Sex disparity in patients with Parkinson’s disease treated using deep brain stimulation
Bibliographic record
Abstract
OBJECTIVE: Studies have suggested that there may be sex differences in the preoperative characteristics and postoperative outcomes of patients with Parkinson's disease (PD) treated with subthalamic nucleus (STN) deep brain stimulation (DBS). Authors of this study aimed to reveal differences in preoperative and 1-year postoperative motor symptoms, dopaminergic medication use, and quality of life (QOL) domains between men and women who had undergone STN DBS. METHODS: In this retrospective cohort study, the authors evaluated patients who underwent bilateral STN DBS at a single center from 2008 to 2023. Motor symptoms were measured using the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III), levodopa equivalent daily dose (LEDD) was used to measure the dosage of dopaminergic medications, and the 39-Item Parkinson's Disease Questionnaire (PDQ-39) was used to determine QOL outcomes. Exploratory linear mixed-effect models were used to investigate sex and time interactions for the UPDRS-III, LEDD, and PDQ-39 scores. RESULTS: Ninety-four patients, 26 females and 68 males, were included in the study. Preoperatively, women presented with a significantly longer disease duration (p = 0.014), greater UPDRS-III off-medication scores (p < 0.001), lower LEDDs (p = 0.001), and worse PDQ-39 mean total score (p < 0.001). One year postoperatively, after adjusting for disease duration, age, UPDRS-III off scores, and LEDD, there was a significant sex and time interaction for the cognition domain of the PDQ-39, which showed worsening over time in women (p = 0.009). There was no significant sex and time interaction in the UPDRS-III off-medication/on-stimulation scores. CONCLUSIONS: Although STN DBS is equally clinically efficacious for both sexes, women are treated later in the disease course. Preoperatively, women present during more advanced stages of PD with worse motor symptoms and a lower QOL. Postoperatively, women score worse on the cognition index, a proxy for mood rather than cognition.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".