Non-Motor Symptoms Different Among Men and Women, Study Shows

Non-motor symptoms (NMS) in Parkinson’s disease are significantly more frequent and differ between men and women, a new study shows.

The study, “Frequency of non-motor symptoms in Parkinson’s disease presenting to tertiary care centre in Pakistan: an observational, cross-sectional study,” was published in the journal BMJ Open.

Parkinson’s NMS include anxiety, depression, dementia, psychosis, sleep impairment, pain, fatigue, constipation, and sexual dysfunction.

Although NMS are common and most of them treatable, some, such as bowel incontinence or sexual dysfunction, may be under-reported due to embarrassment or lack of awareness that they may be associated with Parkinson’s. Prior research in the U.S. has indicated that phsysicians failed to recognize anxiety, depression and fatigue in more than half of encounters with patients.

To determine the frequency of non-motor symptoms in Parkinson’s patients, researchers used the 30-item NMS questionnaire, which is intended to empower patients and caregivers to report relevant NMS not otherwise discussed in routine clinical visits.

This questionnaire has been independently validated and is recommended by the U.K.’s Department of Health for use in clinical practice.

The study included 85 adult Parkinson’s patients who came to a movement disorder clinic at a tertiary care center in Lahore, Pakistan. The team evaluated NMS’ pattern and analyzed potential differences between men and women.

Results revealed a mean of nearly seven different NMS per patient. Constipation (56%) and nocturia (frequent urination at night, 49%) were the most common NMS, while 35% of patients reported urinary urgency.

As for neuropsychiatric complications, 47% of patients reported low mood and sadness, while 36% reported anxiety/panic, and 45% short-term memory impairment.

Light-headedness and dizziness were reported by 40%, sexual dysfuntion by 30%, difficulty falling asleep by 29%, pain unrelated to the musculoskeletal system by 30%, and loss or change in the ability to taste or smell by 29%. All other NMS, including daytime sleepiness, were under 25% in frequency.

Regarding sex differences, feeling sad or blue, light-headededness and dizziness, unexplained pain, unpleasant sensations in the legs while at rest, difficulty in swallowing, and faecal incontinence were the most frequently reported NMS in women; men reported constipation, nocturia, and problems with memory more often.

Male patients reported sexual dysfunction more frequently than women, which the authors attribute to women in Pakistan being uncomfortable with discussing intimate issues.

Among the study’s limitations, the scientists mentioned the low number of women (15), which they hypothesize may be due to men seeking medical care more often.

“In this study we have shown the high frequency of NMS in patients with [Parkinson’s] in Pakistan … Certain NMS are more common in women as compared with men,” researchers wrote, adding that the findings warrant large-scale study to assess the sex-specific incidence of NMS in Parkinson’s patients.