Neural Regeneration Research ›› 2023, Vol. 18 ›› Issue (4): 901-907.doi: 10.4103/1673-5374.353506

Previous Articles     Next Articles

Sex modulates the outcome of subthalamic nucleus deep brain stimulation in patients with Parkinson’s disease

Tian-Shuo Yuan1, #, Ying-Chuan Chen1, #, De-Feng Liu1, Ruo-Yu Ma1, Xin Zhang2, Ting-Ting Du2, Guan-Yu Zhu1, *, Jian-Guo Zhang1, 2, 3, *   

  1. 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;  2Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China;  3Beijing Key Laboratory of Neurostimulation, Beijing, China
  • Online:2023-04-15 Published:2022-10-29
  • Contact: Jian-Guo Zhang, MD, jg.zhang@ccmu.edu.cn; Guan-Yu Zhu, MD, zhuguanyu1991@ccmu.edu.cn.
  • Supported by:
    This study was support by the National Nature Science Foundation of China, Nos. 81830033, 61761166004 (both to JGZ).

PDF

90

Abstract: There are many documented sex differences in the clinical course, symptom expression profile, and treatment response of Parkinson’s disease, creating additional challenges for patient management. Although subthalamic nucleus deep brain stimulation is an established therapy for Parkinson’s disease, the effects of sex on treatment outcome are still unclear. The aim of this retrospective observational study, was to examine sex differences in motor symptoms, non-motor symptoms, and quality of life after subthalamic nucleus deep brain stimulation. Outcome measures were evaluated at 1 and 12 months post-operation in 90 patients with Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation aged 63.00 ± 8.01 years (55 men and 35 women). Outcomes of clinical evaluations were compared between sexes via a Student’s t-test and within sex via a paired-sample t-test, and generalized linear models were established to identify factors associated with treatment efficacy and intensity for each sex. We found that subthalamic nucleus deep brain stimulation could improve motor symptoms in men but not women in the on-medication condition at 1 and 12 months post-operation. Restless legs syndrome was alleviated to a greater extent in men than in women. Women demonstrated poorer quality of life at baseline and achieved less improvement of quality of life than men after subthalamic nucleus deep brain stimulation. Furthermore, Hoehn-Yahr stage was positively correlated with the treatment response in men, while levodopa equivalent dose at 12 months post-operation was negatively correlated with motor improvement in women. In conclusion, women received less benefit from subthalamic nucleus deep brain stimulation than men in terms of motor symptoms, non-motor symptoms, and quality of life. We found sex-specific factors, i.e., Hoehn-Yahr stage and levodopa equivalent dose, that were related to motor improvements. These findings may help to guide subthalamic nucleus deep brain stimulation patient selection, prognosis, and stimulation programming for optimal therapeutic efficacy in Parkinson’s disease.

Key words: chronic effect, deep brain stimulation, generalized linear model, initial effect, motor symptoms, non-motor symptoms, Parkinson’s disease, quality of life, sex, subthalamic nucleus