Objective: To compare pain, fatigue and nausea variables between sexes to see if there is a significant difference.

Background: Patients with PD present motor and non-motor symptoms. Pain and fatigue in PD are influenced by a combination of psychological factors (i.e. depression and anxiety), motor complications, and sleep disturbances. Addressing these factors can improve the quality of life for PD patients. The study of these variables and the difference in predominance between sexes could be beneficial to understand quality of life and improve treatment.

Method: The study involved participants with PD recruited through the Mexican Parkinson’s Research Network (MEX-PD). Pain, nausea when standing up, and fatigue were assessed using items 1.9, 1.12, and 1.13 of the Parkinson’s Disease Rating Scale (UPDRS), respectively, in a subset of 137 female and 137 male PD patients. Analyses included complete datasets, with exact matching for comparisons between women and men, and nearest matching for age adjustment. Statistical analyses were performed using the R version 4.4.1 and included the Wilcoxon rank-sum test, the Chi-square test, linear regression and logistic regression.

Results: Using the Wilcoxon rank-sum test, it was observed that there is no significant difference between sexes for the pain item (p = 0.198), however for the fatigue (p = 0.0043) and nausea (p = 0.0135) items, a significant difference was observed. Using the Chi-square test, it can be seen that no significant p values ​​were found for pain (p = 0.871), fatigue (p = 0.528), or nausea (p = 0.649). A linear regression, showing  the pain variable, suggests that there is no relationship with sexes. For the fatigue item, there is a relationship with sex, motor symptoms and the use of levodopa. For nausea, a relationship is observed with motor symptoms and the use of levodopa.

Conclusion: This study suggests that there is no significant relationship between the UPDRS pain item and sexes. However, the fatigue item shows a significant difference between sexes, with women being more affected. In addition, there is a relationship with motor symptoms, which could mean that the more motor symptoms, the greater the fatigue. For the nausea item, as with fatigue, a relationship is observed with motor symptoms, and with the use of levodopa, which is correlated to the increase of nausea.

Table 1. Sex-based variable distribution

Figure 1. Distribution of age by sex

Figure 2. Score distribution of pain

Figure 3. Score distribution of fatigue

Figure 4. Score distribution of nausea

References: [1] Josephson, S.A. (2010). Harrison´s Neurology in Clinical Medicine (Second Edition ed., Vol. Derived from Harrison´s Principles of Internal Medicine, 17th Edition.). Stephen L. Hauser.
[2] ER, D., T, H., MS, O., & BR, B. (2018). The Emerging Evidence of the Parkinson Pandemic (1st ed.). J Parkinsons Dis.
[3] Jagadeesan AJ, Murugesan R, Vimala Devi S, et al (2017). Current trends in etiology, prognosis and therapeutic aspects of Parkinson’s disease: a review. PubMed. https://pubmed.ncbi.nlm.nih.gov/29083328/
[4] Haaxma, C. A., Bloem, B. R., Borm, G. F., Oyen, W. J. G., Leenders, K. L., Eshuis, S., Booij, J., Dluzen, D. E., & Horstink, M. W. I. M. (2006). Gender differences in Parkinson’s disease. Journal Of Neurology Neurosurgery & Psychiatry, 78(8), 819-824. https://doi.org/10.1136/jnnp.2006.103788
[5] Russillo, M. C., Andreozzi, V., Erro, R., Picillo, M., Amboni, M., Cuoco, S., Barone, P., & Pellecchia, M. T. (2022). Sex Differences in Parkinson’s Disease: From Bench to Bedside. Brain Sciences, 12(7), 917. https://doi.org/10.3390/brainsci12070917
[6] Hagell, P., & Brundin, L. (2009). Towards an understanding of fatigue in Parkinson disease. Journal Of Neurology Neurosurgery & Psychiatry, 80(5), 489-492. https://doi.org/10.1136/jnnp.2008.159772
[7] Berardelli, A. et al (2012) Pathophysiology of pain and fatigue in Parkinson’s disease. Parkinsonism & Related Disorders, Volume 18, S226 – S228
[8] Siciliano, M., Trojano, L., Santangelo, G., De Micco, R., Tedeschi, G., & Tessitore, A. (2018). Fatigue in Parkinson’s disease: A systematic review and meta‐analysis. Movement Disorders, 33(11), 1712-1723. https://doi.org/10.1002/mds.27461
[9] Bove, C., & Travagli, R. A. (2019). Neurophysiology of the brain stem in Parkinson’s disease. Journal Of Neurophysiology, 121(5), 1856-1864. https://doi.org/10.1152/jn.00056.2019

« Back to 2025 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/sex-variations-in-non-motor-symptoms-pain-fatigue-and-nausea-in-parkinsons-disease-patients-an-analysis-from-the-mexican-parkinsons-research-network/