Advertisement

Journal of Neurology

, Volume 257, Issue 4, pp 603–608 | Cite as

Transient gender-related effects in Parkinson’s disease patients with subthalamic stimulation

  • Luigi Michele RomitoEmail author
  • Fiorella Maria Contarino
  • Alberto Albanese
Original Communication

Abstract

Little is known about the gender-related long-term efficacy and safety after subthalamic nucleus deep brain stimulation (STN DBS) implant for Parkinson’s disease (PD), although some differences could be expected as recently stated in a short-term report. We assessed the possible gender-related differences in clinical outcome and disease progression along a 5-year period after STN DBS for PD. A prospective cohort of PD patients who underwent STN DBS and reached the 5-year follow-up (FU) was considered. Clinical outcome, disease progression and side effects were assessed at baseline and 1, 3, and 5 years after surgery. Eleven men and nine women were included in the study. At baseline, no inter-gender difference of age at implant, disease duration and severity or levodopa responsiveness was detected. A higher motor responsiveness in men compared to women was detected only at 1-year FU: this difference was mainly related to worse lower limb akinesia and gait score in women. The difference was not confirmed at 3 and 5 years. Antiparkinsonian drugs reduction, improvement in motor fluctuations and dyskinesias, functional measures and progression of underlying PD, were comparable in both groups. Women had persistent adverse events comparable to men. The present long-term observation confirms the occurrence of slight gender-related differences in PD patients treated with STN DBS, indicating a transient poorer outcome in women. Further observational time and a wider number of patients are needed to better analyze the dimension of long-term gender-related differences.

Keywords

Parkinson’s disease Deep brain stimulation Gender Subthalamus Surgery Movement disorders 

Abbreviations

DBS

Deep brain stimulation

IPG

Implantable pulse generator

LEDD

Levodopa-equivalent daily dose

PD

Parkinson’s disease

STN

Subthalamic nucleus

TEED

Total electrical energy delivered

UPDRS

Unified Parkinson’s Disease Rating Scale

Notes

Acknowledgments

The study was partly funded by the Italian Ministry of University and Research (National Interest Project number 2001062543 to AA).

References

  1. 1.
    Accolla E, Caputo E, Cogiamanian F, Tamma F, Mrakic-Sposta S, Marceglia S, Egidi M, Rampini P, Locatelli M, Priori A (2007) Gender differences in patients with Parkinson’s disease treated with subthalamic deep brain stimulation. Mov Disord 22:1150–1156CrossRefPubMedGoogle Scholar
  2. 2.
    Cahill L (2006) Why sex matters for neuroscience. Nat Rev Neurosci 7:477–484CrossRefPubMedGoogle Scholar
  3. 3.
    Cantuti-Castelvetri I, Keller-McGandy C, Bouzou B, Asteris G, Clark TW, Frosch MP, Standaert DG (2007) Effects of gender on nigral gene expression and Parkinson disease. Neurobiol Dis 26:606–614CrossRefPubMedGoogle Scholar
  4. 4.
    Defer GL, Widner H, Marie RM, Remy P, Levivier M (1999) Core assessment program for surgical interventional therapies in Parkinson’s disease (CAPSIT-PD). Mov Disord 14:572–584CrossRefPubMedGoogle Scholar
  5. 5.
    Haaxma CA, Bloem BR, Borm GF, Oyen WJ, Leenders KL, Eshuis S, Booij J, Dluzen DE, Horstink MW (2007) Gender differences in Parkinson’s disease. J Neurol Neurosurg Psychiatry 78:819–824CrossRefPubMedGoogle Scholar
  6. 6.
    Hariz GM, Lindberg M, Hariz MI, Bergenheim AT (2003) Gender differences in disability and health-related quality of life in patients with Parkinson’s disease treated with stereotactic surgery. Acta Neurol Scand 108:28–37CrossRefPubMedGoogle Scholar
  7. 7.
    Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184CrossRefPubMedGoogle Scholar
  8. 8.
    Koss AM, Alterman RL, Tagliati M, Shils JL (2005) Calculating total electrical energy delivered by deep brain stimulation systems. Ann Neurol 58:168–169CrossRefPubMedGoogle Scholar
  9. 9.
    Krack P, Batir A, Van BN, Chabardes S, Fraix V, Ardouin C, Koudsie A, Limousin PD, Benazzouz A, Lebas JF, Benabid AL, Pollak P (2003) Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 349:1925–1934CrossRefPubMedGoogle Scholar
  10. 10.
    Marceglia S, Mrakic-Sposta S, Foffani G, Cogiamanian F, Caputo E, Egidi M, Barbieri S, Priori A (2006) Gender-related differences in the human subthalamic area: a local field potential study. Eur J Neurosci 24:3213–3222CrossRefPubMedGoogle Scholar
  11. 11.
    Romito LM, Contarino MF, Vanacore N, Bentivoglio AR, Scerrati M, Albanese A (2008) Replacement of dopaminergic medication with subthalamic nucleus stimulation in Parkinson’s disease: long-term observation. Mov Disord 24:555–561CrossRefGoogle Scholar
  12. 12.
    Romito LM, Scerrati M, Contarino MF, Bentivoglio AR, Tonali P, Albanese A (2002) Long-term follow up of subthalamic nucleus stimulation in Parkinson’s disease. Neurology 58:1546–1550PubMedGoogle Scholar
  13. 13.
    Scott B, Borgman A, Engler H, Johnels B, Aquilonius SM (2000) Gender differences in Parkinson’s disease symptom profile. Acta Neurol Scand 102:37–43CrossRefPubMedGoogle Scholar
  14. 14.
    Shulman LM, Bhat V (2006) Gender disparities in Parkinson’s disease. Expert Rev Neurother 6:407–416CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Luigi Michele Romito
    • 1
    • 2
    Email author
  • Fiorella Maria Contarino
    • 3
    • 4
  • Alberto Albanese
    • 1
    • 2
  1. 1.Università Cattolica del Sacro CuoreMilanItaly
  2. 2.Neurology DepartmentFondazione IRCCS Istituto Neurologico “Carlo Besta”MilanItaly
  3. 3.Istituto di NeurologiaUniversità Cattolica del Sacro CuoreRomaItaly
  4. 4.Department of Neurology, H2-222Academic Medical CentreAmsterdamThe Netherlands

Personalised recommendations