Sex Differences in Brain and Cognition in de novo Parkinson's Disease

Background and Objective: Brain atrophy and cognitive impairment in neurodegenerative diseases are influenced by sex. We aimed to investigate sex differences in brain atrophy and cognition in de novo Parkinson's disease (PD) patients.Methods: Clinical, neuropsychological and T1-weighted MRI data from 205 PD patients (127 males: 78 females) and 69 healthy controls (40 males: 29 females) were obtained from the PPMI dataset.Results: PD males had a greater motor and rapid eye movement sleep behavior disorder symptomatology than PD females. They also showed cortical thinning in postcentral and precentral regions, greater global cortical and subcortical atrophy and smaller volumes in thalamus, caudate, putamen, pallidum, hippocampus, and brainstem, compared with PD females. Healthy controls only showed reduced hippocampal volume in males compared to females. PD males performed worse than PD females in global cognition, immediate verbal recall, and mental processing speed. In both groups males performed worse than females in semantic verbal fluency and delayed verbal recall; as well as females performed worse than males in visuospatial function.Conclusions: Sex effect in brain and cognition is already evident in de novo PD not explained by age per se, being a relevant factor to consider in clinical and translational research in PD.

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The REM Sleep Behavior Disorder Screening Questionnaire is not Valid in De Novo Parkinson's Disease

Movement Disorders Clinical Practice ◽

10.1002/mdc3.12591 ◽

2018 ◽

Vol 5 (2) ◽

pp. 171-176 ◽

Cited By ~ 10

Author(s):

Claire Halsband ◽

Antonia Zapf ◽

Friederike Sixel‐Döring ◽

Claudia Trenkwalder ◽

Brit Mollenhauer

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rem Sleep ◽

De Novo ◽

Rem Sleep Behavior Disorder ◽

Behavior Disorder ◽

Sleep Behavior ◽

Screening Questionnaire

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Parkinson Disease–Related Brain Metabolic Patterns and Neurodegeneration in Isolated REM Sleep Behavior Disorder

Neurology ◽

10.1212/wnl.0000000000012228 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012228

Author(s):

Jung Hwan Shin ◽

Jee-Young Lee ◽

Yu-Kyeong Kim ◽

Eun Jin Yoon ◽

Heejung Kim ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Eye Movement ◽

Fdg Pet ◽

Rating Scale ◽

De Novo ◽

Behavior Disorder ◽

Rapid Eye Movement ◽

Rapid Eye Movement Sleep ◽

Sleep Behavior

ABSTRACTObjective:To elucidate the role of Parkinson’s disease (PD)-related brain metabolic patterns as a biomarker in isolated rapid-eye-movement sleep behavior disorder (iRBD) for future disease conversion.Method:This is a prospective cohort study consisting of 30 iRBD patients, 25 de novo PD patients with a premorbid history of RBD, 21 long-standing PD patients on stable treatment and 24 healthy controls. iRBD group was longitudinally followed up. All participants underwent 18F-Fluorodeoxyglucose (FDG) PET and were evaluated with olfaction, cognition, and the Movement disorders society-Unified PD Rating Scale (MDS-UPDRS) at baseline. From FDG-PET scans, we derived metabolic patterns from the long-standing PD group (PD-RP) and de novo PD group with RBD (dnPDRBD-RP). Subsequently, we calculated the PD-RP and dnPDRBD-RP scores in iRBD patients. We validated the metabolic patterns in each PD group and separate iRBD cohort (n=14).Result:The two patterns significantly correlated with each other and were spatially overlapping yet distinct. The MDS-UPDRS motor scores significantly correlated with PD-RP (p = 0.013) but not with dnPDRBD-RP (p = 0.076). In contrast, dnPDRBD-RP correlated with olfaction in butanol threshold test (p = 0.018) in iRBD subjects, but PD-RP did not (p = 0.21). High dnPDRBD-RP in iRBD patients predicted future phenoconversion with all cut-off ranges from 1.5 to 3 standard deviations of the control value, whereas predictability of PD-RP was only significant in a partial range of cut-off.Conclusion:The dnPDRBD-RP is an efficient neuroimaging biomarker that reflects prodromal features of PD and predicts phenoconversion in iRBD that can be applied individually.Classification of Evidence:This study provides Class IV evidence that a de novo Parkinson's disease pattern on FDG-PET predict future conversion to neurodegenerative disease in patients with isolated rapid-eye-movement sleep behavior disorder (iRBD).

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