Sex differences in the short-term and long-term effects of subthalamic nucleus stimulation in Parkinson's disease

Objective: To assess the influence of sex on the short-term and long-term effects of subthalamic nucleus stimulation (STN-DBS) in Parkinson's disease (PD) Methods: We evaluated 48 male and 52 female PD patients enrolled in our prospective DBS registry who received bilateral STN-DBS between 2005 and 2013 and had 5-year follow-up data. Motor function, dyskinesia duration/disability, activities of daily living, health-related quality of life (HRQoL), cognitive function, and depression severity were investigated at baseline and at the 1- and 5-year follow-up visits. HRQoL was assessed using the 36-Item Short Form Health Survey (SF-36), which consists of physical-component summary (PCS) and mental-component summary scores. Results: None of the changes from baseline to the 1- or 5-year follow-up in clinical outcomes differed between the men and women except for the SF-36 PCS scores. Compared with the baseline, there was an improvement in the PCS scores in both men (p < 0.001) and women (p = 0.001) at the 1-year follow-up; however, a trend toward greater improvement in men was observed (p = 0.061). At the 5-year follow-up, STN-DBS improved the PCS scores in men (p < 0.001) but not in women (p =0.409) compared with the baseline, and there was a significant difference between the groups (p = 0.002). Conclusions: Our data suggest that STN-DBS induce a similar degree of short-term and long-term effects on motor function, cognitive and depressive symptoms, and functional status between male and female PD patients. Nevertheless, physical HRQoL seemed to improve to a greater extent in men, and this sex difference was more prominent with long-term observation.