Comparison of Parkinson’s Disease Patients’ Characteristics by Indication for Deep Brain Stimulation: Men Are More Likely to Have DBS for Tremor

Dalrymple, W. Alex; Pusso, Antonia; Sperling, Scott A.; Flanigan, Joseph L.; Huss, Diane; Harrison, Madaline B.; Elias, W. Jeffrey; Shah, Binit; Barrett, Matthew J.

doi:10.7916/tohm.v0.676

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…Our sample was comprised of 70.3% male patients and very few (7.2%) had less than a 12th-grade education. Having fewer female patients and a negative educational skew may have contributed to the nonsignificance of our results, though the ratio of males to females in our sample closely reflects the ratio reported in other studies of PD (e.g., Dalrymple et al, 2019;Deuschl et al, 2006).…”

Section: Relationships With Demographic Characteristicssupporting

confidence: 75%

Factor structure of the BDI-II in Parkinson’s disease.

Stohlman¹,

Sperling²

2021

Neuropsychology

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Objective: There is substantial heterogeneity in depressive symptomology for individuals with Parkinson's disease (PD). It is unknown whether the Beck Depression Inventory-Second Edition (BDI-II) is capable of identifying such phenotypic variations of depression. Method: We investigated the factor structure of the BDI-II and its associations with demographic characteristics and other nonmotor symptoms in PD. We reviewed the cases of 236 patients with a confirmed PD diagnosis. Evaluations included the BDI-II, Montreal Cognitive Assessment (MoCA), Apathy Scale (AS), and Geriatric Anxiety Inventory (GAI). We used exploratory structural equation modeling (ESEM) with target rotations as this method integrates aspects of exploratory and confirmatory factor analysis. We conducted hierarchical regressions to assess for associations between the BDI-II factors and gender, age, education, disease duration, cognition, anxiety, and apathy. Results: ESEM supported the retention of a Somatic factor and an Affective factor that accounted for 53% of the model variance. Model goodness-of-fit measures were within normal limits. Higher AS scores were positively associated with the Somatic and Affective factors. Higher GAI scores were positively associated only with the Affective factor. There were no other significant relationships with factor scores. Conclusions: This study supports the retention of a two-factor model of the BDI-II in PD. These unique clusters of depressive symptoms in PD can be used to guide clinical decisions about the need for further psychiatric evaluation and the appropriateness of different therapeutic interventions. Key PointsQuestion: What Is the Factor Structure of the BDI-II in Parkinson's Disease? Findings: This study provides support for the retention of an Affective factor and a Somatic factor for the BDI-II in Parkinson's disease. Importance: These factors provide insight into the phenotypic variations of depressive symptomology in Parkinson's disease. Next Steps: Future studies should explore whether participant responses across these factors change in response to various treatments.

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Section: Relationships With Demographic Characteristicssupporting

confidence: 75%

Factor structure of the BDI-II in Parkinson’s disease.

Stohlman¹,

Sperling²

2021

Neuropsychology

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“…Dalrymple et al examined differences based on the primary indication for DBS. They demonstrated that men were more likely to be treated with DBS for medication refractory tremor than women ( 18 ). Interestingly, Vinke et al reported that more women underwent STN-DBS surgery after moving from awake to asleep surgery ( 19 ).…”

Section: Resultsmentioning

confidence: 99%

“…Regarding gender discrepancies, men are more likely than women to receive DBS ( 14 , 15 ), and their indications differ from women ( 18 ). Our observation that men are more likely to receive DBS is in line with a meta-analysis performed by Hariz et al, who also found a global male predominance, except for Asia ( 63 ).…”

Section: Discussionmentioning

confidence: 99%

Gender discrepancies and differences in motor and non-motor symptoms, cognition, and psychological outcomes in the treatment of Parkinson’s disease with subthalamic deep brain stimulation

Hendriks,

Vinke,

Georgiev

2024

Front. Neurol.

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Available data suggest that there may be gender differences in the effect of STN-DBS in the treatment of Parkinson’s disease (PD). The aim of this study was to review data on gender discrepancies and gender differences in clinical outcomes in PD patients treated with deep brain stimulation of the subthalamic nucleus (STN-DBS). Included were original studies that specifically examined gender discrepancies or gender differences in PD patients with STN-DBS. Men receive more DBS than women, for various indications. The decision-making process for DBS in women compared to men is more influenced by personal preferences and external factors. Motor symptoms improve in both genders, but bradykinesia improves more in men. The postoperative reduction of the levodopa equivalent daily dose seems to be more pronounced in men. Men show more cognitive deterioration and less improvement than women after STN-DBS. Women show more depressive symptoms before surgery, but they improve similarly to men. Men show more improvement in impulsivity and less decrease in impulsive behaviour symptoms than women. Anxiety and personality traits remain unchanged in both genders. Voice quality improves more in men and deteriorates less often than in women. Men gain fat-free mass and fat mass, but women only gain fat mass. Regarding sexual function the evidence is inconsistent. More urinary symptoms improve in women than in men. Pain and restless leg syndrome seems to improve more in men. Regarding quality of life, the evidence seems to be inconsistent, and activities of daily living seems to improve in both genders. Better prospective controlled studies, focusing directly on gender differences in PD patients treated with STN-DBS, are needed to better explain gender differences in STN-DBS for PD.

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“…Surgical: Deep brain stimulation (DBS), a neurosurgical procedure that involves electrical stimulation of the global pallidus internus (GPi) or subthalamic nucleus (STN), is an alternative treatment for PD, particularly in advanced PD (187). In terms of sex disparities and treatment outcomes, three trends emerged: (1) sex disparities in DBS selection, particularly in the undertreatment, referral and follow-ups of female PwP, (2) similar surgical outcomes postoperatively after DBS between sexes, although males were more likely to display lasting improvements and (3) quality of life postoperatively depend on sex-specific symptoms phenotype (187)(188)(189)(190)(191)(192)(193).…”

Section: Pharmacologicalmentioning

confidence: 99%

Sex differences in alpha-synucleinopathies: a systematic review

Raheel,

Deegan,

Di Giulio

et al. 2023

Front. Neurol.

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BackgroundPast research indicates a higher prevalence, incidence, and severe clinical manifestations of alpha-synucleinopathies in men, leading to a suggestion of neuroprotective properties of female sex hormones (especially estrogen). The potential pathomechanisms of any such effect on alpha-synucleinopathies, however, are far from understood. With that aim, we undertook to systematically review, and to critically assess, contemporary evidence on sex and gender differences in alpha-synucleinopathies using a bench-to-bedside approach.MethodsIn this systematic review, studies investigating sex and gender differences in alpha-synucleinopathies (Rapid Eye Movement (REM) Behavior Disorder (RBD), Parkinson’s Disease (PD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA)) from 2012 to 2022 were identified using electronic database searches of PubMed, Embase and Ovid.ResultsOne hundred sixty-two studies were included; 5 RBD, 6 MSA, 20 DLB and 131 PD studies. Overall, there is conclusive evidence to suggest sex-and gender-specific manifestation in demographics, biomarkers, genetics, clinical features, interventions, and quality of life in alpha-synucleinopathies. Only limited data exists on the effects of distinct sex hormones, with majority of studies concentrating on estrogen and its speculated neuroprotective effects.ConclusionFuture studies disentangling the underlying sex-specific mechanisms of alpha-synucleinopathies are urgently needed in order to enable novel sex-specific therapeutics.

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Comparison of Parkinson’s Disease Patients’ Characteristics by Indication for Deep Brain Stimulation: Men Are More Likely to Have DBS for Tremor

Cited by 5 publications

References 13 publications

Factor structure of the BDI-II in Parkinson’s disease.

Factor structure of the BDI-II in Parkinson’s disease.

Gender discrepancies and differences in motor and non-motor symptoms, cognition, and psychological outcomes in the treatment of Parkinson’s disease with subthalamic deep brain stimulation

Sex differences in alpha-synucleinopathies: a systematic review

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