eshuis, Silvia" sort="Eshuis, Silvia" uniqKey="Eshuis S" first="Silvia" last="Eshuis">Silvia Eshuis</name><affiliation><mods:affiliation>Department of Neurology, Groningen University Medical Centre, Groningen, the Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Booij, Jan" sort="Booij, Jan" uniqKey="Booij J" first="Jan" last="Booij">Jan Booij</name><affiliation><mods:affiliation>Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, the Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Dluzen, Dean E" sort="Dluzen, Dean E" uniqKey="Dluzen D" first="Dean E" last="Dluzen">Dean E. Dluzen</name><affiliation><mods:affiliation>Department of Anatomy, Northeastern Ohio Universities, College of Medicine, Rootstown, Ohio, USA</mods:affiliation></affiliation></author><author><name sortKey="Horstink, Martin W I M" sort="Horstink, Martin W I M" uniqKey="Horstink M" first="Martin W I M" last="Horstink">Martin W I M. Horstink</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2007-08">2007-08</date><biblScope unit="volume">78</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="819">819</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">487A8744080F4A9B24B2E7F7BD1830AD07EF1804</idno><idno type="DOI">10.1136/jnnp.2006.103788</idno><idno type="href">jnnp-78-819.pdf</idno><idno type="PMID">17098842</idno><idno type="local">0780819</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>PD, Parkinson’s disease</term><term>SPECT, single photon emission computed tomography</term><term>UPDRS-III, Unified Parkinson’s Disease Rating Scale III</term><term>sUPDRS-III, selection of items of the Unified Parkinson’s Disease Rating Scale III</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: To investigate gender differences in basic disease characteristics, motor deterioration and nigrostriatal degeneration in Parkinson’s disease (PD). Methods: We studied 253 consecutive PD patients who were not receiving levodopa or dopamine agonists (disease duration ⩽10 years). We investigated the influence of gender and oestrogen status on: (1) age at onset, (2) presenting symptom, (3) severity and progression of motor symptoms (Unified Parkinson’s Disease Rating Scale III (UPDRS-III) scores) and (4) amount and progression of nigrostriatal degeneration ([123I]FP-CIT single photon emission computed tomography measurements). Results: Age at onset was 2.1 years later in women (53.4 years) than in men (51.3 years). In women, age at onset correlated positively with parity, age at menopause and fertile life span. Women more often presented with tremor (67%) than men (48%). Overall, patients presenting with tremor had a 3.6 year higher age at onset and a 38% slower UPDRS-III deterioration. Mean UPDRS-III scores at disease onset were equal for both genders, as was the rate of deterioration. Women had a 16% higher striatal [123I]FP-CIT binding than men at symptom onset and throughout the course of PD. Conclusions: Our results suggest that, in women, the development of symptomatic PD may be delayed by higher physiological striatal dopamine levels, possibly due to the activity of oestrogens. This could explain the epidemiological observations of a lower incidence and higher age at onset in women. Women also presented more often with tremor which, in turn, is associated with milder motor deterioration and striatal degeneration. Taken together, these findings suggest a more benign phenotype in women with PD.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>Charlotte A Haaxma</name><affiliations><json:string>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</json:string></affiliations></json:item><json:item><name>Bastiaan R Bloem</name><affiliations><json:string>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</json:string></affiliations></json:item><json:item><name>George F Borm</name><affiliations><json:string>Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</json:string></affiliations></json:item><json:item><name>Wim J G Oyen</name><affiliations><json:string>Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</json:string></affiliations></json:item><json:item><name>Klaus L Leenders</name><affiliations><json:string>Department of Neurology, Groningen University Medical Centre, Groningen, the Netherlands</json:string></affiliations></json:item><json:item><name>Silvia Eshuis</name><affiliations><json:string>Department of Neurology, Groningen University Medical Centre, Groningen, the Netherlands</json:string></affiliations></json:item><json:item><name>Jan Booij</name><affiliations><json:string>Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, the Netherlands</json:string></affiliations></json:item><json:item><name>Dean E Dluzen</name><affiliations><json:string>Department of Anatomy, Northeastern Ohio Universities, College of Medicine, Rootstown, Ohio, USA</json:string></affiliations></json:item><json:item><name>Martin W I M Horstink</name><affiliations><json:string>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Papers</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Drugs: CNS (not psychiatric)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiology</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Radiology (diagnostics)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PD, Parkinson’s disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SPECT, single photon emission computed tomography</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>sUPDRS-III, selection of items of the Unified Parkinson’s Disease Rating Scale III</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>UPDRS-III, Unified Parkinson’s Disease Rating Scale III</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Objective: To investigate gender differences in basic disease characteristics, motor deterioration and nigrostriatal degeneration in Parkinson’s disease (PD). Methods: We studied 253 consecutive PD patients who were not receiving levodopa or dopamine agonists (disease duration ⩽10 years). We investigated the influence of gender and oestrogen status on: (1) age at onset, (2) presenting symptom, (3) severity and progression of motor symptoms (Unified Parkinson’s Disease Rating Scale III (UPDRS-III) scores) and (4) amount and progression of nigrostriatal degeneration ([123I]FP-CIT single photon emission computed tomography measurements). Results: Age at onset was 2.1 years later in women (53.4 years) than in men (51.3 years). In women, age at onset correlated positively with parity, age at menopause and fertile life span. Women more often presented with tremor (67%) than men (48%). Overall, patients presenting with tremor had a 3.6 year higher age at onset and a 38% slower UPDRS-III deterioration. Mean UPDRS-III scores at disease onset were equal for both genders, as was the rate of deterioration. Women had a 16% higher striatal [123I]FP-CIT binding than men at symptom onset and throughout the course of PD. Conclusions: Our results suggest that, in women, the development of symptomatic PD may be delayed by higher physiological striatal dopamine levels, possibly due to the activity of oestrogens. This could explain the epidemiological observations of a lower incidence and higher age at onset in women. Women also presented more often with tremor which, in turn, is associated with milder motor deterioration and striatal degeneration. Taken together, these findings suggest a more benign phenotype in women with PD.</abstract><qualityIndicators><score>7.6</score><pdfVersion>1.2</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>8</keywordCount><abstractCharCount>1736</abstractCharCount><pdfWordCount>4600</pdfWordCount><pdfCharCount>29575</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>259</abstractWordCount></qualityIndicators><title>Gender differences in Parkinson’s disease</title><pmid><json:string>17098842</json:string></pmid><genre><json:string>research-article</json:string></genre><host><volume>78</volume><pages><first>819</first></pages><issn><json:string>0022-3050</json:string></issn><issue>8</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><publicationDate>2007</publicationDate><copyrightDate>2007</copyrightDate><doi><json:string>10.1136/jnnp.2006.103788</json:string></doi><id>487A8744080F4A9B24B2E7F7BD1830AD07EF1804</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/487A8744080F4A9B24B2E7F7BD1830AD07EF1804/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/487A8744080F4A9B24B2E7F7BD1830AD07EF1804/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/487A8744080F4A9B24B2E7F7BD1830AD07EF1804/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Gender differences in Parkinson’s disease</title><respStmt xml:id="ISTEX-API" resp="Références bibliographiques récupérées via GROBID" name="ISTEX-API (INIST-CNRS)"></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2006-11-10</date></publicationStmt><notesStmt><note>Correspondence to:
Dr Bastiaan R Bloem
Department of Neurology (935), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, the Netherlands; b.bloem@neuro.umcn.nl</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Gender differences in Parkinson’s disease</title><author><persName><forename type="first">Charlotte A</forename><surname>Haaxma</surname></persName><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation></author><author><persName><forename type="first">Bastiaan R</forename><surname>Bloem</surname></persName><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation></author><author><persName><forename type="first">George F</forename><surname>Borm</surname></persName><affiliation>Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation></author><author><persName><forename type="first">Wim J G</forename><surname>Oyen</surname></persName><affiliation>Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation></author><author><persName><forename type="first">Klaus L</forename><surname>Leenders</surname></persName><affiliation>Department of Neurology, Groningen University Medical Centre, Groningen, the Netherlands</affiliation></author><author><persName><forename type="first">Silvia</forename><surname>Eshuis</surname></persName><affiliation>Department of Neurology, Groningen University Medical Centre, Groningen, the Netherlands</affiliation></author><author><persName><forename type="first">Jan</forename><surname>Booij</surname></persName><affiliation>Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, the Netherlands</affiliation></author><author><persName><forename type="first">Dean E</forename><surname>Dluzen</surname></persName><affiliation>Department of Anatomy, Northeastern Ohio Universities, College of Medicine, Rootstown, Ohio, USA</affiliation></author><author><persName><forename type="first">Martin W I M</forename><surname>Horstink</surname></persName><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2007-08"></date><biblScope unit="volume">78</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="819">819</biblScope></imprint></monogr><idno type="istex">487A8744080F4A9B24B2E7F7BD1830AD07EF1804</idno><idno type="DOI">10.1136/jnnp.2006.103788</idno><idno type="href">jnnp-78-819.pdf</idno><idno type="PMID">17098842</idno><idno type="local">0780819</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2006-11-10</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective: To investigate gender differences in basic disease characteristics, motor deterioration and nigrostriatal degeneration in Parkinson’s disease (PD). Methods: We studied 253 consecutive PD patients who were not receiving levodopa or dopamine agonists (disease duration ⩽10 years). We investigated the influence of gender and oestrogen status on: (1) age at onset, (2) presenting symptom, (3) severity and progression of motor symptoms (Unified Parkinson’s Disease Rating Scale III (UPDRS-III) scores) and (4) amount and progression of nigrostriatal degeneration ([123I]FP-CIT single photon emission computed tomography measurements). Results: Age at onset was 2.1 years later in women (53.4 years) than in men (51.3 years). In women, age at onset correlated positively with parity, age at menopause and fertile life span. Women more often presented with tremor (67%) than men (48%). Overall, patients presenting with tremor had a 3.6 year higher age at onset and a 38% slower UPDRS-III deterioration. Mean UPDRS-III scores at disease onset were equal for both genders, as was the rate of deterioration. Women had a 16% higher striatal [123I]FP-CIT binding than men at symptom onset and throughout the course of PD. Conclusions: Our results suggest that, in women, the development of symptomatic PD may be delayed by higher physiological striatal dopamine levels, possibly due to the activity of oestrogens. This could explain the epidemiological observations of a lower incidence and higher age at onset in women. Women also presented more often with tremor which, in turn, is associated with milder motor deterioration and striatal degeneration. Taken together, these findings suggest a more benign phenotype in women with PD.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Drugs: CNS (not psychiatric)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Radiology</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Radiology (diagnostics)</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>ABR</head><item><term>PD, Parkinson’s disease</term></item><item><term>SPECT, single photon emission computed tomography</term></item><item><term>sUPDRS-III, selection of items of the Unified Parkinson’s Disease Rating Scale III</term></item><item><term>UPDRS-III, Unified Parkinson’s Disease Rating Scale III</term></item></list></keywords></textClass></profileDesc><revisionDesc><change 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Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">0780819</article-id><article-id pub-id-type="doi">10.1136/jnnp.2006.103788</article-id><article-id pub-id-type="other">jnnp;78/8/819</article-id><article-id pub-id-type="other">jnnp;jnnp.2006.103788</article-id><article-id pub-id-type="pmid">17098842</article-id><article-id pub-id-type="other">819</article-id><article-id pub-id-type="other">jnnp.2006.103788</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Papers</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Drugs: CNS (not psychiatric)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Radiology</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Radiology (diagnostics)</subject></subj-group></article-categories><title-group><article-title>Gender differences in Parkinson’s disease</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Haaxma</surname><given-names>Charlotte A</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Bloem</surname><given-names>Bastiaan R</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Borm</surname><given-names>George F</given-names></name><xref rid="AFF2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Oyen</surname><given-names>Wim J G</given-names></name><xref rid="AFF3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Leenders</surname><given-names>Klaus L</given-names></name><xref rid="AFF4">4</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Eshuis</surname><given-names>Silvia</given-names></name><xref rid="AFF4">4</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Booij</surname><given-names>Jan</given-names></name><xref rid="AFF5">5</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Dluzen</surname><given-names>Dean E</given-names></name><xref rid="AFF6">6</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Horstink</surname><given-names>Martin W I M</given-names></name><xref rid="AFF1">1</xref></contrib><aff id="AFF1"><label>1</label>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</aff><aff id="AFF2"><label>2</label>Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</aff><aff id="AFF3"><label>3</label>Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</aff><aff id="AFF4"><label>4</label>Department of Neurology, Groningen University Medical Centre, Groningen, the Netherlands</aff><aff id="AFF5"><label>5</label>Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, the Netherlands</aff><aff id="AFF6"><label>6</label>Department of Anatomy, Northeastern Ohio Universities, College of Medicine, Rootstown, Ohio, USA</aff></contrib-group><author-notes><corresp>Correspondence to:
Dr Bastiaan R Bloem
Department of Neurology (935), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, the Netherlands; <ext-link xlink:href="b.bloem@neuro.umcn.nl" ext-link-type="email" xlink:type="simple">b.bloem@neuro.umcn.nl</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>8</month><year>2007</year></pub-date><pub-date pub-type="epub"><day>10</day><month>11</month><year>2006</year></pub-date><volume>78</volume><volume-id pub-id-type="other">78</volume-id><volume-id pub-id-type="other">78</volume-id><issue>8</issue><issue-id pub-id-type="other">jnnp;78/8</issue-id><issue-id pub-id-type="other">8</issue-id><issue-id pub-id-type="other">78/8</issue-id><fpage>819</fpage><history><date date-type="accepted"><day>24</day><month>10</month><year>2006</year></date><date date-type="received"><day>15</day><month>08</month><year>2006</year></date><date date-type="rev-recd"><day>24</day><month>10</month><year>2006</year></date></history><permissions><copyright-statement>Copyright 2007 Journal of Neurology Neurosurgery and Psychiatry</copyright-statement><copyright-year>2007</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-78-819.pdf"></self-uri><abstract xml:lang="en"><p><bold>Objective:</bold> To investigate gender differences in basic disease characteristics, motor deterioration and nigrostriatal degeneration in Parkinson’s disease (PD).</p><p><bold>Methods:</bold> We studied 253 consecutive PD patients who were not receiving levodopa or dopamine agonists (disease duration ⩽10 years). We investigated the influence of gender and oestrogen status on: (1) age at onset, (2) presenting symptom, (3) severity and progression of motor symptoms (Unified Parkinson’s Disease Rating Scale III (UPDRS-III) scores) and (4) amount and progression of nigrostriatal degeneration ([<sup>123</sup>I]FP-CIT single photon emission computed tomography measurements).</p><p><bold>Results:</bold> Age at onset was 2.1 years later in women (53.4 years) than in men (51.3 years). In women, age at onset correlated positively with parity, age at menopause and fertile life span. Women more often presented with tremor (67%) than men (48%). Overall, patients presenting with tremor had a 3.6 year higher age at onset and a 38% slower UPDRS-III deterioration. Mean UPDRS-III scores at disease onset were equal for both genders, as was the rate of deterioration. Women had a 16% higher striatal [<sup>123</sup>I]FP-CIT binding than men at symptom onset and throughout the course of PD.</p><p><bold>Conclusions:</bold> Our results suggest that, in women, the development of symptomatic PD may be delayed by higher physiological striatal dopamine levels, possibly due to the activity of oestrogens. This could explain the epidemiological observations of a lower incidence and higher age at onset in women. Women also presented more often with tremor which, in turn, is associated with milder motor deterioration and striatal degeneration. Taken together, these findings suggest a more benign phenotype in women with PD.</p></abstract><kwd-group kwd-group-type="ABR" xml:lang="en"><kwd>PD, Parkinson’s disease</kwd><kwd>SPECT, single photon emission computed tomography</kwd><kwd>sUPDRS-III, selection of items of the Unified Parkinson’s Disease Rating Scale III</kwd><kwd>UPDRS-III, Unified Parkinson’s Disease Rating Scale III</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Gender differences in Parkinson’s disease</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Gender differences in Parkinson’s disease</title></titleInfo><name type="personal"><namePart type="given">Charlotte A</namePart><namePart type="family">Haaxma</namePart><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bastiaan R</namePart><namePart type="family">Bloem</namePart><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">George F</namePart><namePart type="family">Borm</namePart><affiliation>Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wim J G</namePart><namePart type="family">Oyen</namePart><affiliation>Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Klaus L</namePart><namePart type="family">Leenders</namePart><affiliation>Department of Neurology, Groningen University Medical Centre, Groningen, the Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Silvia</namePart><namePart type="family">Eshuis</namePart><affiliation>Department of Neurology, Groningen University Medical Centre, Groningen, the Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jan</namePart><namePart type="family">Booij</namePart><affiliation>Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, the Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dean E</namePart><namePart type="family">Dluzen</namePart><affiliation>Department of Anatomy, Northeastern Ohio Universities, College of Medicine, Rootstown, Ohio, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Martin W I M</namePart><namePart type="family">Horstink</namePart><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Drugs: CNS (not psychiatric)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Radiology</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Radiology (diagnostics)</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2007-08</dateIssued><dateCreated encoding="w3cdtf">2006-11-10</dateCreated><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Objective: To investigate gender differences in basic disease characteristics, motor deterioration and nigrostriatal degeneration in Parkinson’s disease (PD). Methods: We studied 253 consecutive PD patients who were not receiving levodopa or dopamine agonists (disease duration ⩽10 years). We investigated the influence of gender and oestrogen status on: (1) age at onset, (2) presenting symptom, (3) severity and progression of motor symptoms (Unified Parkinson’s Disease Rating Scale III (UPDRS-III) scores) and (4) amount and progression of nigrostriatal degeneration ([123I]FP-CIT single photon emission computed tomography measurements). Results: Age at onset was 2.1 years later in women (53.4 years) than in men (51.3 years). In women, age at onset correlated positively with parity, age at menopause and fertile life span. Women more often presented with tremor (67%) than men (48%). Overall, patients presenting with tremor had a 3.6 year higher age at onset and a 38% slower UPDRS-III deterioration. Mean UPDRS-III scores at disease onset were equal for both genders, as was the rate of deterioration. Women had a 16% higher striatal [123I]FP-CIT binding than men at symptom onset and throughout the course of PD. Conclusions: Our results suggest that, in women, the development of symptomatic PD may be delayed by higher physiological striatal dopamine levels, possibly due to the activity of oestrogens. This could explain the epidemiological observations of a lower incidence and higher age at onset in women. Women also presented more often with tremor which, in turn, is associated with milder motor deterioration and striatal degeneration. Taken together, these findings suggest a more benign phenotype in women with PD.</abstract><note type="author-notes">Correspondence to:
Dr Bastiaan R Bloem
Department of Neurology (935), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, the Netherlands; b.bloem@neuro.umcn.nl</note><subject lang="en"><genre>ABR</genre><topic>PD, Parkinson’s disease</topic><topic>SPECT, single photon emission computed tomography</topic><topic>sUPDRS-III, selection of items of the Unified Parkinson’s Disease Rating Scale III</topic><topic>UPDRS-III, Unified Parkinson’s Disease Rating Scale III</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>78</number></detail><detail type="issue"><caption>no.</caption><number>8</number></detail><extent unit="pages"><start>819</start></extent></part></relatedItem><identifier type="istex">487A8744080F4A9B24B2E7F7BD1830AD07EF1804</identifier><identifier type="DOI">10.1136/jnnp.2006.103788</identifier><identifier type="href">jnnp-78-819.pdf</identifier><identifier type="PMID">17098842</identifier><identifier type="local">0780819</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright 2007 Journal of Neurology Neurosurgery and Psychiatry</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/487A8744080F4A9B24B2E7F7BD1830AD07EF1804/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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