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Neural circuitry relevant to erection. PAG = Periaqueductal gray; LC = locus coeruleus; NBM = nucleus basalis Meynert; A = adrenergic/noradrenergic; ZI = zona incerta; VTA = ventral tegmental area; SNC = substantia nigra pars compacta; DLTN = dorsolateral tegmental nucleus; PBN = parabrachial nucleus; IML = IML nucleus; GABA = γ-aminobutyric acid; T = thoracic; L = lumbar; S = sacral; NA = noradrenaline; Ach = acetylcholine; NO = nitric oxide.
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Sexual dysfunction (erectile dysfunction) is a common non-motor disorder in Parkinson's disease (PD). In contrast to motor disorder, sexual dysfunction is often not responsive to levodopa treatment. Among brain pathologies, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered...
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Context 1
... with a suprasacral spinal cord lesion, reflexive erection might be preserved, whereas psychogenic erection is severely disturbed because of a lesion in the spinal pathways to the sacral cord. Libido and erection are thought to be regulated by the hypothalamus; particularly the medial preoptic area (MPOA) and the paraventricular nucleus (PVN; fig. 1) [5]. Electrical or chemical stimulation in the MPOA/PVN evoked erection and mating behaviors in experimental animals; both were abolished by destruction of these areas. Somatosensory input from the genitalia ascends in the anterior spinal cord and project to the MPOA/PVN via the thalamic nuclei. Erotic visual input from the retina is ...
Citations
... This evidence proposed that sexual dysfunction may occur through distinct pathobiological processes. According to PD patients' brain histopathological findings, hypothalamic dysfunction and, consequently, libido and erection-prompting dopamine-oxytocin pathways disruption can be considered the primary etiology for the sexual issues [34]. ...
Neurological disorders are illnesses in which the function of neurons in the brain and spinal cord is disrupted. In neurodegenerative diseases, based on various factors such as the etiology of the disease, the patient's age, and the brain and /or spinal cord region involved, the affected person may face a wide variety of signs and symptoms. In numerous neurodegenerative disorders such as Alzheimer's disease (AD), Parkinson's disease (PD), and multiple sclerosis (MS), according to the disease pathobiology, some sexual and reproductive problems, like sexual dysfunction, low sperm quality, and sterility, have been raised. Although sexual and fertility issues could result in several individual complications and heavy social burdens, limited studies have addressed these topics. This narrative review highlights sexual and reproductive disabilities in several neurological disorders, such as spinal cord injury (SCI) and MS.
... It is becoming clearer that PD should no longer be regarded as merely a complex motor disorder characterized by dopamine deficiency, but as a progressive multisystem disease with several neural and non-motor deficiencies (McIntosh and Wilson, 2018). Among the PD-associated non-motor deficits are reproductive health deficits which may be due to hypothalamic dysfunction associated with decreased libido (Sakakibara et al., 2012). While the mechanisms involved in the etiopathology of PD are not yet clearly understood, neuroinflammation, oxidative damage, mitochondrial dysfunction, and aggregates of α-syn (forming Lewy bodies) traceable to genetic and environmental predisposition have been reported (Gökçal et al., 2017). ...
... Although the pathogenic mechanisms involved remain yet unclear, α-synucleinopathies including PD have been recently linked to several reproductive health dysfunctions (Magerkurth et al., 2005;Sakakibara et al., 2012). Ragonese et al.(inconclusive), reported a relationship between PD and the factors that reduce estrogen stimulation during life, these support the speculation that endogenous estrogens may play a role in PD development (Ragonese et al., 2004). ...
Context: Parkinson's disease (PD) is a multisystem neurodegenerative disorder associated with oxidative stress and disrupted mitochondrial function. It is characterized by motor and non-motor symptoms due to multi-factors. Coconut (Cocos nucifera) milk contains a complex mixture of highly nutritional constituents such as carbohydrates, vitamins, and minerals which have remarkable health benefits. Lauric acid (LA) which makes up 54.5% of the total nutrient composition of coconut milk (CM) possesses strong antioxidant properties. Objectives: This study evaluated the effect of CM on PD-associated motor and non-motor deficits in alpha-synuclein (α-syn) transgenic Drosophila melanogaster (D. melanogaster). Methods: W 1118 strain (control) and α-syn transgenic (PD strain) of D. melanogaster aged between 1 to 3 days were randomized into various groups. The control flies were fed on untreated diets, while the PD flies were orally exposed to varying concentrations (0, 5, 10, and 15% v/v) of the coconut milk diet for 14 days. Subsequently, longevity, behavioral, fecundity, and biochemical analyses were conducted across the groups. Results: The results showed that CM significantly increased longevity, climbing ability, egg count, and the rate of emergence (P< 0.05). In addition, MDA and NO levels as well as AChE activity were significantly decreased, while GSH levels alongside SOD and CAT activities were increased (P< 0.05) in the CM-treated PD flies in a concentration-dependent manner. Conclusions: CM ameliorated PD-associated deficits in D. melanogaster by prolonging lifespan, and improving locomotor function, fecundity, and redox status.
... At the same time, western studies on PD reported a prevalence of sexual dysfunction ranging from 37 to 65%. [22] Autonomic symptoms are reported in 14-80% of PD patients and are best evaluated by the scales for outcomes in Parkinson's disease-autonomic dysfunction scale. [23] Orthostatic hypotension, syncope, excessive sweating, and urinary symptoms are predominant autonomic symptoms and they correlate with the progression of the disease and are often aggravated by dopaminergic therapy. ...
Background: During the past decade the view of Parkinson’s disease (PD) as a motor disorder has changed significantly and currently it is
recognized as a multisystem disorder with diverse non‐motor symptoms (NMS). Aims: The present study aimed to evaluate and characterize
the NMS and study their impact on quality of life (QoL) in a PD patient cohort. Material and Methods: This was a cross‐sectional study
where 92 PD patients fulfilling the UK Parkinson’s disease society brain bank criteria were enrolled from a movement disorder clinic. All
patients were evaluated using unified Parkinson’s disease rating scale, non‐motor symptoms scale (NMSS) for the non‐motor symptoms,
and Parkinson’s disease questionnaire‐39 (PDQ‐39) for the QoL. The impact of NMS on QoL was assessed statistically. Results: A total of
92 patients were enrolled with a mean age of 55.40 ± 7.37 years, mean age of onset of disease 51.62 ± 6.38 years, and mean disease duration
of 3.78 ± 1.54 years. Type of disease was akinetic rigid variant in 29.3% (n = 27), tremor predominant type in 36.9%(n = 34), and mixed
type in 33.6% (n = 31). Mean Hoehn and Yahr stage was 2.12 ± 0.54. In the NMSS, most common symptom was sleep and fatigue (83%),
followed by urinary tract symptoms (63%), mood and cognition (51%), cardiovascular symptoms and falls (43%), gastrointestinal tract
symptoms (38%), and sexual function (33%). Univariate analyses showed that all NMS domains had a significant correlation with PDQ‐39
with P < 001. Conclusion: Our study shows that NMS in PDare fairly common and significantly impact the QoL.
... At the same time, western studies on PD reported a prevalence of sexual dysfunction ranging from 37 to 65%. [22] Autonomic symptoms are reported in 14-80% of PD patients and are best evaluated by the scales for outcomes in Parkinson's disease-autonomic dysfunction scale. [23] Orthostatic hypotension, syncope, excessive sweating, and urinary symptoms are predominant autonomic symptoms and they correlate with the progression of the disease and are often aggravated by dopaminergic therapy. ...
Background:
During the past decade the view of Parkinson's disease (PD) as a motor disorder has changed significantly and currently it is recognized as a multisystem disorder with diverse non-motor symptoms (NMS).
Aims:
The present study aimed to evaluate and characterize the NMS and study their impact on quality of life (QoL) in a PD patient cohort.
Material and methods:
This was a cross-sectional study where 92 PD patients fulfilling the UK Parkinson's disease society brain bank criteria were enrolled from a movement disorder clinic. All patients were evaluated using unified Parkinson's disease rating scale, non-motor symptoms scale (NMSS) for the non-motor symptoms, and Parkinson's disease questionnaire-39 (PDQ-39) for the QoL. The impact of NMS on QoL was assessed statistically.
Results:
A total of 92 patients were enrolled with a mean age of 55.40 ± 7.37 years, mean age of onset of disease 51.62 ± 6.38 years, and mean disease duration of 3.78 ± 1.54 years. Type of disease was akinetic rigid variant in 29.3% (n = 27), tremor predominant type in 36.9%(n = 34), and mixed type in 33.6% (n = 31). Mean Hoehn and Yahr stage was 2.12 ± 0.54. In the NMSS, most common symptom was sleep and fatigue (83%), followed by urinary tract symptoms (63%), mood and cognition (51%), cardiovascular symptoms and falls (43%), gastrointestinal tract symptoms (38%), and sexual function (33%). Univariate analyses showed that all NMS domains had a significant correlation with PDQ-39 with P < 001.
Conclusion:
Our study shows that NMS in PDare fairly common and significantly impact the QoL.
Sexual function which comprises of desire, arousal, orgasm and satisfaction and pain, involves coordinated physiologic responses from multiple different pathways. Sexual dysfunction (SD) occurs when these domains of the sexual response cycle are affected. SD is a common but under-recognized non-motor feature in Parkinson's disease (PD), a common age-related neurodegenerative disorder. SD significantly affects the quality of life of PD patients and their partners. Advanced age, gender, hormone deficiency, neuropsychiatric and medical comorbidities contribute to SD in PD. Possible potential pathological mechanisms include vasculogenic, endocrinologic, neurogenic and psychogenic factors. Various therapeutic interventions, both pharmacological and non-pharmacological modalities have been suggested to improve SD in PD. However, erectile dysfunction (ED) is the only SD with evidence-based treatment available. Non-pharmacological therapies are also offering promising evidence in the improvement of SD. A multidisciplinary approach in the assessment, investigation, and treatment is needed to address the real life complex issues (gender and comorbidities, neurobiological, vasoactive, hormonal as well as psychosocial aspects). Future clinical studies with validated and standardized methods in assessing SD as well as experimental models will be necessary for better insight into the pathophysiology. This would facilitate appropriate therapy and improve sexual rehabilitation in PD patients.
