Evaluation of DBS Timeline in Movement Disorders: A Comparison Between Genders

Deshpande, Nachiket; Gibbs, River; Ali, Rushna

doi:10.1016/j.wneu.2022.04.092

Cited by 4 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Resultsmentioning

confidence: 99%

“…A study that examined gender disparity from diagnosis to DBS found no gender differences in the interval between diagnosis and surgery or DBS outcomes ( 20 ). Interestingly, women had a greater reduction in motor scores before surgery ON medication than men ( 20 ). On the other hand, women were more likely to be rejected for DBS because of depression at presurgical evaluation ( 16 ) and they were more likely to decide against DBS because of personal preference ( 21 ).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

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.

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

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.

View full text Add to dashboard Cite

show abstract

“…This comprehensive review of the literature highlights disparities based on gender in the utilization of DBS for PD, which aligns with prior research examining disparities in access to invasive treatments for cardiac and gastrointestinal conditions ( Hvelplund et al, 2010 ; Chibber and Baranchuk, 2020 ). Several studies have identified a notable gender disparity in the utilization of DBS for PD, with a significantly higher proportion of men undergoing the procedure than women and these studies have been conducted in various countries ( Hariz et al, 2003 , 2013 ; Mathkour et al, 2017 ; Deshpande et al, 2022 ). These findings emphasize the need for additional study regarding potential unconscious bias among healthcare providers, variations in the clinical indications for surgery based on gender, concerns specific to women regarding surgical complications, and gender-specific coping mechanisms for managing disease symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…These variations in clinical phenotype may influence the decision to undergo DBS and contribute to the observed gender disparities. However, when it comes to clinical outcomes and responses to DBS, existing research suggests that men and women show comparable results in terms of quality of life, motor symptoms, medication needs, and motor outcomes ( Chandran et al, 2014 ; Shpiner et al, 2019 ; Deshpande et al, 2022 ; Jost et al, 2022 ). These findings suggest that nonclinical factors likely play a role in the observed gender gap in DBS utilization.…”

Section: Discussionmentioning

confidence: 99%

“…This systematic review is based on studies with limitations that must be acknowledged. Most studies are derived from single-center experiences ( Chandran et al, 2014 ; Shpiner et al, 2019 ; Deshpande et al, 2022 ; Watanabe et al, 2022 ; Skelton et al, 2023 ), capturing only the final stages of the extensive clinical pathway for DBS surgeries and may restrict the generalizability of the findings. The small sample sizes in some studies limit the statistical power of the primary outcomes ( Shpiner et al, 2019 ; Deshpande et al, 2022 ; Watanabe et al, 2022 ; Skelton et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review of health disparities research in deep brain stimulation surgery for Parkinson’s disease

Memon,

Gelman,

Melott

et al. 2023

Front. Hum. Neurosci.

View full text Add to dashboard Cite

BackgroundDeep brain stimulation (DBS) is the primary surgical intervention for Parkinson’s disease (PD) patients with insufficient response to medication, significantly improving motor symptoms and quality of life. Despite FDA approval for over two decades, access to this therapy remains limited. This systematic review aims to evaluate the influence of gender, race/ethnicity, socioeconomic status, and age on health disparities associated with DBS for PD, providing an overview of current research in this field.MethodsA systematic literature search was conducted in PubMed/MEDLINE, Embase, Web of Science and Cochrane databases from 1960 to September 12th, 2023, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Studies that examine the disparities in accessing DBS among patients with PD were included, comparing different demographic factors. Findings were synthesized and presented narratively to identify and understand DBS disparities.ResultsAfter screening for relevance, 25 studies published between 1960 and 2023 were included, with 16 studies meeting full-text review criteria. While reviewing the references of the 16 articles, two additional studies were included, bringing the total number of included studies to 18. Most studies originated from the United States (44%). The identified studies were categorized as identifying disparities, understanding disparities, or reducing disparities. The majority focused on identifying disparities (72%), while fewer studies delved into understanding the underlying factors (28%). No studies evaluated strategies for reducing disparities. The findings indicate that elderly, female, and Black people, as well as those from low socioeconomic backgrounds and developing countries face greater obstacles in accessing DBS for PD.ConclusionThis study highlights factors contributing to disparities in DBS utilization for PD, including race, gender, and socioeconomic status. Public health policymakers, practitioners, and clinicians should recognize these inequalities and work toward reducing disparities, particularly among vulnerable populations.

show abstract

Access to device-aided therapies in advanced Parkinson’s disease: navigating clinician biases, patient preference, and prognostic uncertainty

et al. 2023

View full text Add to dashboard Cite

Device-aided therapies (DAT), which include deep brain stimulation and pump-based continuous dopaminergic stimulation with either levodopa or apomorphine, are among the major advances in the clinical management of Parkinson’s disease (PD). Although DAT are being increasingly offered earlier in the disease course, their classical indication remains advanced PD. Theoretically, every patient should be offered transition to DAT when faced with refractory motor and nonmotor fluctuations and functional decline. Worldwide clinical reality is far from these ideal, and, therefore, question the “real-world” equal opportunity of access to DAT for PD patients with advanced PD—even within a single health care system. Differences in access to care, referral pattern (timing and frequency), as well as physician biases (unconscious/implicit or conscious/explicit bias), and patients’ preferences or health-seeking behaviour are to be considered. Compared to DBS, little information is available concerning infusion therapies, as well as neurologists’ and patients’ attitudes towards them. This viewpoint aims to be thought-provoking and to assist clinicians in moving through the process of DAT selection, by including in their decision algorithm their own biases, patient perspective, ethical concerns as well as the current unknowns surrounding PD prognosis and DAT-related long-term side effects for a given patient.

show abstract

Evaluation of DBS Timeline in Movement Disorders: A Comparison Between Genders

Cited by 4 publications

References 19 publications

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

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

A systematic review of health disparities research in deep brain stimulation surgery for Parkinson’s disease

Access to device-aided therapies in advanced Parkinson’s disease: navigating clinician biases, patient preference, and prognostic uncertainty

Contact Info

Product

Resources

About