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Meta-Analysis
. 2024 Nov;11(11):1335-1344.
doi: 10.1002/mdc3.14227. Epub 2024 Oct 9.

Sex Differences in Neuropsychiatric Symptoms in Alpha-Synucleinopathies: A Systematic Review and Meta-Analysis

Vincent Couture  1 , Jean-François Carmel  2 , Katerine Rousseau  1 , Geneviève Létourneau  1 , Doris Clerc  2 , Philippe Huot  3   4 , Marie-France Forget  5 , Quoc Dinh Nguyen  5   6 , Richard Camicioli  7 , Philippe Desmarais  5   6
Affiliations
Meta-Analysis

Sex Differences in Neuropsychiatric Symptoms in Alpha-Synucleinopathies: A Systematic Review and Meta-Analysis

Vincent Couture et al. Mov Disord Clin Pract. 2024 Nov.

Abstract

Background: Alpha-synucleinopathies, such as Parkinson's disease (PD), Parkinson's disease dementia (PDD), and dementia with Lewy bodies (DLB), demonstrate sex differences with regard to prevalence, age of onset, and motor manifestations. Neuropsychiatric symptoms (NPS) are common early and late manifestations of these disorders.

Objectives: We aimed to describe sex differences in NPS across alpha-synucleinopathies.

Methods: We searched Web of Science Core collection databases to identify observational studies published between January 1, 2000, and June 1, 2022, reporting the prevalence or severity of NPS among individuals with a diagnosis of PD, PDD, or DLB. Prevalence and severity were pooled for each NPS according to sex using random-effects models.

Results: Two-hundred-and-forty studies, representing 796,026 participants (45% females), were included in the meta-analysis. Female sex was associated with a higher prevalence of anxiety (OR = 1.60 [95% CI: 1.40, 1.82]), depression (OR = 1.56 [1.45, 1.67]), fatigue (OR = 1.21 [1.02, 1.43]), and psychotic symptoms (OR = 1.26 [1.14, 1.40]) and more severe anxiety (g = 1.35 [95% CI: 0.58, 2.13]), depression (g = 1.57 [1.05, 2.08]), and fatigue (g = 0.86 [0.41, 1.32]), while male sex was associated with a higher prevalence of apathy (OR = 0.77 [0.63, 0.93]), impulse control disorders (OR = 0.67 [0.55, 0.82]), REM sleep behavior disorder (OR = 0.54 [0.42, 0.70]), hypersomnolence (OR = 0.67 [0.56, 0.80]), and suicide (OR = 0.30 [0.20, 0.44]).

Conclusions: NPS have different prevalences and severities in alpha-synucleinopathies according to sex. These findings support consideration of sex in the elaboration of clinical tools.

Keywords: Parkinson's disease; alpha‐synucleinopathy; dementia with Lewy bodies; neuropsychiatric symptoms; sex differences.

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Figures

Figure 1
Figure 1
PRISMA Flow chart of study selection and reasons for exclusion. NPS, neuropsychiatric symptom.
Figure 2
Figure 2
Prevalence and severity of neuropsychiatric symptoms in alpha‐synucleinopathies according to sex. REM, Rapid eye movement.
Figure 3
Figure 3
Radar plot summarizing pooled prevalences of neuropsychiatric symptoms in alpha‐synucleinopathies according to sex in observational studies. Percentages between parentheses represent overall pooled prevalences (females and males). Asterisk symbols denote statistically significant sex differences. REM, rapid eye movement.
See this image and copyright information in PMC

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