Gender differences in disability and health-related quality of life in patients with Parkinson's disease treated with stereotactic surgery

Hariz, Gun‐Marie; Lindberg, Maria; Hariz, Marwan; Bergenheim, A. Tommy

doi:10.1034/j.1600-0404.2003.00092.x

Cited by 84 publications

(80 citation statements)

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“…Further study is needed to delineate the individual contributions of these confounders. Univariate and multivariate regression analyses were concordant in showing that motor fluctuations and dyskinesia occurred more frequently in women, suggesting a true biologic difference, which has been demonstrated repeatedly in the literature [1] [13] [14]. Specifically, women have been found to achieve higher plasma concentration of levodopa after oral administration, leading to a greater incidence of motor side effects [13].…”

Section: Discussionmentioning

confidence: 66%

“…Men experience sexual dysfunction [8] [11], fatigue [11], olfactory dysfunction [8] [11], and use caregivers more than women [12]. Dyskinesia has been widely reported to cluster in women [1] [13] [14], and women have been observed to experience dysphagia [15], restless legs [11], pain [11], and depressive symptoms more frequently than men [8] [11] [16].…”

Section: Introductionmentioning

confidence: 99%

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Exploring Gender-Associated Socioeconomic Differences in Parkinson’s Disease

McInnis¹,

Cavanaugh²,

Weinberg³

et al. 2015

APD

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Background: Research on gender in Parkinson's disease (PD) frequently focuses on clinical differences between men and women. Socioeconomic factors such as race, ethnicity, insurance type, and level of educational attainment, have not been extensively examined in relation to gender differences in PD. The goal of this study was to identify differences in PD presentation in men and women, and identify socioeconomic factors that may confound such differences. Methods: A movement disorder patient database containing 445 patients with idiopathic PD was analyzed for gender differences in motor symptoms and disease complications using linear or logistic regression. Socioeconomic variables were then evaluated as possible confounders. Results: A greater proportion of women were non-white (p < 0.05). Univariate analysis of gender, and multivariate analysis controlling for age at diagnosis and socioeconomic factors were concordant in demonstrating increased frequency of motor fluctuations and dyskinesia in women (p < 0.05). Controlled, multivariate analysis, when compared to univariate analysis, uniquely demonstrated that women were less likely to experience dementia and autonomic dysfunction, relative to men (p < 0.05). Conclusion: Women with PD are susceptible to motor fluctuations and dyskinesia, but may be relatively protected against dementia and autonomic dysfunction. Women and men with PD in our population had different socioeconomic profiles, which may have confounded some gender-associated differences.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Exploring Gender-Associated Socioeconomic Differences in Parkinson’s Disease

McInnis¹,

Cavanaugh²,

Weinberg³

et al. 2015

APD

View full text Add to dashboard Cite

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“…En pacientes en quienes el temblor es el síntoma relevante, el objetivo quirúrgico más adecuado es el núcleo ventral-intermedio del tálamo (Vim), cuya lesión y estimulación eléctrica disminuyen los síntomas de forma eficaz 3,4,11,17,37,39 . Debemos considerar, además, que la palidotomía es capaz de aliviar parcialmente el temblor.…”

Section: Indicación De La Intervenciónunclassified

“…De acuerdo con los datos bibliográficos, la palidotomía fue eficaz sobre la rigidez e hipocinesia en el 92% de los casos; el temblor disminuyó en el 81% 5,7,10,17,20,22,31,32,37 , lo cual concuerda con los resultados obtenidos durante nuestro trabajo. Varios autores se refieren a la importancia del uso de microelectrodos en el Gpi (región somatosensorial), ya que permite determinar el sitio óptimo para la lesión.…”

Section: Diagrama 8 Updrs III Después De La Palido-talamotomía Combiunclassified

“…Por otro lado, es de conocimiento general que, al contrario de la palidotomía, la talamotomía, en esencia, disminuye los síntomas hipercinéticos, como el temblor y la discinesia 16,26,37 . En realidad, la palidotomía no suprime de forma eficaz el temblor como lo hace la talamotomía, razón por lo cual se introdujeron procedimientos quirúrgicos combinados (en el núcleo Vim, Ventral -oral -posterior /Vop/, del tálamo, así como en el globo pálido región postero ventral /palidotomía postero-ventral = PPV/) 17,19,32,38 . La talamotomía (Vim) trae como resultado la interrupción del círculo rubro-tálamo-cortical, mientras que la palidotomía interrumpe la eferencia de las fibras del Gpi, lo cual podría interferir o bloquear el efecto inhibitorio del mesencéfalo y del centro locomotor espinal.…”

Section: Diagrama 8 Updrs III Después De La Palido-talamotomía Combiunclassified

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Tratamiento de la enfermedad de Parkinson con palidotomía y palido-talamotomía estereotáctica guiada por microelectrodos

Llumiguano¹,

Dóczi²,

Baths³

2006

Neurocirugía

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ResumenObjetivo. Los autores valoraron el efecto terapéu-tico de palidotomía y palido-talamotomía combinada guiada por MR y microelectrodos en 33 pacientes con enfermedad de Parkinson, cuyos síntomas fueron resistentes al tratamiento farmacológico.Material y métodos. Los pacientes fueron evaluados en base a los test estandarizados a nivel internacional que se efectuaron antes y después de la operación: al 2º día, así como a lo largo de 12 meses, con un intervalo de 3 meses entre ellos. Los pacientes fueron divididos en dos grupos; en los del grupo "A", los síntomas parkinsonianos, incluso el temblor, disminuyeron después de una palidotomía. En los pacientes del grupo "B", el temblor no disminuyó tras la palidotomía, razón por la cual ésta se complementó con una talamotomía.Resultados. Con la ayuda de la escala UPDRS III se obtuvieron los siguientes resultados: después de la palidotomía en "fase on" el promedio preoperatorio de 51,2 disminuyó a 29,5 al 2º día, a 26 a los 3, 6 y 9 meses, y a 28,7 a los 12 meses después de la operación; en "fase off" el promedio preoperatorio de 64,3 declinó a 31,6 al 2º día, a 26 a los 3, 6 y 9 meses, y a 30,5 a los 12 meses después de la operación. Después de la palidotalamotomía en "fase on" el promedio preoperatorio de 43,5 disminuyó a 27,9 al 2º día, a 22,9 a los 3 meses, a 22,8 a los 6 meses, y a 24,5 a los 9 y 12 meses después de la operación. De igual manera, en "fase off" el promedio preoperatorio de 62,6 declinó a 38 al 2º día, a 30 a los 3 meses, a 31,8 a los 6 meses, y a 33,8 a los 9 y 12 meses después de la operación.Conclusión. Para aquellos pacientes, en quienes la palidotomía no fue suficiente en el control del temblor, la palido-talamotomía fue efectiva. Los síntomas clínicos, de acuerdo con las escalas utilizadas, mejoraron significativamente en los dos grupos (student t: P<0,0001); sin embargo, las lesiones bilaterales conllevan un alto riesgo de morbilidad.PALABRAS CLAVE: Enfermedad de Parkinson. Palidotomía. Talamotomía. Microeletrode guided stereotactic pallidotomy and pallido-thalamotomy for treatment of Parkinson's disease AbstractObjective. Authors evaluated the therapeutic effect of the MRI and microelectrodeguided stereotactic pallido-and pallido-thalamotomy in 33 patients with Parkinson's disease (PD), whose symptoms were refractory to pharmacological therapy.Matherial and methods. The patients were evaluated according to the internationally standardized rating scales (UPDRS part II, III, Schawb & England, Hoehn & Yahr, and Fahn) at six timepoints: before the operation, and 2 days, 3, 6, 9 and 12 months postoperatively. The patients were divided into 2 groups. Those in group A had relief of all main parkinsonian symptoms after pallidotomy including tremor. The patients in group B had no relief of tremor after pallidotomy. For them the pallidotomy was completed by thalamotomy in the same sitting, which had resulted in cessation of tremor.Results. The following results were obtained by using the UPDRS part III: after pallidotomy "On state" mean: preoperati...

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Dinu¹,

Peeters

2012

Bell Labs Tech. J.

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Poor skin permeability limits the application of peptides to the skin. Enhanced skin permeation could facilitate the development of new therapies for dermatologic and cosmeceutical applications. The aim of this study was to investigate the application of iontophoresis to the delivery of small peptide model compounds (5‐aminolevulinic acid and L‐alanine‐L‐tryptophan) across human skin. Under the conditions tested, iontophoresis increased the in vitro permeability coefficient of ALA.HCl across human epidermis from 7 × 10−5 cm/h with passive diffusion to 110 × 10−5 cm/h with iontophoresis. D‐Glucose permeation elucidated the iontophoretic electrotransport of ALA.HCl to have contributions of both electrorepulsion and electroosmosis. The L‐alanine‐L‐tryptophan permeability coefficient was increased from 1.5 × 10−5 cm/h to 35 × 10−5 cm/h with iontophoretic application. Iontophoretic delivery of the dipeptide increased markedly at lower pH because of an increase in electrorepulsive transport. The study demonstrates that iontophoresis can enhance epidermal permeation of a small peptide and peptide‐like drug by up to 15‐ and 22‐fold under the conditions tested. © 2010 Wiley Periodicals, Inc. Biopolymers (Pept Sci) 96: 166–171, 2011.

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Gender differences in disability and health-related quality of life in patients with Parkinson's disease treated with stereotactic surgery

Abstract: Perhaps women with PD should be offered surgery more often and earlier in the course of their disease.

Cited by 84 publications

References 35 publications

Exploring Gender-Associated Socioeconomic Differences in Parkinson’s Disease

Exploring Gender-Associated Socioeconomic Differences in Parkinson’s Disease

Tratamiento de la enfermedad de Parkinson con palidotomía y palido-talamotomía estereotáctica guiada por microelectrodos

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