用深度大脑刺激治疗帕金森病患者的性别差异
Muhammad Faran1, Danielle A Pietramala1, Franziska A Schmidt1,2
11Faculty of Medicine, Department of Surgery, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada.
Journal of neurosurgery
|May 16, 2025
概括
患有帕金森病 (PD) 的女性在病程晚些时候接受下丘脑核深脑刺激 (STN DBS). 虽然STN DBS对两性都有效,但女性经历了更糟糕的术前运动症状和生活质量,术后认知能力下降.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 运动障碍 运动障碍
背景情况:
- 脑下核深度大脑刺激 (STN DBS) 是对帕金森病 (PD) 的治疗方法.
- 在PD呈现和治疗结果中潜在的性别差异需要进行调查.
研究的目的:
- 对接受STN DBS的帕金森病患者手术前特征和1年术后结果的基于性别的差异进行调查.
- 为了比较运动症状,多巴胺激素药物使用和STN后的男性和女性DBS之间的生活质量 (QOL).
主要方法:
- 94名患者 (26名女性,68名男性) 的回顾性队列研究,他们接受了双边STN DBS.
- 在手术前和1年后评估运动症状 (UPDRS-III),药物剂量 (LEDD) 和QOL (PDQ-39).
- 分析使用线性混合效应模型来识别性别和时间的相互作用.
主要成果:
- 在手术前,与男性相比,女性的疾病持续时间更长,运动症状更差 (UPDRS-III),药物使用量更低 (LEDD) 和质量生活 (PDQ-39) 更差.
- 术后一年,在PDQ-39认知领域观察到显著的性别和时间相互作用,这表明女性的认知恶化.
- 对于运动症状得分 (UPDRS-III) 没有发现显著的性别和时间相互作用.
结论:
- 在帕金森病中,STN DBS在两性之间表现出同等的临床疗效.
- 患有PD的女性通常在疾病晚期接受STN DBS治疗,呈现出更先进的症状和较低的QOL.
- 女性手术后的QOL显示认知领域的下降,可能反映的是情绪,而不是认知变化.
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