Gender disparities in deep brain stimulation surgery for Parkinson disease and essential tremor

Abstract

Background

Women with Parkinson’s Disease (PD) receive Deep Brain Stimulation (DBS) less often than men.

Objective

To determine gender differences in the use of DBS for PD and essential tremor (ET) in the United States and at a single academic center.

Methods

The Nationwide Readmissions Database (NRD) was used to identify patients with PD and ET who underwent DBS from 2016 to 2017. The primary outcome was a comparison of the proportions of women and men who underwent DBS using chi-square tests. Locally, we identified patients with PD and ET referred for DBS from 2011 to 2020. The primary outcomes included a comparison of the proportions of women and men who were referred, completed the evaluation, were approved for surgery, and underwent DBS using Fisher’s exact tests.

Results

From 2016–2017, 6952 patients with PD (30.5% women) and 3000 patients with ET (42.6% women) underwent DBS in the United States. At a single academic center, 428 patients with PD (30.6% women) and 126 patients with ET (34% women) were referred for DBS, which was significantly different than the proportion of women with PD and ET in the neurology clinic population (p = 0.001 and p < 0.001, respectively). In both groups, women and men were equally likely to complete the evaluation and be approved for surgery; however, women with ET were more likely to decline surgery (35% vs 13%, p = 0.05).

Conclusion

Women with PD and ET were less likely to be referred for DBS evaluation, and women with ET were more likely to decline surgery once approved.