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Sex Differences in Neuropsychiatric Symptoms in Alpha-Synucleinopathies: A Systematic Review and Meta-Analysis
Vincent Couture1, Jean-François Carmel2, Katerine Rousseau1
1Department of Psychiatry, Division of Geriatric Psychiatry, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.
Movement Disorders Clinical Practice
|October 10, 2024
Summary
Neuropsychiatric symptoms (NPS) manifest differently in alpha-synucleinopathies between sexes. This meta-analysis reveals distinct NPS prevalence and severity in Parkinson's disease (PD), dementia with Lewy bodies (DLB), and Parkinson's disease dementia (PDD) based on sex.
Area of Science:
- Neurology
- Psychiatry
- Genetics
Background:
- Alpha-synucleinopathies, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and Parkinson's disease dementia (PDD), exhibit known sex-based variations in disease progression and presentation.
- Neuropsychiatric symptoms (NPS) are significant early and late-stage manifestations in these neurodegenerative conditions.
Approach:
- A comprehensive meta-analysis was conducted, synthesizing data from 240 observational studies published between 2000 and 2022.
- Prevalence and severity data for NPS were extracted from studies involving individuals diagnosed with PD, DLB, or PDD, encompassing 796,026 participants.
- Random-effects models were employed to pool NPS data stratified by sex.
Key Points:
- Female sex was linked to increased prevalence and severity of anxiety, depression, and fatigue, alongside higher rates of psychotic symptoms.
- Male sex showed a higher prevalence of apathy, impulse control disorders, REM sleep behavior disorder, hypersomnolence, and suicide.
- Significant sex-based differences were observed in the prevalence and severity of various NPS across alpha-synucleinopathies.
Conclusions:
- Neuropsychiatric symptoms present with distinct patterns of prevalence and severity between males and females in alpha-synucleinopathies.
- These sex-specific differences underscore the importance of considering sex as a critical factor in the development and refinement of clinical diagnostic and management tools for these disorders.
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