Sex differences in clinical and prognostic trajectories in patients with idiopathic REM sleep behavior disorder: Insights from the FARPRESTO cohort
Year: 2025
Type: article
Abstract: IntroductionThere are conflicting findings regarding the influence of sex on idiopathic REM sleep behavior disorder (iRBD) in terms of prevalence and associated clinical characteristics. This study, conducted as part of the Italian multicenter longitudinal FARPRESTO project, aims to explore sex-related differences in the age of onset, iRBD diagnosis, and phenoconversion, as well as in cognitive and non-motor features and the occurrence of RBD-related injuries among male and female patients with iRBD.MethodsThe FARPRESTO study included 536 iRBD patients recruited from 13 Italian centers. This analysis assessed the age at iRBD diagnosis, diagnostic delay, motor and non-motor symptoms, global cognitive performance, conversion rates to neurodegenerative disorders, and the prevalence of RBD-related injuries at the time of iRBD diagnosis, stratified by sex.ResultsFemale patients were older at iRBD diagnosis compared to males (males: 67.8 years, IQR 62.5-72.6; females: 69.8 years, IQR 65.1-74.8; p = 0.003). Compared to male patients, female patients exhibited a higher prevalence of orthostatic hypotension (27.9% vs. 16.2%; p = 0.019), depression (43.9% vs. 26.6%; p = 0.010), and hallucinations (43.9% vs. 26.6%; p = 0.010) at iRBD diagnosis. Additionally, self-directed injuries were significantly more frequent in females compared to males at the first visit (71% vs. 53.2%; p = 0.034). No significant differences were observed in the phenoconversion rate between sexes.ConclusionAlthough research on sex-related differences in iRBD remains limited, this study highlights the importance of understanding sex-specific characteristics. As diagnostic and therapeutic approaches evolve, incorporating these differences will be essential for tailoring clinical strategies and improving patient outcomes.
Source: Journal of Parkinson s Disease
Authors: Michelangelo Maestri, Michela Figorilli, Federico Meloni, Elisa Casaglia, Marcello Mario Mascia, Martina Mulas, Federica Provini, Luca Baldelli, Luisa Sambati, Felice Di Laudo, Pietro Mattioli, Beatrice Orso, Mattia Losa, Dario Arnaldi, Luigi Ferini Strambi, Sara Marelli, Alessandra Castelnuovo, Francesca Marta Casoni, Michele Terzaghi, Elena Capriglia, Gaetano Malomo, Valter Rustioni, Giuseppe Plazzi, Francesco Biscarini, Claudio Liguori, Mariana Fernandes, Flavia Cirillo, Domeniko Hoxhaj, Enrica Bonanni, Giacomo Della Marca, Valerio Brunetti, Raffaele Ferri, Giuseppe Lanza, Gaia Pellitteri, Gianluca Rossato, Biancamaria Guarnieri, Elena Antelmi, Francesca Ingravallo, Monica Puligheddu
Institutions: University of Pisa, Azienda Ospedaliera Universitaria Pisana, University of Cagliari, Azienda Ospedaliero-Universitaria Cagliari, Istituto delle Scienze Neurologiche di Bologna, University of Bologna, Ospedale Policlinico San Martino, University of Genoa, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, University of Pavia, University of Modena and Reggio Emilia, University of Rome Tor Vergata, Policlinico Tor Vergata, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, University of Catania, University of Udine, Azienda sanitaria universitaria Friuli Centrale, Ospedale Sacro Cuore Don Calabria, University of Verona
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Award: G2765279317
OpenAlex ID: W4415877650