Sexually Active Life Linked to ‘Milder’ Disease Progression in Men with Early Stage Parkinson’s, Study Finds

sexual life and disease

An active sexual life is associated with less severe motor and non-motor disability and a better quality of life in men with early Parkinson’s disease, a study reports.

Its findings are “in line with data showing a close relationship between sexual health and general health both in healthy individuals and in patients with chronic disease,” its researchers wrote, calling on doctors to be watchful of their patients’ sexual life.

The study, “The PRIAMO study: active sexual life is associated with better motor and non‐motor outcomes in men with early Parkinson’s disease,” was published in the European Journal of Neurology.

Because people with Parkinson’s disease have to deal with important changes in sexual function, “achieving a satisfying intimate and sexual relationship is often a challenge.”

Data from previous studies indicate that patients’ sexual performance is affected by their illness, and men with erectile dysfunction, particularly, have worse disease progression.

It is important to stress, however, that an active sexual life — rather than a person’s sexual function — can serve as a general indicator of good health. But little is known about how sexual activity influences the course of Parkinson’s disease.

A team of researchers with the Center for Neurodegenerative Diseases (CEMAND) at the University of Salerno, Italy, analyzed data from a group of 355 people (238 men and 117 women) with early stage Parkinson’s disease who were enrolled in the PRIAMO (PaRkinson dIseAse non MOtor symptoms) study and followed for two years.

Researchers wanted to understand if an active sexual life associates with better outcomes, and how prevalent sexual dysfunction is among sexually active Parkinson’s patients.

Individuals were asked whether they had been sexually active in the past 12 months. Those who responded positively were then questioned about specific issues that arose in the last month, including reduced sexual desire, impotence, loss of erection, or inability to reach an orgasm.

Motor disability, cognitive abilities, and quality of life were measured using validated scales: respectively, the  UPDRS‐III, MMSE, PDQ‐39 and EQ-VAS scales. Depression and other non-motor symptoms were also evaluated.

Early stage Parkinson’s was defined as a score of 2 or lower in the Hoehn and Yahr (H&Y) scale, a five-stage measure of disease progression and disability level, at the study’s start.

Data showed that patients’ sexual activity progressively dropped over time, with 56.3% of patients reporting to be sexually active at the study’s start and 50.8% reporting the same two years later. Men were twice as likely to be active as women.

Nearly half of sexually active men complained about erectile dysfunction (difficulties with erection and impotence) and orgasmic disorders at every time point.

Sexually active men tended to be younger and to have had an earlier onset of symptoms than non-active male patients.

Noticeably, sexually active men were less likely to have gastrointestinal problems and less likely to be affected by apathy (a general lack of motivation and interest) than those not sexually active. The odds of lower chances of these non-motor symptoms were 44% (gastrointestinal problems) and 58% (apathy).

Male patients with an active sexual life were associated with less severe motor disability, better quality of life, and lower depression scores. At two years, they were taking levodopa less frequently and had lesser fatigue as well as attention or memory problems, “reflecting a milder motor impairment and disease progression,” the researchers wrote.

No association between sexual activity and disease symptoms were shown for women, which researchers suggested might be because of gender differences in symptoms and attitudes toward open discussion of sexual drive and difficulties, and the smaller group of female patients in the study.

“The most novel finding of our analysis was that, irrespective of disease severity as evaluated by the H&Y, sexually active men displayed distinctive demographic and clinical features,” the researchers wrote, adding that the findings suggest “that sexual activity might be associated with reduced motor and non‐motor burden and milder disease progression in men with early [Parkinson’s disease].”

They added that, from a “clinician’s perspective, examination of a patient’s sexual life is often neglected during the clinical interview.”

While further studies are needed to confirm such data, they “should prompt movement disorders specialists to periodically inquiry about their patients’ sexual life,” the team concluded.

It is important to note that all correlations between sexual activity and patient outcomes were controlled for patients’ age and disease duration.

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Vitamin B3 Compound May Prevent Motor Decline in Parkinson’s Disease, Study Says

vitamin B3 nicotinamide riboside

A form of vitamin B3 can prevent degeneration and death of nerve cells linked to Parkinson’s and other neurodegenerative diseases.

The study with that finding, “The NAD+ precursor, nicotinamide riboside, rescues mitochondrial defects and neuronal loss in iPSC and fly models of Parkinson’s disease,” was published in Cell Reports.

It was shown recently that defective mitochondria are responsible for the death of dopaminergic neurons in the substantia nigra, a brain region particularly affected in Parkinson’s disease.

Mitochondria — tiny structures located inside cells that function as their powerhouse — produce the energy necessary for cell survival and function. However, their role in Parkinson’s is still controversial as alternative lines of research have suggested that mitochondrial defects may actually protect the brain by preventing the formation of protein aggregates.

“In our study we aimed to investigate whether damaged mitochondria were merely a side effect or whether they cause Parkinson’s disease,” Michela Deleidi, MD, said in a press release. Deleidi is a researcher at the German Center for Neurodegenerative Diseases and the University of Tübingen, and senior author of the study.

The team collected skin cell samples from Parkinson’s patients. They then converted skin cells into stem cells — which can give rise to almost any type of cell in the body — and then into nerve cells.

These cells had a defect in the GBA gene — the most frequent gene risk for Parkinson’s — and their mitochondria. Consequently, their energy production was impaired. Importantly, these cells produced higher levels of damaging oxygen molecules, also known as ROS.

This type of mitochondrial dysfunction and overall damaging response has been associated previously with aging and the decline of an important metabolic compound called NAD+.

No significant changes were observed concerning NAD+ levels in GBA-defective neurons compared to healthy study participants.

However, when researchers analyzed the brains of a fish model of Parkinson’s disease, which also had a mutation in the GBA gene, they found the animals had less nicotinamide mononucleotide, which is the molecule that gives rise to NAD+ compounds.

By feeding GBA-defective neurons with a form of vitamin B3 (called nicotinamide riboside), the levels of available NAD+ were increased and consequently cells’ energy balance improved.

“The nerve cells’ energy budget improved considerably. New mitochondria formed and energy production rose,” Deleidi said.

Treatment with nicotinamide riboside also prevented the loss of motor function in a fly model of Parkinson’s disease. “The substance had a positive effect here as well. In the flies which were treated, far fewer nerve cells died off,” Deleidi added.

Researchers believe that impaired mitochondria play an important role in the development of Parkinson’s and that nicotinamide riboside may represent a potential treatment to overcome this process.

The team is planning to further test the effects of nicotinamide riboside and assess if the vitamin can be of real help for patients with Parkinson’s, as studies have shown this form of vitamin B3 is well-tolerated by healthy subjects and also boosts their energy metabolism.

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Source: Parkinson's News Today