Sexual Dysfunction in Early-Onset Parkinson's Disease: A Cross-Sectional, Multicenter Study.

BACKGROUND: Sexual dysfunction (SD) is one of the least studied non-motor symptoms in Parkinson's disease (PD). OBJECTIVES: To assess sexual function in a cohort of patients with early-onset PD (EOPD) and compare it to a group of healthy controls. METHODS: In this cross-sectional multicenter study, SD was assessed with gender-specific multi-dimensional self-reported questionnaires: The Brief Male Sexual Function Inventory (BSFI-M) and the Female Sexual Function Index (FSFI). Scores between patients and controls were compared and associations between SD and demographical and clinical variables were studied. RESULTS: One hundred and five patients (mean age 47.35±7.8, disease duration 6 (3-11) years, UPDRS part III 17 (10-23) and 90 controls were recruited. The BSFI-M total score was lower in EOPD men than in controls, and specific items were also significantly lower, such as drive, erections, ejaculation, and satisfaction. EOPD women had lower scores than controls in totalFSFI, and certain domains such as lubrication and pain. SD was present in 70.2% of patients and 52.5% of controls. Sexual satisfaction in 35.2% of patients and 81.2% of controls. By gender, male and female patients had more SD than controls but only male patients had more dissatisfaction than controls. Gender, higher depression scores and urinary dysfunction were associated with SD in multivariate analysis; and gender, UPDRS and urinary dysfunction with sexual satisfactionConclusion:In this Spanish cohort, SD and sexual dissatisfaction was more prevalent in EOPD patients than in the general population. Gender and urinary disfunction were associated with SD and sexual dissatisfaction.

A 17-year experience of abobotulinumtoxina in cervical dystonia.

OBJECTIVE: To investigate the long-term efficacy and safety of a botulinum toxin type A (BoNT-A) for the treatment of cervical dystonia (CD). METHODS: We conducted a retrospective chart review of patients with CD treated with abobotulinumtoxinA (Dysport™ 100-800 units [U] for injection) between 1993 and 2009 at the University Hospital "La Paz" (LPUH). Affected muscles were selected using electromyography (EMG). RESULTS: Thirty-seven patients were included in the study; most were female (62%) and had idiopathic CD (60%). Almost half (46%) of patients were diagnosed with the condition more than 10 years ago. The most common clinical presentations of CD were rotation (46%) and laterocollis (43%). On average, patients were treated with Dysport for 7 years (range: 1-17 years) and received 487 (range: 320 to 650) U over 15.9 (range: 1 to 40) injection cycles. Most (97%) patients maintained a response from treatment initiation to end of evaluation period. Overall, 70% of patients were taking concomitant oral medication. Dysport was generally well tolerated. Dysphagia was reported by 18.9% of patients, but this did not lead to discontinuation of Dysport treatment. CONCLUSION: These data confirm the long-term efficacy and safety of Dysport in CD over a period of up to 17 years.

Assessment of Parkinson disease: what do we need to show neuroprotection?

To date, no pharmacological agent has convincingly demonstrated the ability to slow the progression of Parkinson disease (PD). The development of treatments that slow down the progressive degeneration of the nigrostriatal dopaminergic system (true neuroprotection), which is ultimately responsible for the patients' functional decline, has become one of the basic goals of PD research. In this review, we have attempted to analyze the role of different methods that measure PD severity (basically, clinical scales, timed tests, and neuroimaging techniques) in the evaluation of the "neuroprotection" provided by different types of treatment for the disease, on the basis of clinical evidence.