Browse by author
Lookup NU author(s): Professor Nicola PaveseORCiD, Dr David Ledingham
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.Background Disproportionately fewer females with Parkinson’s disease (PD) undergo deep brain stimulation surgery (DBS). Some data show worse depression, anxiety, and quality of life (QOL) in females with PD. Investigations into these gender disparities, or the effect of DBS on these non-motor symptoms, remain limited. Methods 61 PD patients across seven UK DBS centres were recruited for the Clinical Response of Impulsive behaviours to deep brain Stimulation in PD (CRISP) prospective cohort study. Questionnaires measured primary outcomes of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7) and QOL (Parkinson’s Disease Questionnaire-39) before and 6months after bilateral subthalamic nucleus DBS, and secondary outcomes of predictors of postoperative changes in mood. Results Females were disproportionately under-referred for DBS (28% of cohort). Baseline depression and anxiety were similar between genders. While DBS significantly improved overall anxiety (p<0.001), females reported significantly more postoperative anxiety than males (median score 7 vs 1.5, Cohen’s d=0.33, p=0.009). Postoperatively, only males experienced a significant reduction in moderate depression, by 29% (p=0.004) (12% in females). QOL improved significantly by similar proportions, thus significantly worse QOL in females preoperatively was sustained as 9.12% worse postoperatively (Cohen’s d=0.75, p=0.02). Preoperatively, females reported significantly worse mobility, social support, and pain; postoperatively, the significant difference in mobility was sustained. Longer PD duration, worse QOL, and mobility predicted postoperative depression (R2 =0.156, p=0.003), while female gender and reduced social support predicted postoperative anxiety (R2=0.23, p<0.001). Conclusions DBS showed clinical efficacy for non-motor PD symptoms across genders, evidencing the need to close the gender gap in DBS. Analysis by gender highlighted significant disparities and postoperative predictors that provide impetus for tailored DBS counselling.
Author(s): Abbott MG, Ahmed A, Pavese N, Macerollo A, Newman EJ, Farah JO, Sarangmat N, Misbahuddin A, Ledingham D, GIbbs M, Mills R, Ashkan K, Silverdale M, Samuel M, Okai D, Shotbolt P
Publication type: Article
Publication status: Published
Journal: BMJ Neurology Open
Year: 2025
Volume: 7
Issue: 2
Online publication date: 30/09/2025
Acceptance date: 13/09/2025
Date deposited: 21/10/2025
ISSN (electronic): 2632-6140
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/bmjno-2025-001246
DOI: 10.1136/bmjno-2025-001246
Data Access Statement: t Data may be obtained from a third party and are not publicly available. All data relevant to the study are included in the article or uploaded as supplementary information
Altmetrics provided by Altmetric
