Dataset Information

Erectile Dysfunction Preceding Clinically Diagnosed ?-Synucleinopathies: A Case-Control Study in Olmsted County.

ABSTRACT:

Objective

Autonomic symptoms are common in ?-synuclein disorders: multiple system atrophy (MSA), Parkinson's disease (PD), dementia with Lewy bodies (DLB), and Parkinson's disease with dementia (PDD). These symptoms may precede the motor findings/clinical diagnosis by years. Erectile dysfunction (ED) is an autonomic symptom that has rarely been studied in these ?-synuclein disorders. In this population-based, case-control study, we investigated the association between premonitory erectile dysfunction surfacing prior to the clinical-motor manifestations of these ?-synucleinopathies.

Methods

We used the medical record-linkage system of the Rochester Epidemiology Project to identify cases of ?-synucleinopathies in Olmsted County from 1991 to 2010. Each male case was matched by age (±1?year) of symptom onset and sex to a control. We reviewed complete medical records of cases and controls to detect erectile dysfunction prior to the clinical-motor onset of ?-synucleinopathies of any type. We used conditional logistic regression to calculate the odds ratio of all ?-synucleinopathies, as well as by type, adjusting for diabetes, coffee, and smoking.

Results

A history of male erectile dysfunction was associated with 1.5-fold increased odds of an ?-synucleinopathy diagnosis of any type in univariate analyses (p=0.06). When stratifying ?-synucleinopathies by type, early erectile dysfunction was most frequent in MSA cases than matched controls (45% vs. 9%). Premotor phase ED was next most frequent among the DLB cases (46% vs. 27% among the controls; OR?=?2.83, p=0.03; when adjusted for diabetes, smoking, and coffee, OR?=?2.98, p=0.04). Premotor phase ED was not significantly associated with PD or PDD.

Conclusions

Early erectile dysfunction may be a premotor symptom of MSA and DLB, reflecting premonitory dysautonomia. It was not associated with premotor PD or PDD.

SUBMITTER: Hasan S

PROVIDER: S-EPMC6481034 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Erectile Dysfunction Preceding Clinically Diagnosed <i>α</i>-Synucleinopathies: A Case-Control Study in Olmsted County.

Hasan Shemonti S Mielke Michelle M MM Ahlskog J Eric JE Bower James J Turcano Pierpaolo P Savica Rodolfo R

Parkinson's disease 20190409

<h4>Objective</h4>Autonomic symptoms are common in <i>α</i>-synuclein disorders: multiple system atrophy (MSA), Parkinson's disease (PD), dementia with Lewy bodies (DLB), and Parkinson's disease with dementia (PDD). These symptoms may precede the motor findings/clinical diagnosis by years. Erectile dysfunction (ED) is an autonomic symptom that has rarely been studied in these <i>α</i>-synuclein disorders. In this population-based, case-control study, we investigated the association between premo ...[more]

PMID: 31093326

Similar Datasets

Project description:Background & aimsIsolated autosomal-dominant polycystic liver disease (ADPLD) is generally considered a rare disease. However, the frequency of truncating mutations to ADPLD genes in large, population sequencing databases is 1:496. With the increasing use of abdominal imaging, incidental detection of hepatic cysts and ADPLD has become more frequent. The present study was performed to ascertain the incidence and point prevalence of ADPLD in Olmsted County, MN, USA, and how these are impacted by the increasing utilisation of abdominal imaging.MethodsThe Rochester Epidemiology Project and radiology databases of Mayo Clinic and Olmsted Medical Center were searched to identify all subjects meeting diagnostic criteria for definite, likely, or possible ADPLD. Annual incidence rates were calculated using incident cases during 1980-2016 as numerator, and age- and sex-specific estimates of the population of Olmsted County as denominator. Point prevalence was calculated using prevalence cases as numerator, and age- and sex-specific estimates of the population of Olmsted County on 1 January 2010 as denominator.ResultsThe incidence rate and point prevalence of combined definite and likely ADPLD were 1.01 per 100,000 person-years and 9.5 per 100,000 population, respectively. Only 15 of 35 definite and likely incident ADPLD cases had received a diagnostic code, and only 8 had clinically significant hepatomegaly. The incidence rates were much higher when adding possible cases, mainly identified through radiology databases, particularly in recent years and in older patients because of the increased utilisation of imaging studies.ConclusionsClinically significant isolated ADPLD is a rare disease with a prevalence <1:10,000 population. The overall prevalence of ADPLD, however, to a large extent not clinically significant, is likely much higher and closer to the reported genetic prevalence.Lay summaryIsolated autosomal-dominant polycystic liver disease (ADPLD) is generally considered a rare disease. However, we demonstrate that it is a relatively common disease, which is rarely (<1:10,000 population) clinically significant.

Project description:ImportanceTrabeculectomy is the surgical standard of care for patients with medically refractory glaucoma. The use of antimetabolite agents, such as mitomycin, has increased the rate of complications after trabeculectomy.ObjectiveTo determine the rate of trabeculectomy-related complications during a 25-year study.Design, setting, and participantsFor this retrospective, population-based study, we enrolled the residents of Olmsted County, Minnesota, who underwent a trabeculectomy from January 1, 1985, through December 31, 2010, at the Mayo Clinic and Olmsted Community Hospital. Data were collected from August 2012 to September 2013 followed by data analysis through January 2014.ExposuresAfter reviewing the patient records, we determined the occurrence of complications, including bleb leak, hypotony, hyphema, choroidal effusion, choroidal hemorrhage, blebitis, and endophthalmitis, as they relate to the mitomycin concentration administered during the operation. We reviewed relevant publications in Ovid, MEDLINE, and PubMed to identify studies representative of the reported trabeculectomy complication rate.Main outcomes and measuresCumulative probabilities of short- and long-term complications, determined using the Kaplan-Meier method, and the relation to mitomycin concentration applied during trabeculectomy.ResultsIn 334 patients, 460 eyes underwent trabeculectomy (mean [SD; range] follow-up, 7.7 [5.7; 0-27.7] years). Among them, 159 eyes had complications, with early complications (<3 months) in 100 eyes and late complications (≥3 months) in 59 eyes during the follow-up. Ten eyes had an early and a late complication. The 20-year cumulative chances of early, late, or any complication were 19.7% (95% CI, 16.2%-23.6%), 26.0% (95% CI, 15.0%-36.0%), and 45.0% (95% CI, 38.0%-52.0%), respectively. The cumulative probabilities of vision-threatening complications during 20 years were 2.0% (95% CI, 0%-4.0%) for blebitis and 5.0% (95% CI, 1.0%-9.0%) for endophthalmitis. Association between the rate of trabeculectomy complications and mitomycin dose used was P = .77. In total, 98 cases (21.3%) underwent further surgical procedures related directly to the complication.Conclusions and relevanceThe rate of trabeculectomy-related complications does not appear to be associated with mitomycin use during a mean follow-up of 7.7 years. The rate of vision-threatening complications appears to be comparable to those of previous studies of shorter duration.