Evidence map›Paper›PMID 42155302›Full record

ArticleClinical neurology and neurosurgery2026

The current landscape of sex-based disparities in surgical treatment of essential tremor and Parkinson's disease amidst MRgFUS adoption.

Manish Ranjan, Vishal Thakur, Johnie Hodge, David Fletcher, Justin Oh, Ann M Murray, Huanwen Alvin Chen, Adam A Dmytriw, Vivek S Yedavalli, Marco Colasurdo and 3 more

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Article in Clinical neurology and neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Manish RanjanDepartment of Neurosurgery, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA. Electronic address: manish.ranjan@hsc.wvu.edu.
Vishal ThakurDepartment of Neurosurgery, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Johnie HodgeDepartment of Neurosurgery, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
David FletcherSchool of Medicine, West Virginia University, Morgantown, WV, USA.
Justin OhDepartment of Neurosurgery, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Ann M MurrayDepartment of Neurology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Huanwen Alvin ChenDepartment of Neurology, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA; Neurointerventional and Neuroanalytics Consortium, School of Medicine, Toronto Metropolitan University, Toronto, Ontario, Canada.
Vivek S YedavalliDepartment of Radiology, Johns Hopkins Medicine, Baltimore, MD, USA.
Marco ColasurdoDepartment of Intervention Radiology, Oregon Health & Science University, Portland, OR, USA.
Ajay MalhotraDepartment of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA.
Dheeraj GandhiDepartment of Radiology, University of Maryland, Baltimore, MD, USA.
Dhairya A LakhaniDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI JUDITH FEINBERG · 2012 to 2026
$81.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

backgroundSex disparities in surgical treatment for movement disorders such as essential Tremor (ET) and Parkinson's disease (PD) are well documented for deep brain stimulation (DBS), but remain less understood in the context of newer, less invasive procedures such as magnetic resonance-guided focused ultrasound (MRgFUS).

objectiveTo examine sex differences in the utilization of deep brain stimulation (DBS) and MRgFUS for ET and PD patients using a large, propensity score-matched cohort.

methodsData from over 600,000 ET or PD patients were analyzed from TriNetX (07/2005-06/2025). Propensity score matching balanced male and female cohorts. Hazards of receiving DBS, MRgFUS, or combined surgical treatment were compared by sex using hazard ratios (HR) with 95% confidence intervals (CI).

resultsIn the ET cohort (N = 279,600), females had a significantly lower likelihood of receiving surgical treatment compared with males (HR=0.56, 95% CI:0.53-0.59, p < 0.001), and the trends were similar for the subgroup receiving MRgFUS (HR=0.38, 95% CI:0.34-0.43, p < 0.001) and DBS (HR=0.61, 95% CI:0.58-0.64, p < 0.001). In the PD cohort (N = 344,314), females similarly exhibited lower likelihood of receiving surgical treatment compared with males (HR=0.68, 95% CI:0.65-0.70, p < 0.001), and the trends were similar for subgroup receiving MRgFUS (HR=0.53, 95% CI:0.42-0.68, p < 0.001) and DBS (HR=0.68, 95% CI:0.65-0.71, p < 0.001.

conclusionsIn this multi-institutional analysis, female patients with ET or PD were significantly less likely to undergo surgical treatment with either DBS or MRgFUS, even after adjusting for demographics and comorbidities. The persistence of this disparity despite the availability of MRgFUS suggests that barriers to surgical care extend beyond procedural invasiveness alone. Addressing these inequities will require targeted, multidisciplinary efforts spanning patient education, referral practices, and health system-level factors.

Indexed as

Deep Brain StimulationEssential TremorHealthcare DisparitiesParkinson DiseaseAgedCohort StudiesFemaleHumansMaleMiddle AgedSex FactorsEssential tremorMovement disordersMR guided focused ultrasoundParkinson’s diseaseSex disparity

Identifiers

PMID42155302
PMCPMC13233090

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.