Development of a Screening Tool for Assessing Sexual Difficulties Among Patients with Parkinson's Disease: The PD-SDS.

Background: People with Parkinson's disease (PwPD) exhibit various sexual difficulties (SDs) that may be due to motor and/or nonmotor symptoms or the use of antiparkinsonian medication. SDs are often underreported by PwPD and underexplored by physicians. Objective: This study aimed to explore the SDs experienced by PwPD and create a scale for assessing them. Methods: A corpus of items was generated from semistructured interviews to represent the experience of PwPD as closely as possible. The number of items was reduced according to the psychometric properties, and the scale's structure was subsequently examined. The final phase consisted of measuring the scale's validity and reliability. Results: After assessment of the original corpus of 59 items by PwPD and clinicians, a 25-item version was obtained. The analysis of item properties led to the removal of fifteen items. An exploratory factor analysis of the first 10-item version with a first PwPD sample identified four components of the SDs among PwPD: "low sexual esteem," "sexual displeasure," "impact on sexual position" and "hypersexuality." With a second PwPD sample, a confirmatory factor analysis demonstrated a satisfactory fit between the model with four components and the data. The 10-item scale had good internal consistency and good temporal reliability. Conclusions: The Parkinson's Disease Sexual Difficulties Scale (PD-SDS) is a valid screening tool that facilitates the investigation of and communication about PD-related SDs. It is intended to improve the identification of vulnerable PwPD and to target the domain of sexual experience impacted by PD to better support PwPD.

Cognitive Impairment Is Part of the Phenotype of Cerebellar Ataxia, Neuropathy, Vestibular Areflexia Syndrome (CANVAS).

BACKGROUND: Little is known about the impact of the cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) on cognition. OBJECTIVE: Our objective was to determine the frequency and severity of cognitive impairment in RFC1-positive patients and describe the pattern of deficits. METHODS: Participants underwent a comprehensive neuropsychological assessment. Volume of the cerebellum and its lobules was measured in those who underwent a 3 Tesla-magnetic resonance scan. RESULTS: Twenty-one patients underwent a complete assessment, including 71% scoring lower than the cutoff at the Montreal Cognitive assessment and 71% having a definite cerebellar cognitive affective/Schmahmann syndrome. Three patients had dementia and seven met the criteria of mild cognitive impairment. Severity of cognitive impairment did not correlate with severity of clinical manifestations. Performance at memory and visuospatial functions tests negatively correlated with the severity of cerebellar manifestations. CONCLUSION: Cognitive manifestations are frequent in RFC1-related disorders. They should be included in the phenotype and screened systematically. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Impaired visual perception in rapid eye movement sleep behavior disorder.

OBJECTIVE: Patients with idiopathic REM sleep behavior disorder (iRBD) often develop synucleinopathies (Parkinson's disease [PD], in particular). Cognitive disorders affecting different domains have been reported in patients with iRBD. Dysexecutive disorders seem to predominate, but there is no consensus on the nature of visuospatial disorders in iRBD. The objective is to identify and characterize visuospatial disorders in patients with REM sleep behavior disorder (RBD - either idiopathic or associated with PD). METHODS: Fifteen patients with iRBD, 30 patients with PD (15 of whom had RBD), and 20 healthy control subjects underwent an extensive assessment of visuospatial functions. Two computerized tasks were used: a Biederman task (to assess the 3 levels of visuoperceptive processing) and a Posner paradigm (to assess visual attention). RESULTS: The visual priming effects classically described for the Biederman task in healthy controls were not found in iRBD patients. Patients with iRBD were no quicker in naming objects with the same general structure as previously presented objects but did have a normal priming effect for strictly identical objects. Parkinson's disease patients with RBD had poorer visuoperceptive performance levels than PD patients without RBD. There were no significant differences between the 4 groups in the Posner attentional task. CONCLUSIONS: First, this study confirms the presence of visuoperceptive dysfunction in iRBD patients and revealed a selective defect in intermediate visuoperceptive processing (i.e., general object representation). Second, RBD in PD appeared to be associated with poorer visuoperceptive abilities. Third, this visuoperceptive dysfunction in RBD patients was not associated with impaired attention.