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Publication year
2007Source
Journal of Neurology, Neurosurgery, and Psychiatry, 78, 8, (2007), pp. 819-24ISSN
Publication type
Article / Letter to editor
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Organization
Neurology
Donders Centre for Cognitive Neuroimaging
Health Evidence
IQ Healthcare
Nuclear Medicine
Medical Imaging
Former Organization
Epidemiology, Biostatistics & HTA
Journal title
Journal of Neurology, Neurosurgery, and Psychiatry
Volume
vol. 78
Issue
iss. 8
Page start
p. 819
Page end
p. 24
Subject
DCN 2: Functional Neurogenomics; N4i 1: Pathogenesis and modulation of inflammation; NCEBP 10: Human Movement & Fatigue; NCEBP 2: Evaluation of complex medical interventions; ONCOL 3: Translational research; ONCOL 5: Aetiology, screening and detection; UMCN 1.5: Interventional oncology; UMCN 3.2: Cognitive neurosciencesAbstract
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 < or = 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.
This item appears in the following Collection(s)
- Academic publications [245131]
- Donders Centre for Cognitive Neuroimaging [4021]
- Electronic publications [132449]
- Faculty of Medical Sciences [93207]
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