title: Gender differences in patients with Parkinson's disease treated with subthalamic deep brain stimulation.
abstract: We investigated gender-differences in clinical phenomenology and response to deep brain stimulation (DBS) of the subthalamic nucleus (STN) in a group of patients with advanced Parkinson's disease (PD). Thirty-eight consecutive patients with PD (22 men and 16 women), bilaterally implanted for DBS of the STN, were evaluated 1 month before and 11 to 14 months after surgery. Gender differences in severity of the disease (HY and UPDRS), ability in the activities of daily living (ADL, UPDRS II), tremor and rigidity (UPDRS III), bradykinesia (UPDRS III and hand tapping test), levodopa-induced dyskinesias (LIDs, UPDRS IV), and levodopa equivalent daily dosage (LEDD) were analyzed before and after intervention. We found a predominantly male population, with no gender-related differences in age at onset, disease progression rate, or severity of disease. Nevertheless, women had more severe LIDs than men, only before the intervention. Bradykinesia was significantly less responsive to any kind of treatment (pharmacologic and neurosurgical) in women than in men. Finally, although STN-DBS induced similar total benefits in both genders, postoperative assessment suggested that the ADL improved more in women than in men. Women and men with advanced PD appear to differ in some clinical features and in response to dopaminergic and STN-DBS treatment.
authors.affiliation: Dipartimento di Scienze Neurologiche, Università di Milano, Fondazione IRCCS Ospedale, Policlinico, Milano, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Accolla
authors.forename: Elena
authors.initials: E
authors.lastname: Caputo
authors.forename: Filippo
authors.initials: F
authors.lastname: Cogiamanian
authors.forename: Filippo
authors.initials: F
authors.lastname: Tamma
authors.forename: Simona
authors.initials: S
authors.lastname: Mrakic-Sposta
authors.forename: Sara
authors.initials: S
authors.lastname: Marceglia
authors.forename: Marcello
authors.initials: M
authors.lastname: Egidi
authors.forename: Paolo
authors.initials: P
authors.lastname: Rampini
authors.forename: Marco
authors.initials: M
authors.lastname: Locatelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Priori
mesh_terms: D000328:Adult; D017668:Age of Onset; D001921:Brain / Q000601:surgery; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D018476:Hypokinesia / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010300:Parkinson Disease / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy*; D011300:Preoperative Care; D015995:Prevalence; D012720:Severity of Illness Index; D012737:Sex Factors; D020531:Subthalamic Nucleus / Q000502:physiology*