The objective of this study was to determine whether the characteristics of Parkinson’s disease (PD) patients undergoing deep brain stimulation (DBS) differed based on the primary surgical indication.

The most common motor symptoms targeted by DBS are motor fluctuations and refractory tremor.  Little is known about whether patient characteristics differ based on the surgical indication.

We analyzed retrospective data from 149 consecutive PD patients treated with DBS at the University of Virginia between January 1, 2010 and September 30, 2017.  Patients were sorted into different groups based on surgical indication, and various pre-surgical characteristics were compared.

Of the 149 PD patients who had DBS, the primary indications for surgery were motor fluctuations (n=106), tremor (n=31), tremor and motor fluctuations (n=5), medication intolerance (n=5), and dystonia (n=2). A greater proportion of men had DBS for tremor than for motor fluctuations (93.5% vs 62.3%, p=0.001). PD patients who had DBS for tremor had a significantly shorter duration of disease (8.3 years vs 10.7 years, p=0.01) and later age at onset (56.7 years vs 52.2 years, p=0.007) compared to those who had surgery for motor fluctuations.  When men and women who underwent DBS for tremor or motor fluctuations were compared, there was no difference in either disease duration (9.8 vs 10.7 years, p=0.31) or age at onset (53.5 vs 52.5, p=0.55); however, women had a significantly worse quality of life compared to men as measured by the Parkinson’s Disease Questionnaire-39 (61.2 vs. 49.2, p=0.008). There were otherwise no significant differences in clinical characteristics between men and women who underwent DBS for tremor or motor fluctuations.

Patients who underwent DBS for tremor were predominantly men, while patients who received surgery for motor fluctuations approximated the commonly reported gender distribution of PD. Understanding the mechanism of this gender difference may influence future treatment approaches.