To determine whether there is a gender disparity in access to deep brain stimulation surgery (DBS) for Parkinson’s disease (PD) at a large single health system, and to better understand the reasons for this discrepancy.

DBS is a safe and effective treatment in the management of advanced PD. Some studies have suggested that women are less likely to receive surgery compared to men despite similar post-surgical improvements. To improve access, it is important to understand the reasons for this disparity.

Data was taken from the University of Miami DBS Database, from January 2014 to December 2017. The sample included 3,251 PD patients (61.9% male). Data was analyzed using c² and t-tests to examine group gender differences among the number of patients referred for surgery, reasons for referral, numbers receiving/not receiving surgery, reasons for not receiving surgery, and post-surgical outcomes.

Overall, 207 were referred for DBS (73.9% male), and 100 underwent surgery (77.0% male). Of the patients who did not receive surgery, the most common reasons were need for further medical optimization (26.2%), suboptimal performance on neuropsychological evaluation (22.4%), other reason (20.6%), lost to follow-up (18.7%), or patient preference (12.2%). Women were more likely to not receive surgery due to patient preference (30.0%, p= 0.005). Men were more likely to be lost to follow-up (p=0.032). There were no significant differences in post-surgical outcomes.

Despite similar post-surgical improvements, women were less likely to undergo deep brain stimulation surgery compared to men, frequently due to their own preference. These data underscore the need for increased education and community outreach in order to increase awareness and access to DBS, particularly for women, so that all PD patients who qualify for surgery can benefit from this procedure.