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Semin Neurol 2017; 37(06): 653-660
DOI: 10.1055/s-0037-1608845
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Movement Disorders in Women

Jessica M. Baker
1   Division of Movement Disorders, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
,
Albert Y. Hung
1   Division of Movement Disorders, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
› Author Affiliations
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Publication History

Publication Date:
21 December 2017 (online)

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Abstract

Movement disorders such as Parkinson's disease (PD), restless legs syndrome (RLS), chorea, essential tremor, and Tourette syndrome, occur in men and women of all ages. Yet, considerable sex differences in epidemiology, clinical features, and treatment exist in these disorders. In this review, we highlight key differences in the evaluation and management of women with movement disorders, addressing sex-specific complications of treatment and unique challenges surrounding the management of movement disorders during pregnancy. We review the complex relationship between estrogen and movement disorders, including the putative neuroprotective effects of estrogen in PD and the modulatory effects on RLS and chorea associated with autoimmune disease. Further understanding of sex-specific and hormonal effects on clinical features will be important to optimize the management of women with movement disorders in the future.

Keywords

Parkinson's disease - restless legs syndrome - Tourette syndrome - chorea gravidarum - essential tremor - estrogen - sex differences - pregnancy
 

  • References

  • 1 Kompoliti K. Estrogen and movement disorders. Clin Neuropharmacol 1999; 22: 318-326
    PubMedGoogle Scholar
  • 2 Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry 1988; 51 (06) 745-752
    CrossrefPubMedGoogle Scholar
  • 3 Pringsheim T, Jette N, Frolkis A, Steeves TDL. The prevalence of Parkinson's disease: a systematic review and meta-analysis. Mov Disord 2014; 29 (13) 1583-1590
    CrossrefPubMedGoogle Scholar
  • 4 Postuma RB, Berg D. Advances in markers of prodromal Parkinson disease. Nat Rev Neurol 2016; 12 (11) 622-634
    PubMedGoogle Scholar
  • 5 Wooten GF, Currie LJ, Bovbjerg VE, Lee JK, Patrie J. Are men at greater risk for Parkinson's disease than women?. J Neurol Neurosurg Psychiatry 2004; 75 (04) 637-639
    CrossrefPubMedGoogle Scholar
  • 6 Taylor KSM, Cook JA, Counsell CE. Heterogeneity in male to female risk for Parkinson's disease. J Neurol Neurosurg Psychiatry 2007; 78 (08) 905-906
    CrossrefPubMedGoogle Scholar
  • 7 Nandipati S, Litvan I. Environmental exposures and Parkinson's disease. Int J Environ Res Public Health 2016; 13 (09) 881
    CrossrefPubMedGoogle Scholar
  • 8 Gardner RC, Burke JF, Nettiksimmons J, Goldman S, Tanner CM, Yaffe K. Traumatic brain injury in later life increases risk for Parkinson disease. Ann Neurol 2015; 77 (06) 987-995
    CrossrefPubMedGoogle Scholar
  • 9 Ritz B, Ascherio A, Checkoway H. , et al. Pooled analysis of tobacco use and risk of Parkinson disease. Arch Neurol 2007; 64 (07) 990-997
    CrossrefPubMedGoogle Scholar
  • 10 Searles Nielsen S, Gallagher LG, Lundin JI. , et al. Environmental tobacco smoke and Parkinson's disease. Mov Disord 2012; 27 (02) 293-296
    CrossrefPubMedGoogle Scholar
  • 11 Hu G, Bidel S, Jousilahti P, Antikainen R, Tuomilehto J. Coffee and tea consumption and the risk of Parkinson's disease. Mov Disord 2007; 22 (15) 2242-2248
    CrossrefPubMedGoogle Scholar
  • 12 Ascherio A, Zhang SM, Hernán MA. , et al. Prospective study of caffeine consumption and risk of Parkinson's disease in men and women. Ann Neurol 2001; 50 (01) 56-63
    CrossrefPubMedGoogle Scholar
  • 13 Smith KM, Dahodwala N. Sex differences in Parkinson's disease and other movement disorders. Exp Neurol 2014; 259: 44-56
    CrossrefPubMedGoogle Scholar
  • 14 Rocca WA, Bower JH, Maraganore DM. , et al. Increased risk of parkinsonism in women who underwent oophorectomy before menopause. Neurology 2008; 70 (03) 200-209
    CrossrefPubMedGoogle Scholar
  • 15 Benedetti MD, Maraganore DM, Bower JH. , et al. Hysterectomy, menopause, and estrogen use preceding Parkinson's disease: an exploratory case-control study. Mov Disord 2001; 16 (05) 830-837
    CrossrefPubMedGoogle Scholar
  • 16 Rugbjerg K, Christensen J, Tjønneland A, Olsen JH. Exposure to estrogen and women's risk for Parkinson's disease: a prospective cohort study in Denmark. Parkinsonism Relat Disord 2013; 19 (04) 457-460
    CrossrefPubMedGoogle Scholar
  • 17 Liu R, Baird D, Park Y. , et al. Female reproductive factors, menopausal hormone use, and Parkinson's disease. Mov Disord 2014; 29 (07) 889-896
    CrossrefPubMedGoogle Scholar
  • 18 Wang P, Li J, Qiu S, Wen H, Du J. Hormone replacement therapy and Parkinson's disease risk in women: a meta-analysis of 14 observational studies. Neuropsychiatr Dis Treat 2014; 11: 59-66
    PubMedGoogle Scholar
  • 19 Ascherio A, Weisskopf MG, O'Reilly EJ. , et al. Coffee consumption, gender, and Parkinson's disease mortality in the cancer prevention study II cohort: the modifying effects of estrogen. Am J Epidemiol 2004; 160 (10) 977-984
    CrossrefPubMedGoogle Scholar
  • 20 Ascherio A, Chen H, Schwarzschild MA, Zhang SM, Colditz GA, Speizer FE. Caffeine, postmenopausal estrogen, and risk of Parkinson's disease. Neurology 2003; 60 (05) 790-795
    CrossrefPubMedGoogle Scholar
  • 21 Palacios N, Gao X, McCullough ML. , et al. Caffeine and risk of Parkinson's disease in a large cohort of men and women. Mov Disord 2012; 27 (10) 1276-1282
    CrossrefPubMedGoogle Scholar
  • 22 Simon KC, Chen H, Gao X, Schwarzschild MA, Ascherio A. Reproductive factors, exogenous estrogen use, and risk of Parkinson's disease. Mov Disord 2009; 24 (09) 1359-1365
    CrossrefPubMedGoogle Scholar
  • 23 Parkinson Study Group POETRY Investigators. A randomized pilot trial of estrogen replacement therapy in post-menopausal women with Parkinson's disease. Parkinsonism Relat Disord 2011; 17 (10) 757-760
    CrossrefPubMedGoogle Scholar
  • 24 Tsang KL, Ho SL, Lo SK. Estrogen improves motor disability in parkinsonian postmenopausal women with motor fluctuations. Neurology 2000; 54 (12) 2292-2298
    CrossrefPubMedGoogle Scholar
  • 25 Blanchet PJ, Fang J, Hyland K, Arnold LA, Mouradian MM, Chase TN. Short-term effects of high-dose 17beta-estradiol in postmenopausal PD patients: a crossover study. Neurology 1999; 53 (01) 91-95
    CrossrefPubMedGoogle Scholar
  • 26 Nicoletti A, Arabia G, Pugliese P. , et al. Hormonal replacement therapy in women with Parkinson disease and levodopa-induced dyskinesia: a crossover trial. Clin Neuropharmacol 2007; 30 (05) 276-280
    CrossrefPubMedGoogle Scholar
  • 27 Lobo RA. Hormone-replacement therapy: current thinking. Nat Rev Endocrinol 2017; 13 (04) 220-231
    CrossrefPubMedGoogle Scholar
  • 28 Davis JW, Grandinetti A, Waslien CI, Ross GW, White LR, Morens DM. Observations on serum uric acid levels and the risk of idiopathic Parkinson's disease. Am J Epidemiol 1996; 144 (05) 480-484
    CrossrefPubMedGoogle Scholar
  • 29 de Lau LML, Koudstaal PJ, Hofman A, Breteler MMB. Serum uric acid levels and the risk of Parkinson disease. Ann Neurol 2005; 58 (05) 797-800
    CrossrefPubMedGoogle Scholar
  • 30 Weisskopf MG, O'Reilly E, Chen H, Schwarzschild MA, Ascherio A. Plasma urate and risk of Parkinson's disease. Am J Epidemiol 2007; 166 (05) 561-567
    CrossrefPubMedGoogle Scholar
  • 31 Wen M, Zhou B, Chen Y-H. , et al. Serum uric acid levels in patients with Parkinson's disease: A meta-analysis. PLoS One 2017; 12 (03) e0173731 . Doi: 10.1371/journal.pone.0173731
    CrossrefPubMedGoogle Scholar
  • 32 Gao X, O'Reilly EJ, Schwarzschild MA, Ascherio A. Prospective study of plasma urate and risk of Parkinson disease in men and women. Neurology 2016; 86 (06) 520-526
    CrossrefPubMedGoogle Scholar
  • 33 O'Reilly EJ, Gao X, Weisskopf MG. , et al. Plasma urate and Parkinson's disease in women. Am J Epidemiol 2010; 172 (06) 666-670
    CrossrefPubMedGoogle Scholar
  • 34 Chen H, Mosley TH, Alonso A, Huang X. Plasma urate and Parkinson's disease in the Atherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol 2009; 169 (09) 1064-1069
    CrossrefPubMedGoogle Scholar
  • 35 Schwarzschild MA, Ascherio A, Beal MF. , et al; Parkinson Study Group SURE-PD Investigators. Inosine to increase serum and cerebrospinal fluid urate in Parkinson disease: a randomized clinical trial. JAMA Neurol 2014; 71 (02) 141-150
    CrossrefPubMedGoogle Scholar
  • 36 Schwarzschild MA, Macklin EA, Ascherio A. ; Parkinson Study Group SURE-PD Investigators. Urate and neuroprotection trials. Lancet Neurol 2014; 13 (08) 758
    PubMedGoogle Scholar
  • 37 Haaxma CA, Bloem BR, Borm GF. , et al. Gender differences in Parkinson's disease. J Neurol Neurosurg Psychiatry 2007; 78 (08) 819-824
    CrossrefPubMedGoogle Scholar
  • 38 Alves G, Müller B, Herlofson K. , et al; Norwegian ParkWest study group. Incidence of Parkinson's disease in Norway: the Norwegian ParkWest study. J Neurol Neurosurg Psychiatry 2009; 80 (08) 851-857
    CrossrefPubMedGoogle Scholar
  • 39 Perrin AJ, Nosova E, Co K. , et al. Gender differences in Parkinson's disease depression. Parkinsonism Relat Disord 2017; 36: 93-97
    CrossrefPubMedGoogle Scholar
  • 40 Liu R, Umbach DM, Peddada SD. , et al. Potential sex differences in nonmotor symptoms in early drug-naive Parkinson disease. Neurology 2015; 84 (21) 2107-2115
    CrossrefPubMedGoogle Scholar
  • 41 Szewczyk-Krolikowski K, Tomlinson P, Nithi K. , et al. The influence of age and gender on motor and non-motor features of early Parkinson's disease: initial findings from the Oxford Parkinson Disease Center (OPDC) discovery cohort. Parkinsonism Relat Disord 2014; 20 (01) 99-105
    CrossrefPubMedGoogle Scholar
  • 42 Martinez-Martin P, Falup Pecurariu C, Odin P. , et al. Gender-related differences in the burden of non-motor symptoms in Parkinson's disease. J Neurol 2012; 259 (08) 1639-1647
    CrossrefPubMedGoogle Scholar
  • 43 Song Y, Gu Z, An J, Chan P. ; Chinese Parkinson Study Group. Gender differences on motor and non-motor symptoms of de novo patients with early Parkinson's disease. Neurol Sci 2014; 35 (12) 1991-1996
    CrossrefPubMedGoogle Scholar
  • 44 Picillo M, Amboni M, Erro R. , et al. Gender differences in non-motor symptoms in early, drug naïve Parkinson's disease. J Neurol 2013; 260 (11) 2849-2855
    CrossrefPubMedGoogle Scholar
  • 45 Pigott K, Rick J, Xie SX. , et al. Longitudinal study of normal cognition in Parkinson disease. Neurology 2015; 85 (15) 1276-1282
    CrossrefPubMedGoogle Scholar
  • 46 Anang JBM, Gagnon J-F, Bertrand J-A. , et al. Predictors of dementia in Parkinson disease: a prospective cohort study. Neurology 2014; 83 (14) 1253-1260
    CrossrefPubMedGoogle Scholar
  • 47 Safarpour D, Thibault DP, DeSanto CL. , et al. Nursing home and end-of-life care in Parkinson disease. Neurology 2015; 85 (05) 413-419
    CrossrefPubMedGoogle Scholar
  • 48 Umeh CC, Pérez A, Augustine EF. , et al. No sex differences in use of dopaminergic medication in early Parkinson disease in the US and Canada - baseline findings of a multicenter trial. PLoS One 2014; 9 (12) e112287 . Doi: 10.1371/journal.pone.0112287
    CrossrefPubMedGoogle Scholar
  • 49 Fabbrini G, Brotchie JM, Grandas F, Nomoto M, Goetz CG. Levodopa-induced dyskinesias. Mov Disord 2007; 22 (10) 1379-1389 , quiz 1523
    CrossrefPubMedGoogle Scholar
  • 50 Warren Olanow C, Kieburtz K, Rascol O. , et al; Stalevo Reduction in Dyskinesia Evaluation in Parkinson's Disease (STRIDE-PD) Investigators. Factors predictive of the development of levodopa-induced dyskinesia and wearing-off in Parkinson's disease. Mov Disord 2013; 28 (08) 1064-1071
    CrossrefPubMedGoogle Scholar
  • 51 Hassin-Baer S, Molchadski I, Cohen OS. , et al. Gender effect on time to levodopa-induced dyskinesias. J Neurol 2011; 258 (11) 2048-2053
    CrossrefPubMedGoogle Scholar
  • 52 Bjornestad A, Forsaa EB, Pedersen KF, Tysnes O-B, Larsen JP, Alves G. Risk and course of motor complications in a population-based incident Parkinson's disease cohort. Parkinsonism Relat Disord 2016; 22: 48-53
    CrossrefPubMedGoogle Scholar
  • 53 Hariz G-M, Nakajima T, Limousin P. , et al. Gender distribution of patients with Parkinson's disease treated with subthalamic deep brain stimulation; a review of the 2000-2009 literature. Parkinsonism Relat Disord 2011; 17 (03) 146-149
    CrossrefPubMedGoogle Scholar
  • 54 Willis AW, Schootman M, Kung N, Wang X-Y, Perlmutter JS, Racette BA. Disparities in deep brain stimulation surgery among insured elders with Parkinson disease. Neurology 2014; 82 (02) 163-171
    CrossrefPubMedGoogle Scholar
  • 55 Picillo M, Palladino R, Moccia M. , et al. Gender and non motor fluctuations in Parkinson's disease: a prospective study. Parkinsonism Relat Disord 2016; 27: 89-92
    CrossrefPubMedGoogle Scholar
  • 56 Weintraub D, Koester J, Potenza MN. , et al. Impulse control disorders in Parkinson disease: a cross-sectional study of 3090 patients. Arch Neurol 2010; 67 (05) 589-595
    CrossrefPubMedGoogle Scholar
  • 57 Giovannoni G, O'Sullivan JD, Turner K, Manson AJ, Lees AJL. Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies. J Neurol Neurosurg Psychiatry 2000; 68 (04) 423-428
    CrossrefPubMedGoogle Scholar
  • 58 Evans AH, Lawrence AD, Potts J, Appel S, Lees AJ. Factors influencing susceptibility to compulsive dopaminergic drug use in Parkinson disease. Neurology 2005; 65 (10) 1570-1574
    CrossrefPubMedGoogle Scholar
  • 59 Maeda T, Shimo Y, Chiu S-W. , et al; J-FIRST group. Clinical manifestations of nonmotor symptoms in 1021 Japanese Parkinson's disease patients from 35 medical centers. Parkinsonism Relat Disord 2017; 38: 54-60
    CrossrefPubMedGoogle Scholar
  • 60 Allen RP, Picchietti DL, Garcia-Borreguero D. , et al; International Restless Legs Syndrome Study Group. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria–history, rationale, description, and significance. Sleep Med 2014; 15 (08) 860-873
    CrossrefPubMedGoogle Scholar
  • 61 Trenkwalder C, Allen R, Högl B, Paulus W, Winkelmann J. Restless legs syndrome associated with major diseases: a systematic review and new concept. Neurology 2016; 86 (14) 1336-1343
    CrossrefPubMedGoogle Scholar
  • 62 Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep Med Rev 2012; 16 (04) 283-295
    CrossrefPubMedGoogle Scholar
  • 63 Gupta R, Dhyani M, Kendzerska T. , et al. Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurol Scand 2016; 133 (05) 320-329
    CrossrefPubMedGoogle Scholar
  • 64 Sikandar R, Khealani BA, Wasay M. Predictors of restless legs syndrome in pregnancy: a hospital based cross sectional survey from Pakistan. Sleep Med 2009; 10 (06) 676-678
    CrossrefPubMedGoogle Scholar
  • 65 Hübner A, Krafft A, Gadient S, Werth E, Zimmermann R, Bassetti CL. Characteristics and determinants of restless legs syndrome in pregnancy: a prospective study. Neurology 2013; 80 (08) 738-742
    CrossrefPubMedGoogle Scholar
  • 66 Manconi M, Govoni V, De Vito A. , et al. Restless legs syndrome and pregnancy. Neurology 2004; 63 (06) 1065-1069
    CrossrefPubMedGoogle Scholar
  • 67 Cesnik E, Casetta I, Turri M. , et al. Transient RLS during pregnancy is a risk factor for the chronic idiopathic form. Neurology 2010; 75 (23) 2117-2120
    CrossrefPubMedGoogle Scholar
  • 68 Allen RP, Walters AS, Montplaisir J. , et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 2005; 165 (11) 1286-1292
    CrossrefPubMedGoogle Scholar
  • 69 Berger K, Luedemann J, Trenkwalder C, John U, Kessler C. Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 2004; 164 (02) 196-202
    CrossrefPubMedGoogle Scholar
  • 70 Pantaleo NP, Hening WA, Allen RP, Earley CJ. Pregnancy accounts for most of the gender difference in prevalence of familial RLS. Sleep Med 2010; 11 (03) 310-313
    CrossrefPubMedGoogle Scholar
  • 71 Winkelman JW, Armstrong MJ, Allen RP. , et al. Practice guideline summary: Treatment of restless legs syndrome in adults: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2016; 87 (24) 2585-2593
    CrossrefPubMedGoogle Scholar
  • 72 Picchietti DL, Hensley JG, Bainbridge JL. , et al; International Restless Legs Syndrome Study Group (IRLSSG). Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation. Sleep Med Rev 2015; 22: 64-77
    CrossrefPubMedGoogle Scholar
  • 73 García-Borreguero D, Williams A-M. Dopaminergic augmentation of restless legs syndrome. Sleep Med Rev 2010; 14 (05) 339-346
    CrossrefPubMedGoogle Scholar
  • 74 Duarte C, Couto M, Ines L, Liang MH. Epidemiology of systemic lupus erythematosus. In: Tsokos GC, Buyon JP, Koike T, Lahita RG, eds. Systemic Lupus Erythematosus. 5th ed. 2011:673–696
    PubMedGoogle Scholar
  • 75 Miyakis S, Lockshin MD, Atsumi T. , et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemostas 2006; 4: 295-306
    CrossrefPubMedGoogle Scholar
  • 76 Asherson RA, Derksen RHWM, Harris EN. , et al. Chorea in systemic lupus erythematosus and “lupus-like” disease: association with antiphospholipid antibodies. Semin Arthritis Rheum 1987; 16 (04) 253-259
    CrossrefPubMedGoogle Scholar
  • 77 Sanna G, Bertolaccini ML, Cuadrado MJ. , et al. Neuropsychiatric manifestations in systemic lupus erythematosus: prevalence and association with antiphospholipid antibodies. J Rheumatol 2003; 30 (05) 985-992
    PubMedGoogle Scholar
  • 78 Cervera R, Asherson RA, Font J. , et al. Chorea in the antiphospholipid syndrome. Clinical, radiologic, and immunologic characteristics of 50 patients from our clinics and the recent literature. Medicine (Baltimore) 1997; 76 (03) 203-212
    CrossrefPubMedGoogle Scholar
  • 79 Reiner P, Galanaud D, Leroux G. , et al. Long-term outcome of 32 patients with chorea and systemic lupus erythematosus or antiphospholipid antibodies. Mov Disord 2011; 26 (13) 2422-2427
    CrossrefPubMedGoogle Scholar
  • 80 Orzechowski NM, Wolanskyj AP, Ahlskog JE, Kumar N, Moder KG. Antiphospholipid antibody-associated chorea. J Rheumatol 2008; 35 (11) 2165-2170
    CrossrefPubMedGoogle Scholar
  • 81 Baizabal-Carvallo JF, Bonnet C, Jankovic J. Movement disorders in systemic lupus erythematosus and the antiphospholipid syndrome. J Neural Transm (Vienna) 2013; 120 (11) 1579-1589
    CrossrefPubMedGoogle Scholar
  • 82 Espinosa G, Cervera R. Current treatment of antiphospholipid syndrome: lights and shadows. Nat Rev Rheumatol 2015; 11 (10) 586-596
    CrossrefPubMedGoogle Scholar
  • 83 Robottom BJ, Weiner WJ. Chorea gravidarum. Handb Clin Neurol 2011; 100: 231-235
    CrossrefPubMedGoogle Scholar
  • 84 Maia DP, Fonseca PG, Camargos ST, Pfannes C, Cunningham MC, Cardoso F. Pregnancy in patients with Sydenham's Chorea. Parkinsonism Relat Disord 2012; 18 (05) 458-461
    CrossrefPubMedGoogle Scholar
  • 85 Miyasaki JM, Aldakheel A. Movement disorders in pregnancy. Continuum (Minneap Minn) 2014; 20 (1 Neurology of Pregnancy): 148-161
    PubMedGoogle Scholar
  • 86 Fasano A, Elia AE, Guidubaldi A, Tonali PA, Bentivoglio AR. Dystonia gravidarum: a new case with a long follow-up. Mov Disord 2007; 22 (04) 564-566
    CrossrefPubMedGoogle Scholar
  • 87 Lim EC-H, Seet RC-S, Wilder-Smith EPV, Ong BK-C. Dystonia gravidarum: a new entity?. Mov Disord 2006; 21 (01) 69-70
    CrossrefPubMedGoogle Scholar
  • 88 Louis ED, Rios E. Embarrassment in essential tremor: prevalence, clinical correlates and therapeutic implications. Parkinsonism Relat Disord 2009; 15 (07) 535-538
    CrossrefPubMedGoogle Scholar
  • 89 Elble RJ. Diagnostic criteria for essential tremor and differential diagnosis. Neurology 2000; 54 (11) (Suppl. 04) S2-S6
    CrossrefPubMedGoogle Scholar
  • 90 Louis ED, Ford B, Frucht S. Factors associated with increased risk of head tremor in essential tremor: a community-based study in northern Manhattan. Mov Disord 2003; 18 (04) 432-436
    CrossrefPubMedGoogle Scholar
  • 91 Soland VL, Bhatia KP, Marsden CD. Sex prevalence of focal dystonias. J Neurol Neurosurg Psychiatry 1996; 60 (02) 204-205
    CrossrefPubMedGoogle Scholar
  • 92 Patel A, Frucht SJ. Isolated vocal tremor as a focal phenotype of essential tremor: a retrospective case review. J Clin Mov Disord 2015; 2: 4
    CrossrefPubMedGoogle Scholar
  • 93 Robertson MM, Eapen V, Singer HS. , et al. Gilles de la Tourette syndrome. Nat Rev Dis Primers 2017; 3: 16097
    CrossrefPubMedGoogle Scholar
  • 94 Freeman RD, Zinner SH, Müller-Vahl KR. , et al. Coprophenomena in Tourette syndrome. Dev Med Child Neurol 2009; 51 (03) 218-227
    CrossrefPubMedGoogle Scholar
  • 95 Yang J, Hirsch L, Martino D, Jette N, Roberts J, Pringsheim T. The prevalence of diagnosed tourette syndrome in Canada: a national population-based study. Mov Disord 2016; 31 (11) 1658-1663
    CrossrefPubMedGoogle Scholar
  • 96 Lichter DG, Finnegan SG. Influence of gender on Tourette syndrome beyond adolescence. Eur Psychiatry 2015; 30 (02) 334-340
    CrossrefPubMedGoogle Scholar
  • 97 Lewin AB, Murphy TK, Storch EA. , et al. A phenomenological investigation of women with Tourette or other chronic tic disorders. Compr Psychiatry 2012; 53 (05) 525-534
    CrossrefPubMedGoogle Scholar
  • 98 Kompoliti K, Goetz CG, Leurgans S, Raman R, Comella CL. Estrogen, progesterone, and tic severity in women with Gilles de la Tourette syndrome. Neurology 2001; 57 (08) 1519
    PubMedGoogle Scholar
  • 99 Schwabe MJ, Konkol RJ. Menstrual cycle-related fluctuations of tics in Tourette syndrome. Pediatr Neurol 1992; 8 (01) 43-46
    CrossrefPubMedGoogle Scholar
  • 100 Stern JS, Orth M, Robertson MM. Gilles de la Tourette syndrome in pregnancy: a retrospective series. Obstet Med 2009; 2 (03) 128-129
    CrossrefPubMedGoogle Scholar