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Erectile Dysfunction Preceding Clinically Diagnosed α-Synucleinopathies: A Case-Control Study in Olmsted County
Shemonti Hasan1, Michelle M Mielke1,2, J Eric Ahlskog1
1Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Parkinson'S Disease
|May 17, 2019
Summary
Erectile dysfunction (ED) may be an early sign of alpha-synuclein disorders like Multiple System Atrophy (MSA) and Dementia with Lewy Bodies (DLB). This study found ED preceded motor symptoms in these conditions, but not Parkinson's Disease (PD) or PDD.
Area of Science:
- Neurology
- Autonomic Dysfunction
- Neurodegenerative Diseases
Background:
- Autonomic symptoms, including erectile dysfunction (ED), are common in alpha-synuclein disorders such as Multiple System Atrophy (MSA), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), and Parkinson's Disease with Dementia (PDD).
- These symptoms can manifest years before motor or cognitive deficits, indicating potential as early diagnostic markers.
- ED has been understudied as a premotor symptom in these conditions.
Purpose of the Study:
- To investigate the association between premonitory erectile dysfunction (ED) and the subsequent clinical diagnosis of alpha-synucleinopathies.
- To determine if ED serves as an early indicator for specific types of alpha-synuclein disorders.
Main Methods:
- A population-based, case-control study utilizing the Rochester Epidemiology Project medical record-linkage system.
- Identification of male cases diagnosed with alpha-synucleinopathies (MSA, PD, DLB, PDD) in Olmsted County between 1991 and 2010.
- Matching cases with age- and sex-matched controls and reviewing medical records to identify pre-clinical ED, followed by conditional logistic regression analysis.
Main Results:
- A history of ED showed a 1.5-fold increased odds of any alpha-synucleinopathy diagnosis (p=0.06).
- Premotor ED was significantly more frequent in MSA (45% vs. 9%) and DLB (46% vs. 27%) cases compared to controls.
- Adjusted analysis for DLB revealed an odds ratio of 2.98 (p=0.04) for ED, while no significant association was found for PD or PDD.
Conclusions:
- Early erectile dysfunction may serve as a premotor symptom for Multiple System Atrophy (MSA) and Dementia with Lewy Bodies (DLB).
- Premotor ED suggests premonitory dysautonomia in these specific alpha-synuclein disorders.
- Erectile dysfunction was not found to be a significant premotor symptom for Parkinson's Disease (PD) or Parkinson's Disease with Dementia (PDD).
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