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Journal of Neurology
Published in: Journal of Neurology 1/2021

Open Access 01-01-2021 | Parkinson's Disease | Original Communication

Sex and freezing of gait in Parkinson’s disease: a systematic review and meta-analysis

Authors: Anouk Tosserams, Masood Mazaheri, Priya Vart, Bastiaan R. Bloem, Jorik Nonnekes

Published in: Journal of Neurology | Issue 1/2021

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Abstract

Objective

It is unknown how sex affects the prevalence of freezing of gait (FOG). We conducted a systematic review and meta-analysis to establish the sex-specific prevalence of FOG in persons with Parkinson’s disease (PD). In addition, we investigated whether men and women were represented accurately in intervention trials targeting FOG.

Methods

We queried the EMBASE and PubMed databases and identified 2637 articles. Of these, 16 epidemiological studies were included in the meta-analysis, and 51 intervention studies were included in the comparative analysis.

Results

In total, 5702 persons were included in the final meta-analysis of epidemiological studies. The pooled estimate of overall FOG prevalence was 43% [95% CI 33–53%]. We found no difference in FOG prevalence between men [44% (34–54%)] and women [42% (31–52%)] with PD. However, women were markedly underrepresented in intervention trials targeting FOG, with an average proportion of only 29.6% of women in trial populations. The percentage of women included in trials was similar across intervention types but differed greatly across geographical regions.

Conclusion

Sex is not a predictor of FOG. This could aid clinicians in counseling persons with PD about FOG. Importantly, a global effort is needed to include more women into clinical trials. Given the skewed distribution of men and women included in intervention trials targeting FOG, caution might be warranted when extrapolating results from FOG trials to women.
Appendix
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Metadata
Title
Sex and freezing of gait in Parkinson’s disease: a systematic review and meta-analysis
Authors
Anouk Tosserams
Masood Mazaheri
Priya Vart
Bastiaan R. Bloem
Jorik Nonnekes
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 1/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-020-10117-w

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