Gender differences in patients with Parkinson's disease treated with subthalamic deep brain stimulation
Gender differences in patients with Parkinson's disease treated with subthalamic deep brain stimulation
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DOI：
10.1002/mds.21520
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发表时间：
2007-06-15
影响因子：
8.6
通讯作者：
Priori, Alberto
中科院分区：
文献类型：
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作者：
Accolla, Ettore;Caputo, Elena;Priori, Alberto
我们调查了一组晚期帕金森病 (PD) 患者的临床现象学和对丘脑底核 (STN) 深部脑刺激 (DBS) 反应的性别差异。连续 38 名 PD 患者（22 名男性和 16 名女性）接受双侧 STN 植入 DBS，在手术前 1 个月和术后 11 至 14 个月进行评估。分析干预前后疾病严重程度（HY和UPDRS）、日常生活活动能力（ADL、UPDRS II）、震颤和强直（UPDRS III）、运动迟缓（UPDRS III和手敲击试验）、左旋多巴诱发的运动障碍（LIDs、UPDRS IV）和左旋多巴每日等效剂量（LEDD）的性别差异。我们发现主要是男性人群，在发病年龄、疾病进展率或疾病严重程度方面没有性别相关的差异。然而，仅在干预之前，女性的 LID 比男性更严重。女性运动迟缓对任何治疗（药物和神经外科）的反应均明显低于男性。最后，尽管 STN-DBS 在两性中产生相似的总获益，但术后评估表明，女性的 ADL 改善程度高于男性。患有晚期 PD 的女性和男性在某些临床特征以及对多巴胺能和 STN-DBS 治疗的反应方面似乎有所不同。 (c) 2007 年运动障碍协会。
We investigated gender-differences in clinical phenomenology and response to deep brain stimulation (DBS) of the subthalamic nucleus (STN) in a group of patients with advanced Parkinson's disease (PD). Thirty-eight consecutive patients with PD (22 men and 16 women), bilaterally implanted for DBS of the STN, were evaluated 1 month before and 11 to 14 months after surgery. Gender differences in severity of the disease (HY and UPDRS), ability in the activities of daily living (ADL, UPDRS II), tremor and rigidity (UPDRS III), bradykinesia (UPDRS III and hand tapping test), levodopa-induced dyskinesias (LIDs, UPDRS IV), and levodopa equivalent daily dosage (LEDD) were analyzed before and after intervention. We found a predominantly male population, with no gender-related differences in age at onset, disease progression rate, or severity of disease. Nevertheless, women had more severe LIDs than men, only before the intervention. Bradykinesia was significantly less responsive to any kind of treatment (pharmacologic and neurosurgical) in women than in men. Finally, although STN-DBS induced similar total benefits in both genders, postoperative assessment suggested that the ADL improved more in women than in men. Women and men with advanced PD appear to differ in some clinical features and in response to dopaminergic and STN-DBS treatment. (c) 2007 Movement Disorder Society.