Objective: To examine how gender differences influence the motor and non-motor features across the Parkinson’s disease (PD) spectrum.

Background: There is evidence of male predominance in PD, however less is known about the role of gender in the heterogeneous clinical presentation of PD. The Movement Disorder Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), a recommended scale by the NIH Common Data Elements, provides a uniform way to capture PD features including its motor features and motor and non-motor experiences of daily living across studies.

Methods: We examined MDS-UPDRS Parts I-IV administered in a large cohort (n=1321) drawn from three studies: the MDS-UPDRS Clinimetric testing program (CTPS), the Rush PD-Cognitive Behavioral Imaging study (PD-CBI), and the Parkinson’s Progression Markers Initiative (PPMI). We classified motor phenotypes by tremor dominant/postural instability gait disorder (TD/PIGD) ratios. Using published MDS-UPDRS factor structures (Goetz et al., 2008), we examined gender differences in TD/PIGD phenotype using Chi-square statistic and individual factors from Parts I-IV using a multivariate general linear model controlling (MANCOVA) for age and disease duration.

Results: The cohort was 64.8% male and 35.2% female, with mean (SD) age of 68.71 (10.91) and 68.86 (12.08) years and disease duration 6.44 (6.31) and 6.54 (8.22) years, for men and women respectively. PD onset age and disease duration differed by gender, while TD/PIGD classifications did not. Males scored worse on MDS-UPDRS Part II Factor 1 (fine motor functions) (p < 0.0005), Part III Factors 3 (rigidity) (p = 0.003) and 6 (upper extremity tremor) (p = 0.012), while females scored worse on Part I Factor 2 (depression, anxiety, apathy) (p = 0.011), Part II Factor 3 (dressing, hygiene, walking, balance, freezing) (p = 0.024), Part III Factors 5 (upper extremity bradykinesia) (p = 0.019) and 7 (lower extremity bradykinesia) (p = 0.010).

Conclusions: Based upon the MDS-UPDRS, gender may affect certain aspects of motor and non-motor features and experiences of daily living in PD. Recognition of worse fine motor functions, rigidity, and upper extremity tremor in males and worse mood, dressing ability and bradykinesia in females may influence treatments in PD in the future.

References: Goetz, Christopher G, et al. “Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results.” Movement disorders 23.15 (2008):2129-2170. Web.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/gender-differences-in-motor-and-non-motor-features-across-the-parkinsons-disease-spectrum/