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Parkinson’s in Women and Men: recognising the differences
Why is it important?
Factoring gender into research is an essential step toward precision medicine, and developing personalized treatments that work for both women and men.
These important clinical differences necessitate different approaches reflected in tailored medication regimes, psychiatric, dietician, speech and language, and physiotherapy input, and must be taken into account when designing clinical trials. In terms of response to treatments, because of these and other gender differences related to metabolism, women absorb and respond to levodopa more readily, and clear it more slowly than men, suggesting that timing in medication regimes will need to be individually tailored. Women also tend to report greater benefit in terms of quality of life from DBS (deep brain stimulation) compared to men.
The issue of gender is especially important when developing disease modifying approaches to Parkinson’s, as biochemical differences are also present. For example, several studies have highlighted the important role of oestrogen, a female sex hormone, which impacts on how neurons as well as glia, which play a host of roles in inflammation, develop and respond in Parkinson’s. Research has also shown that mitochondria, the powerhouses within neurons, tend to be exposed to lower levels of oxidative stress in women, yet are more vulnerable to excessive levels of calcium compared to mitochondria in men. Findings such as this suggest that different neuroprotective approaches may be suited to women compared to men.