Introduction

Subthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for patients with Parkinson’s disease (PD) with motor complications; the contribution of sex in determining the outcome is still not understood.

Methods

We included 107 patients (71 males) with PD consecutively implanted with STN-DBS at our center. We reviewed patient charts from our database and retrospectively collected demographical and clinical data at baseline and at three follow-up visits (1, 5 and 10 years).

Results

We found a long-lasting effect of DBS on motor complications, despite a progressive worsening of motor performances in the ON medication condition. Bradykinesia and non-dopaminergic features seem to be the major determinant of this progression. Conversely to males, females showed a trend towards worsening in bradykinesia already at 1-year follow-up and poorer scores in non-dopaminergic features at 10-year follow-up. Levodopa Equivalent Daily Dose (LEDD) was significantly reduced after surgery compared to baseline values; however, while in males LEDD remained significantly lower than baseline even 10 years after surgery, in females LEDD returned at baseline values. Males showed a sustained effect on dyskinesias, but this benefit was less clear in females; the total electrical energy delivered was consistently lower in females compared to males. The profile of adverse events did not appear to be influenced by sex.

Conclusion

Our data suggest that there are no major differences on the motor effect of STN-DBS between males and females. However, there may be some slight differences that should be specifically investigated in the future and that may influence therapeutic decisions in the chronic follow-up.

中文翻译：

---

帕金森病 STN-DBS 的短期和长期运动结果：关注性别差异

介绍

丘脑底核深部脑刺激 (STN-DBS) 是一种既定的治疗方法，用于治疗伴有运动并发症的帕金森病 (PD) 患者；性别在决定结果中的作用仍不清楚。

方法

我们纳入了在我们中心连续植入 STN-DBS 的 107 名 PD 患者（71 名男性）。我们审查了我们数据库中的患者图表，并在基线和三次随访（1、5 和 10 年）时回顾性收集了人口统计学和临床​​数据。

结果

我们发现 DBS 对运动并发症有持久的影响，尽管在 ON 用药条件下运动表现逐渐恶化。运动迟缓和非多巴胺能特征似乎是这一进展的主要决定因素。与男性相反，女性在 1 年的随访中表现出运动迟缓恶化的趋势，在 10 年的随访中非多巴胺能特征的评分较差。与基线值相比，手术后左旋多巴当量日剂量 (LEDD) 显着降低；然而，即使在手术后 10 年，男性 LEDD 仍显着低于基线，而女性 LEDD 恢复到基线值。男性表现出对运动障碍的持续影响，但这种益处在女性中不太明显；与男性相比，女性输送的总电能始终较低。

结论

我们的数据表明，男性和女性对 STN-DBS 的运动效应没有重大差异。然而，未来可能会有一些细微的差异需要专门研究，这可能会影响长期随访中的治疗决策。