ArticlePloS one2014
The "brittle response" to Parkinson's disease medications: characterization and response to deep brain stimulation.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Sex differences in alpha-synucleinopathies: a systematic review.Frontiers in neurology · 2023Pooled it
- Adaptive deep brain stimulation for Parkinson's disease using motor cortex sensing.Journal of neural engineering · 2018Trial
- What factors influence the length of stay and readmission after deep brain stimulation surgery? a tertiary centre study.Acta neurochirurgica · 2026Article
- Sex differences in levodopa pharmacokinetics in early Parkinson's disease: implications on levodopa-related complications.Frontiers in pharmacology · 2026Article
- Brittle Response to Levodopa as a Marker of Parkinson's Disease Phenotype Characterized by Heavy Motor and Non Motor Burden.Journal of movement disorders · 2025Article
- A video-atlas of levodopa-induced dyskinesia in Parkinson's disease: terminology matters.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Review
- Gender gap in deep brain stimulation for Parkinson's disease: preliminary results of a retrospective study.Neurosurgical review · 2024Article
- Sex Differences in the Speech of Persons With and Without Parkinson's Disease.American journal of speech-language pathology · 2024Article
- Sex Differences in Parkinson's Disease: From Bench to Bedside.Brain sciences · 2022Article
- Short- and long-term motor outcome of STN-DBS in Parkinson's Disease: focus on sex differences.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Gender Differences in Levodopa Pharmacokinetics in Levodopa-Naïve Patients With Parkinson's Disease.Frontiers in medicine · 2022Article
- Globus Pallidus Internus (GPi) Deep Brain Stimulation for Parkinson's Disease: Expert Review and Commentary.Neurology and therapy · 2021Article
- Analysis of factors associated with brittle response in patients with Parkinson's disease.Annals of clinical and translational neurology · 2020Article
- The relevance of gender in Parkinson's disease: a review.Journal of neurology · 2017Review
- Update on deep brain stimulation in Parkinson's disease.Translational neurodegeneration · 2015Article
- STN vs. GPi Deep Brain Stimulation: Translating the Rematch into Clinical Practice.Movement disorders clinical practice · 2014Article
- Brittle Dyskinesia Following STN but not GPi Deep Brain Stimulation.Tremor and other hyperkinetic movements (New York, N.Y.) · 2014Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
objectiveFormulate a definition and describe the clinical characteristics of PD patients with a "brittle response" (BR) to medications versus a "non-brittle response" (NBR), and characterize the use of DBS for this population.
methodsAn UF IRB approved protocol used a retrospective chart review of 400 consecutive PD patients presenting to the UF Center for Movement Disorders and Neurorestoration. Patient records were anonymized and de-identified prior to analysis. SPSS statistics were used to analyze data.
resultsOf 345 included patients, 19 (5.5%) met criteria for BR PD. The BR group was comprised of 58% females, compared to 29% in the NBR group (P = .008). The former had a mean age of 63.4 compared to 68.1 in the latter. BR patients had lower mean weight (63.5 vs. 79.6, P = <.001), longer mean disease duration (12.6 vs. 8.9 years, P = .003), and had been on LD for more years compared to NBR patients (9.8 vs. 5.9, P = .001). UPDRS motor scores were higher (40.4 vs. 30.0, P = .001) in BR patients. No differences were observed regarding the Schwab and England scale, PDQ-39, and BDI-II. Sixty-three percent of the BR group had undergone DBS surgery compared to 18% (P = .001). Dyskinesias were more common, severe, and more often painful (P = <.001) in the BR group. There was an overall positive benefit from DBS.
conclusionBR PD occurred more commonly in female patients with a low body weight. Patients with longer disease duration and longer duration of LD therapy were also at risk. The BR group responded well to DBS.
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