 |
|
Refractory Nonmotor Symptoms in Male Patients With Parkinson Disease Due to Testosterone Deficiency
A Common Unrecognized Comorbidity
Michael S. Okun, MD;
William M. McDonald, MD;
Mahlon R. DeLong, MD
Arch Neurol. 2002;59:807-811.
Background Many patients with Parkinson disease (PD) suffer from nonmotor symptoms
including depression, anxiety, sexual dysfunction, decreased energy level,
and an overall decline in quality of life. Comorbid depression, hypothyroidism,
and sleep disorders may account for some, but not all, of these problems.
Testosterone deficiency affects 20% to 25% of males over the age of 60 years
in the general population and may cause signs and symptoms of the nonmotor
symptoms seen in PD. We observed numerous patients with PD whose nonmotor
symptoms were refractory to treatment.
Objective To determine whether treatment of comorbid testosterone deficiency in
male patients with PD can lead to improvements in refractory nonmotor symptoms.
Methods Case studies were reviewed of the first 5 male patients who had PD with
symptoms of testosterone deficiency who were treated in our clinic. All patients
had low serum testosterone levels. Screening for testosterone deficiency symptoms
using the St Louis Testosterone Deficiency Questionnaire was performed for
4 of the 5 patients. Additionally, to assess the prevalence of PD, total testosterone
levels in 68 patients in our PD registry were sent for evaluation.
Results Following testosterone replacement therapy, all 5 patients experienced
significant improvements in their refractory nonmotor symptoms. Of 68 male
patients with PD enrolled in our PD registry, 24 (35%) had plasma evidence
of testosterone deficiency. We also noted that the risk of testosterone deficiency
per decade was found to increase 2.8-fold per decade (P<.001),
paralleling that which is found in the general elderly male population.
Conclusions The findings from this study reveal the heretofore unrecognized high
prevalence of testosterone deficiency in elderly male patients with PD similar
to that found in the general population. These symptoms, which may be refractory
to antidepressants, anxiolytics, and antiparkinsonian medications, may respond
to treatment with testosterone. More rigorous controlled studies will need
to be undertaken to examine the treatment of this common comorbidity in male
patients with PD.
From the Departments of Neurology (Drs Okun and DeLong) and Psychiatry
and Behavioral Sciences (Dr McDonald), Emory University, Atlanta, Ga.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
Archives of Neurology Reader's Choice: Continuing Medical Education
Arch Neurol. 2002;59(5):878-880.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Erectile Function and Risk of Parkinson's Disease
Gao et al.
Am J Epidemiol 2007;166:1446-1450.
ABSTRACT
| FULL TEXT
Testosterone Therapy in Men With Parkinson Disease: Results of the TEST-PD Study.
Okun et al.
Arch Neurol 2006;63:729-735.
ABSTRACT
| FULL TEXT
Testosterone deficiency and apathy in Parkinson's disease: a pilot study
Ready et al.
J. Neurol. Neurosurg. Psychiatry 2004;75:1323-1326.
ABSTRACT
| FULL TEXT
Plasma testosterone levels in Alzheimer and Parkinson diseases
Okun et al.
Neurology 2004;62:411-413.
ABSTRACT
| FULL TEXT
Testosterone deficiency in a Parkinson's disease clinic: results of a survey
Okun et al.
J. Neurol. Neurosurg. Psychiatry 2004;75:165-166.
FULL TEXT
Beneficial Effects of Testosterone Replacement for the Nonmotor Symptoms of Parkinson Disease
Okun et al.
Arch Neurol 2002;59:1750-1753.
ABSTRACT
| FULL TEXT
Is Testosterone Deficiency a Cause of Nonmotor Symptoms in PD?
JWatch Psychiatry 2002;2002:13-13.
FULL TEXT
Is Testosterone Deficiency a Cause of Nonmotor Symptoms in PD?
JWatch Neurology 2002;2002:3-3.
FULL TEXT
|
