Category: Surgical Therapy: Parkinson's Disease
Objective: To investigate whether there is a gender bias in patients with Parkinson’s disease (PD) undergoing deep brain stimulation (DBS) at a single health system and to investigate gender differences in quality of life (QoL), motor, and nonmotor symptoms (NMS) in PD patients undergoing DBS.
Background: Recent research has shown that women are less likely to undergo DBS. However, little is known about the reasons for this discrepancy.
Method: We examined the number of referrals and positive/negative indication evaluations for DBS at the University Hospital Cologne. Furthermore, in a prospective, observational, multicenter international study, we analyzed gender difference at baseline and 6-month follow-up in NMS, motor symptoms and QoL.
Results: The proportion of female patients referred for DBS indication evaluations was significantly lower than the known proportion of female patients in the general PD population (p=.002). 229 patients (n=82 female) were approved for DBS in indication evaluations and Chi-square analysis revealed an association between female gender and positive DBS indication evaluation (p=.029). Furthermore, we observed a statistical trend (p=.065) indicating that the proportion of female patients who eventually underwent DBS (63 female out of 190 patients) was smaller than in male patients. Preoperatively, women had longer disease duration, higher dyskinesia, and motor complications scores. No significant gender differences were observed in longitudinal changes for all outcome parameters.
Conclusion: Our study provides evidence of a gender gap to the disadvantage of female patients: (1) disproportionally fewer female patients underwent DBS indication assessments than to be expected from the gender ratio of the general PD population, (2) preoperatively, female patients had longer PD duration and more severe dyskinesia, and, (3) nonetheless, DBS was equally efficacious on total QoL, NMS, and motor symptoms. Therefore, we advocate that more focus should be directed toward the decisional processes and the responsibilities of stakeholders in the implementation of gender equality in the context of DBS.
To cite this abstract in AMA style:S. Jost, L. Strobel, A. Rizos, P. Loehrer, K. Ashkan, J. Evans, F. Rosenkranz, M. Barbe, G. Fink, J. Franklin, A. Sauerbier, C. Nimsky, A. Sattari, K. Ray Chaudhuri, A. Antonini, L. Timmermann, P. Martinez-Martin, M. Silverdale, E. Kalbe, V. Visser-Vandewalle, H. Dafsari. Gender bias in patients with Parkinson’s disease undergoing subthalamic stimulation [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/gender-bias-in-patients-with-parkinsons-disease-undergoing-subthalamic-stimulation/. Accessed December 7, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/gender-bias-in-patients-with-parkinsons-disease-undergoing-subthalamic-stimulation/