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. 2021 Feb;268(2):448-454.
doi: 10.1007/s00415-020-10156-3. Epub 2020 Aug 18.

The PRIAMO study: age- and sex-related relationship between prodromal constipation and disease phenotype in early Parkinson's disease

Marina Picillo  1 , Raffaele Palladino  2   3 , Roberto Erro  1 , Rossella Alfano  3 , Carlo Colosimo  4 , Roberto Marconi  5 , Angelo Antonini  6 , Paolo Barone  7 ; PRIAMO study group
Collaborators, Affiliations

The PRIAMO study: age- and sex-related relationship between prodromal constipation and disease phenotype in early Parkinson's disease

Marina Picillo et al. J Neurol. 2021 Feb.

Abstract

Objectives: To explore the impact of sex and age on relationship between prodromal constipation and disease phenotype in Parkinson's disease at early stages.

Methods: A total of 385 Parkinson's disease patients from the PRIAMO study were classified according to the presence of prodromal constipation and followed for 24 months. Multivariable mixed-effect models were applied. All analyses were performed separately for sex (64.1% men) and median age (different by sex: 67 years-old in men and 68 years-old in women).

Results: As for sex, prodromal constipation was associated with greater odds of attention/memory complaints and apathy symptoms in women only. As for age, prodromal constipation was associated with lower cognitive and higher apathy scores in older patients only.

Conclusions: Prodromal constipation anticipates lower cognitive performances and more severe apathy since the earliest stages in women and older patients. Sex- and age-related heterogeneity of prodromal markers of Parkinson's disease may impact disease phenotype.

Keywords: Constipation; Heterogeneity; Parkinson; Phenotype; Prodromal; Sex.

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Conflict of interest statement

MP is supported by the Michael J Fox Foundation for Parkinson’s research; PB received consultancies as a member of the advisory board for Zambon, Lundbeck, UCB, Chiesi, Abbvie and Acorda; RE received speaking honoraria from Bial and the Movement Disorder Society; AA received personal fees from Abbvie, UCB, Zambon, Boehringer Ingelheim, Ever Pharm, Neuroderm, Chiesi Farmaceutici, Lundbeck and grants from Horizon 2020 and Italian Ministry of Health; CC received personal fees from Sunovion, Zambon, Ipsen, Merz, UCB; other authors declare no relevant financial disclosures or conflict of interest.

Figures

Fig. 1
Fig. 1
Age dependence of predictive values of prodromal constipation (PC) for higher Hamilton Depression scale (HAM) (a) and lower Mini-mental State Examination (MMSE) (b). Error bars indicate 95% confidence intervals. Asterisks indicate significant interaction effect in linear regression models (p < 0.05)
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