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In early PD, functional changes may be detected in primary motor cortex using transcranial magnetic stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We hypothesised that if pathophysiology differs between sexes in PD, this will be reflected in differences of motor cortex measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010one newly diagnosed PD patients (22 males, 19 females) were clinically assessed using MDS\u2010UPDRS part III, and various measures of cortical excitability and sensorimotor cortex plasticity were measured over both hemispheres, corresponding to the less and more affected side, using transcranial magnetic stimulation. Twenty\u2010three healthy (10 men, 13 women) participants were studied for comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among patients, no significant differences between sexes were found in age, age of diagnosis, symptom duration, and total or lateralized motor score. However, male patients had disturbed interhemispheric balance of motor thresholds, caused by decreased resting and active motor thresholds in the more affected hemisphere. Short interval intracortical inhibition was more effective in female compared to male patients in both hemispheres. Female patients had a preserved physiological focal response to sensorimotor plasticity protocol, whereas male patients showed an abnormal spread of the protocol effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study provides one of the first neurophysiological evidences of sex differences in early PD. Female patients have a more favorable profile of transcranial magnetic stimulation measures, possibly reflecting a more successful cortical compensation or delayed maladaptive changes in the sensorimotor cortex. \u00a9 2019 International Parkinson and Movement Disorder Society<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.27870","type":"journal-article","created":{"date-parts":[[2019,10,11]],"date-time":"2019-10-11T09:02:12Z","timestamp":1570784532000},"page":"1873-1881","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Sex differences in Parkinson's disease: A transcranial magnetic stimulation study"],"prefix":"10.1002","volume":"34","author":[{"given":"Kaja","family":"Kolmancic","sequence":"first","affiliation":[{"name":"Institute of Pathophysiology University of Ljubljana, Medical Faculty  Ljubljana Slovenia"},{"name":"Department of Neurology University Medical Centre Ljubljana  Ljubljana 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