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Tayim N, Barbosa P, Panicker J. Hypersexuality in neurological disorders: A systematic review. BMJ MENTAL HEALTH 2024; 27:e300998. [PMID: 38777563 PMCID: PMC11116864 DOI: 10.1136/bmjment-2024-300998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Hypersexuality (HS) accompanying neurological conditions remains poorly characterized despite profound psychosocial impacts. Objective We aimed to systematically review the literature on HS in patients with neurological disorders. Study selection and analysis We conducted a systematic review to identify studies that reported HS in neurological disorders. HS was defined as a condition characterized by excessive and persistent preoccupation with sexual thoughts, urges, and behaviors that cause significant distress or impairment in personal, social, or occupational functioning. Data on demographics, assessment techniques, associated elements, phenotypic manifestations, and management strategies were also extracted. Findings The final analysis included 79 studies on HS, encompassing 32 662 patients across 81 cohorts with neurological disorders. Parkinson's disease was the most frequently studied condition (55.6%), followed by various types of dementia (12.7%). Questionnaires were the most common assessment approach for evaluating HS, although the techniques varied substantially. Alterations in the dopaminergic pathways have emerged as contributing mechanisms based on the effects of medication cessation. However, standardized treatment protocols still need to be improved, with significant heterogeneity in documented approaches. Critical deficiencies include risks of selection bias in participant sampling, uncontrolled residual confounding factors, and lack of blinded evaluations of reported outcomes. Conclusions and clinical implications Despite growth in the last decade, research on HS remains limited across neurological conditions, with lingering quality and methodological standardization deficits. Key priorities include advancing assessment tools, elucidating the underlying neurobiology, and formulating management guidelines. PROSPERO REGISTRATION NUMBER CRD42017036478.
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Affiliation(s)
- Natalie Tayim
- Department of Psychology, Doha Institute for Graduate Studies, Doha, Qatar
| | - Pedro Barbosa
- Movement Disorders Group, Department of Neurology, University of Sao Paulo, Sao Paulo, Brazil
| | - Jalesh Panicker
- Uro-Neurology, National Hospital for Neurology and Neurosurgery, London, UK
- Faculty of Brain Sciences, UCL Queen Square Institute of Neurology, London, UK
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Deebel NA, Thai K, Ramasamy R, Terlecki RP. Understanding the dopaminergic pathway relative to men's sexual dysfunction in patients with Parkinson's disease: a narrative review with implications for future research. Int J Impot Res 2024; 36:181-185. [PMID: 36572757 DOI: 10.1038/s41443-022-00656-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/28/2022]
Abstract
Parkinson's disease (PD) is often most recognized for motor symptoms but associated non-motor symptoms such as sexual dysfunction can significantly impact quality of life. This condition involves a hormonal disruption and has a predilection for male patients, yet there are no formal guidelines for screening or management of sexual health pathology in these patients. While prior publications have addressed the presence of sexual dysfunction (SD) among men with PD, there has been a paucity of work examining the hypothalamic-pituitary-gonadal (HPG) axis and the interplay between dopamine, prolactin (PRL), and testosterone. This review provides an overview of data extracted from the existing peer-reviewed literature regarding hormonal and sexual health changes in men with PD and the impact of dopaminergic and/or androgen replacement therapy. Furthermore, while some research suggests that PD patients are at higher risk for prolactin elevation and testosterone deficiency, heterogeneity of the data limits extrapolation. Additionally, data related to pharmacologic optimization of the HPG axis in this patient population is similarly limited. Prospective studies are needed to better characterize the hormonal pathophysiology of PD as it relates to sexual dysfunction such that men at risk can be effectively identified so as to offer interventions that may improve quality of life.
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Affiliation(s)
- Nicholas A Deebel
- Department of Urology, Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Kim Thai
- Department of Urology, Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Ranjith Ramasamy
- Desai Sethi Urological Institute Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Ryan P Terlecki
- Department of Urology, Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA.
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Deraz HADA, Amer HAH, Suleiman MR, Dahshan A. Sexual dysfunction in a sample of Egyptian patients with Parkinson's disease. Neurol Sci 2024; 45:1071-1077. [PMID: 37783941 PMCID: PMC10857947 DOI: 10.1007/s10072-023-07091-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Sexual dysfunction (SD) is a common, yet underdiagnosed problem in Parkinson Disease (PD) patients. It can negatively impact their quality of life (QoL) and clinical outcome. we tried to assess SD in a group of Egyptian PD patients. METHODS The study is a case-control, cross-sectional study that included 200 participants, consisting of 100 PD patients and 100 matched healthy controls. Social, demographic information, and clinical variables were collected from both groups. Sexual functions were assessed using the Arabic Female Sexual Function Index (ArFSFI), and the Arabic version of International Index of Erectile Function (IIEF). RESULTS Women with PD scored worse on FSFI total score compared to controls (p < 0.001). Regarding the FSFI domains, they scored significantly lower in individual domains of desire (p < 0.001), arousal (p < 0.001), lubrication (p = 0.006), orgasm (p < 0.001), satisfaction (p < 0.001), and pain (p = 0.003), compared with controls. Men with PD scored worse on IIEF total scores compared to controls (p < 0.001). They showed significantly worse scores of erectile functions (p < 0.001), orgasmic function (p < 0.001), sexual desire (p < 0.001), intercourse satisfaction (p < 0.001), and overall satisfaction (p < 0.001). Both groups reported significant effect of SD on their QoL. There was a significant correlation between disease severity and SD. CONCLUSION SD is common in PD patients. It negatively impacts their QoL and partnership. Healthcare professionals should initiate conversations about SD with the patients and provide appropriate education and treatment options.
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Souza BRA, Nóbrega KCC, Silva BEDAD, Gonçalves RA, Martins TS, Santos GF, Frazão AH, Roque AC, Nascimento IAPDS, Piemonte MEP. The Impact of Motor, Non-Motor, and Social Aspects on the Sexual Health of Men Living with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:565-574. [PMID: 38427499 DOI: 10.3233/jpd-230212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Background Sexual health (SH) is influenced by several biological, mental, and social factors that may be negatively impacted by Parkinson's disease (PD). Despite its prevalence and relevance for quality of life, the factors that affect SH in men with PD (MwPD) are still poorly understood. Objectives To investigate the impact of motor, non-motor, and social aspects on the SH in MwPD. Methods We conducted a cross-sectional study of 80 men (mean-age 53.55±10.8) in stages 1-3 of Hoehn and Yahr classification (H&Y), who reported having an active sex life in the last six months. The following data were collected for each person: 1) Demographic and clinical features; 2) global cognitive capacity (T-MoCA); 3) Non-Motor Aspects of Experiences of Daily Living (MDS-UPDRS, part I); 4) Motor Aspects of Experiences of Daily Living (MDS-UPDRS, part II); 5) Fatigue (FSS); 6) Self-esteem (RSES); 7) Sleep disorder (PDSS); 8) Couple relationship quality (DAS); 9) Depressive signals (BDI); 10) Short-term sexual health by International Index of Erectile Function (IIFE); and 11) Long-term sexual health by Sexual Quotient-Male (SQ-M). Results Our results showed that although several motor, non-motor, and social factors were correlated with SH, only motor disability levels in daily living predicted short-term SH and erectile dysfunction, while only depression predicted long-term SH in MwPD. Age, disease onset, and medication daily dosage were not correlated with SH. Conclusions Our findings confirm that multidimensional factors can affect the SH of MwPD and emphasize that only a multi-professional team can offer proper care to improve SH in MwPD.
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Affiliation(s)
| | - Kátia Cirilo Costa Nóbrega
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School, University of São Paulo, São Paulo, Brazil
| | | | | | - Thalyta Silva Martins
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School, University of São Paulo, São Paulo, Brazil
| | - Geovanna Ferreira Santos
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School, University of São Paulo, São Paulo, Brazil
| | - André Helene Frazão
- Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | - Antonio Carlos Roque
- Department of Physics, School of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Maria Elisa Pimentel Piemonte
- Department of Neuroscience and Behavior, Institute of Psychology, University of São Paulo, Brazil
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School, University of São Paulo, São Paulo, Brazil
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De Groote C, Dujardin K, Defebvre L, Flinois B, Herlin V, Carrière N, Wawrziczny E. Development of a Screening Tool for Assessing Sexual Difficulties Among Patients with Parkinson's Disease: The PD-SDS. JOURNAL OF PARKINSON'S DISEASE 2024; 14:1015-1025. [PMID: 38905057 PMCID: PMC11307097 DOI: 10.3233/jpd-240063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/24/2024] [Indexed: 06/23/2024]
Abstract
Background People with Parkinson's disease (PwPD) exhibit various sexual difficulties (SDs) that may be due to motor and/or nonmotor symptoms or the use of antiparkinsonian medication. SDs are often underreported by PwPD and underexplored by physicians. Objective This study aimed to explore the SDs experienced by PwPD and create a scale for assessing them. Methods A corpus of items was generated from semistructured interviews to represent the experience of PwPD as closely as possible. The number of items was reduced according to the psychometric properties, and the scale's structure was subsequently examined. The final phase consisted of measuring the scale's validity and reliability. Results After assessment of the original corpus of 59 items by PwPD and clinicians, a 25-item version was obtained. The analysis of item properties led to the removal of fifteen items. An exploratory factor analysis of the first 10-item version with a first PwPD sample identified four components of the SDs among PwPD: "low sexual esteem," "sexual displeasure," "impact on sexual position" and "hypersexuality." With a second PwPD sample, a confirmatory factor analysis demonstrated a satisfactory fit between the model with four components and the data. The 10-item scale had good internal consistency and good temporal reliability. Conclusions The Parkinson's Disease Sexual Difficulties Scale (PD-SDS) is a valid screening tool that facilitates the investigation of and communication about PD-related SDs. It is intended to improve the identification of vulnerable PwPD and to target the domain of sexual experience impacted by PD to better support PwPD.
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Affiliation(s)
- Clara De Groote
- Lille University, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Kathy Dujardin
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
- Lille University, Inserm, CHU Lille, U1172 – LilNCog – Lille Neuroscience & Cognition, Lille, France
| | - Luc Defebvre
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
- Lille University, Inserm, CHU Lille, U1172 – LilNCog – Lille Neuroscience & Cognition, Lille, France
| | - Bérengère Flinois
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
| | - Virginie Herlin
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
| | - Nicolas Carrière
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
- Lille University, Inserm, CHU Lille, U1172 – LilNCog – Lille Neuroscience & Cognition, Lille, France
| | - Emilie Wawrziczny
- Lille University, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
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Vafaeimastanabad M, Salemi MH, Jodki T, Sabri V, Talab EK, Babaei FN, Manesh SE, Emami D. Sexual dysfunction among patients with Parkinson's disease: A systematic review and meta-analysis. J Clin Neurosci 2023; 117:1-10. [PMID: 37717275 DOI: 10.1016/j.jocn.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/10/2023] [Accepted: 09/12/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Previous studies have reported a higher prevalence of sexual dysfunction (SD) in patients with Parkinson's disease (PD). In the current study, we aimed to conduct a systematic review and meta-analysis to investigate the role of PD as a potential risk factor for SD in both genders. METHODS We performed a comprehensive search on PubMed, Embase, Scopus, and Web of Science. All observational studies comparing the prevalence of SD in PD with the general population were included. RESULTS After screening 22 studies were included in our qualitative and statistical analysis. We included 13 studies that reported odds ratio (OR) and found a significant association between PD and SD (pooled OR = 3.5, 95% CI = 2.19-5.58). Five studies included only male patients and reported an OR of 3.34 (95% CI = 1.34-8.35; heterogeneity I2 = 81%, Tau2 = 0.79, p < 0.00), while seven studies included both sexes and reported an OR of 3.55 (95% CI = 1.89-6.66; heterogeneity I2 = 78%, Tau2 = 0.53, p < 0.00). CONCLUSION In conclusion, our study suggests a strong association between PD and SD in both men and women. Our analysis of 22 observational studies reveals that the prevalence of sexual dysfunction is significantly higher in patients with PD compared to the general population. These findings highlight the importance of addressing SD as part of the comprehensive management of patients with PD.
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Affiliation(s)
- Mahsa Vafaeimastanabad
- Neurosurgery Department, Faculty of Medicine, Qazvin University of Medical Science, Qazvin, Iran
| | | | - Tahereh Jodki
- Department of Clinical Psychology, Sirjan Branch, Islamic Azad University, Sirjan, Iran
| | - Vahid Sabri
- Department of Nursing, Khoy University of Medical Science, Khoy, Iran
| | | | | | | | - Delaram Emami
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Soares GM, Bouça‐Machado R, Abreu D, Ferreira JJ. Contributory Factors to Caregiver Burden in Parkinson's Disease. Mov Disord Clin Pract 2023; 10:1507-1518. [PMID: 37868922 PMCID: PMC10585976 DOI: 10.1002/mdc3.13868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/19/2023] [Accepted: 07/16/2023] [Indexed: 10/24/2023] Open
Abstract
Background Although there is growing recognition of the relevancy of informal caregivers there is scarce information on the contributory factors of caregiver burden in Parkinson's Disease (PD). Objective To identify the main associated factors to caregivers' burden in people caring for a person with PD. Methods We analyzed the data set from a multinational online survey the Parkinson's real-world impact assesSMent (PRISM) focusing on medication use, comorbidities, health-related quality of life, relationship changes and the use of healthcare and supportive care resources by people with PD and their carers. Structured questionnaires including the Parkinson's disease quality of life questionnaire (PDQ-39), non-motor symptoms questionnaire (NMSQuest) and the Questionnaire for impulsive-compulsive disorder in Parkinson's disease (QUIP) were applied. Caregiver burden was assessed by the Zarit Burden Interview (ZBI). Results In a cohort of 245 dyads (patient and respective caregiver), caregivers reported a mild to moderate burden. Carers' perception of PD impact in partnership, financial burden, hours of care, patient's age, hypersexuality and health-related quality of life (HRQoL) were found to be significant contributory factors to caregiver burden. Taken together these variables explained 66.8% of the variance in the Interpretation of the ZBI total score. Conclusions Caring for a person with PD entails substantial burden, particularly when the caregiver perceives greater changes in partnership dynamics, dedicates more time to caregiving tasks, has financial burden, and when the patient is older, reports worst HRQoL and has sexual compulsive urges.
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Affiliation(s)
| | - Raquel Bouça‐Machado
- CNS‐Campus NeurológicoTorres VedrasPortugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
| | - Daisy Abreu
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
| | - Joauqim J. Ferreira
- Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
- CNS‐Campus NeurológicoTorres VedrasPortugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
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Chiew A, Mathew D, Kumar CM, Seet E, Imani F, Khademi SH. Anesthetic Considerations for Cataract Surgery in Patients with Parkinson's Disease: A Narrative Review. Anesth Pain Med 2023; 13:e136093. [PMID: 38021330 PMCID: PMC10664173 DOI: 10.5812/aapm-136093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 12/01/2023] Open
Abstract
Parkinson's disease (PD) is a chronic neurological degenerative disease affecting the central nervous system, which is responsible for progressive disorders such as slow movements, tremors, rigidity, and cognitive disorders. There are no specific recommendations and guidelines for anesthetic management of patients with PD undergoing ophthalmic procedures. This narrative review aims to summarise the anesthetic considerations in patients with PD presenting for cataract surgery.
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Affiliation(s)
- Alyssa Chiew
- Department of Anaesthesia, Khoo Teck Puat Hospital, Yishun, Singapore
| | - David Mathew
- Department of Anaesthesia, Khoo Teck Puat Hospital, Yishun, Singapore
| | - Chandra M. Kumar
- Department of Anaesthesia, Khoo Teck Puat Hospital, Yishun, Singapore
| | - Edwin Seet
- Department of Anaesthesia, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Farnad Imani
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed-Hossein Khademi
- Department of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Caregiver Burden in Movement Disorders and Neurodegenerative Diseases: Editorial. Brain Sci 2022; 12:brainsci12091184. [PMID: 36138919 PMCID: PMC9497330 DOI: 10.3390/brainsci12091184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022] Open
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