Refractory nonmotor symptoms in male patients with Parkinson’s disease due to testosterone deﬁciency: A common unrecognized comorbidity
Okun, M., McDonald, W., & DeLong, M. (2002, May) Refractory nonmotor symptoms in male patients with Parkinson’s disease due to testosterone deﬁciency: A common unrecognized comorbidity , 59, 807-811
Testosterone deficiency is common (20-25%) in men over the age of 60. The deficiency is caused by normal aging as well as certain long-term illnesses and medications. Such a deficiency has been found to cause depression, fatigue, decreased sex drive, and "decreased work performance." Patients with PD also have similar nonmotor difficulties, which are commonly caused by other comorbid conditions. These authors looked at five males diagnosed with PD (age 59-87; duration of PD 7-20 yrs; 2 patients underwent previous pallidotomies (1L and 1R) that were symptomatic of testosterone deficiency. All 5 patients had a poor response to antiparkinsonian and antidepressant medications. All patients were asked daily to apply a testosterone gel to the skin. All patients had an increase in their testosterone levels and improvement in their nonmotor symptoms (e.g. fatigue, depression, anxiety, and sexual dysfunction). Some of the patients also had improvement in their motor symptoms but it was unclear if that was due to improvement in their quality of life (mood and energy) or the testosterone treatment. These authors maintain a PD registry and after looking at their PD patients, the data suggested that testosterone deficiency is more prevalent in PD than the general population (35% vs. 20-25%). They also suggest that this deficiency may be causal to the nonmotor symptoms of PD. There are many studies suggesting that geriatric patients in general respond well to testosterone treatment, as should PD patients, which may result in improved quality of life.