Maccarrone Giuseppe, Saporito Gennaro, Sucapane Patrizia, Rizi Chiara, Bruno Federico, Catalucci Alessia, Pistoia Maria Letizia, Splendiani Alessandra, Ricci Alessandro, Di Cesare Ernesto, Rizzo Marina, Totaro Rocco, Pistoia Francesca
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Department of Neurology, San Salvatore Hospital, L'Aquila, Italy.
Front Neurol. 2024 Sep 25;15:1429251. doi: 10.3389/fneur.2024.1429251. eCollection 2024.
Gender differences in the access to advanced therapies for Parkinson's disease (PD) are poorly investigated.
The objective of this study was to investigate the presence of any gender disparity in the access to advanced therapies for PD.
Retrospective study.
Data from patients with consistent access to the Parkinson's and Movement Disorder Center of L'Aquila over the last 10-year period were screened. Patients selected for advanced therapies were included.
Out of 1,252 patients, 200 (mean age ± SD 71.02 ± 9.70; 72% males; median Hoen Yahr level: 3, minimum 1 maximum 5) were selected for advanced therapies: 133 for Magnetic Resonance guided Focused Ultrasound (MRgFUS) thalamotomy (mean age ± SD 70.0 ± 8.9; 77% males), 49 for Levodopa/Carbidopa Intestinal Gel (LCIG) infusion (mean age ± SD 74.3 ± 11.4; 59% males), 12 for Deep Brain Stimulation (DBS) (mean age ± SD 71.2 ± 6.3; 75% males), and 7 for Continuous Subcutaneous Apomorphine Infusion (CSAI) (mean age ± SD 69.7 ± 5.5; 43% males). No sex differences were found in relation to age (MRgFUS group: males vs. females 70.2 ± 8.9 vs. 70.8 ± 8.9, -value = 0.809; LCIG group: males vs. females 73.5 ± 13.0 vs. 75.5 ± 8.5, -value = 0.557; DBS group: males vs. females 77.2 ± 8.1 vs. 67.3 ± 8.6, -value = 0.843; CSAI group: males vs. females 73.3 ± 4.0 vs. 67.0 ± 5.2, -value = 0.144) and disease duration (MRgFUS group: males vs. females 8.3 ± 4.4 vs. 9.6 ± 6.7, -value = 0.419; LCIG group: males vs. females 14.5 ± 5.81 vs. 17.3 ± 5.5; -value = 0.205; DBS group: males vs. females 15.0 ± 9.6 vs. 15.5 ± 7.7, -value = 0.796; CSAI group: males vs. females 11.7 ± 3.7 vs. 10.3 ± 3.7, -value = 0.505).
The predominance of males is higher than that expected based on the higher prevalence of PD in men. Women are less confident in selecting advanced therapies during the natural progression of their disease. Factors accounting for this discrepancy deserve further investigation.
帕金森病（PD）晚期治疗中的性别差异研究较少。
本研究旨在调查PD晚期治疗中是否存在性别差异。
回顾性研究。
筛选过去10年中持续就诊于拉奎拉帕金森病与运动障碍中心的患者数据。纳入接受晚期治疗的患者。
在1252例患者中，200例（平均年龄±标准差71.02±9.70岁；72%为男性；霍恩-雅尔分级中位数：3级，最低1级，最高5级）接受了晚期治疗：133例接受磁共振引导聚焦超声（MRgFUS）丘脑切开术（平均年龄±标准差70.0±8.9岁；77%为男性），49例接受左旋多巴/卡比多巴肠凝胶（LCIG）输注（平均年龄±标准差74.3±11.4岁；59%为男性），12例接受脑深部电刺激（DBS）（平均年龄±标准差71.2±6.3岁；75%为男性），7例接受皮下持续阿扑吗啡输注（CSAI）（平均年龄±标准差69.7±5.5岁；43%为男性）。在年龄方面未发现性别差异（MRgFUS组：男性与女性，70.2±8.9岁与70.8±8.9岁，P值=0.809；LCIG组：男性与女性，73.5±13.0岁与75.5±8.5岁，P值=0.557；DBS组：男性与女性，77.2±8.1岁与67.3±8.6岁，P值=0.843；CSAI组：男性与女性，73.3±4.0岁与67.0±5.2岁，P值=0.144）以及疾病持续时间方面也未发现性别差异（MRgFUS组：男性与女性，8.3±4.4年与9.6±6.7年，P值=0.419；LCIG组：男性与女性，14.5±5.81年与17.3±5.5年，P值=0.205；DBS组：男性与女性，15.0±9.6年与15.5±7.7年，P值=0.796；CSAI组：男性与女性，11.7±3.7年与10.3±3.7年，P值=0.505）。
男性在晚期治疗中的占比高于基于男性PD患病率较高所预期的比例。女性在疾病自然进展过程中对选择晚期治疗的信心较低。造成这种差异的因素值得进一步研究。
