Print

Print


Low Testosterone Linked to Apathy in Parkinson's Disease

NEW YORK (Reuters Health) Aug 31 - Testosterone deficiency appears to be
associated with increased apathy that is common among men with Parkinson's
disease, results of a pilot study suggest.

Previous research has shown that testosterone administration to male subjects
facilitates functions that are subserved by the prefrontal cortex, lead author Dr.
Rebecca E. Ready and her associates explain in the September Journal of
Neurology, Neurosurgery and Psychiatry. Furthermore, apathy is linked to frontal
systems dysfunction, and frontal systems dysfunction has been implicated in
Parkinson's disease.

To investigate the possible link between low testosterone levels and apathy, the
group, based at Brown Medical School of the University of Pittsburgh, enrolled 49
non-demented men with Parkinson's disease. Patients as well as spouses or other
informants who knew the patients very well completed the Frontal Systems Behavior
Scale (FrSBe). Blood samples were drawn for measurement of testosterone levels.

The authors found that 23 had low total testosterone, defined as 325 ng/dL or less.
Self-reported apathy on the FrSBe was inversely related to free testosterone levels
(p < 0.05). The results were similar when informants completed the FrSBe, and after
controlling for disease severity.

"If future studies corroborate our findings that testosterone deficiency is associated
with symptoms of apathy, then testosterone replacement therapy should be
considered as a potential treatment for apathy in men with Parkinson's disease," Dr.
Ready and her colleagues maintain.

However, until a prospective, placebo-controlled trial is completed, they add,
clinicians should not treat testosterone deficiency in patients with Parkinson's
disease.

In an editorial commentary, Dr. S. F. Farmer suggests, "the idea that dopamine and
testosterone deficiencies act as comorbidities - which combine in susceptible
patients to reduce frontal lobe system functioning leading to reduced libido, sexual
dysfunction, fatigue, mood change, and apathy - is important."

The ability to treat significant non-motor symptoms of Parkinson's disease will be
welcomed, adds Dr. Farmer, a physician at National Hospital for Neurology and
Neurosurgery in London.

J Neurol Neurosurg Psychiatry 2004;75:1323-1326.

SOURCE: Medscape
http://www.medscape.com/viewarticle/488290

* * *

----------------------------------------------------------------------
To sign-off Parkinsn send a message to: mailto:[log in to unmask]
In the body of the message put: signoff parkinsn