Abstract Details

Title Cultural Disparities in Deep Brain Stimulation (DBS) Decision Making in Patients with Parkinson Disease (PD)

Topic Movement Disorders

Presentation(s) P2 - Poster Session 2 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-007

Objective

To identify socio-cultural factors that affect when DBS is initially discussed with patients in a tertiary Movement Disorders center, and how these factors impact a patient’s decision to proceed with the surgical work-up and surgery.

Background Over two million people have PD in the United States. DBS is an important treatment for PD patients whose motor symptoms do not respond adequately to pharmacotherapy. It is unknown if there are socio-cultural disparities influencing access to DBS.

Design/Methods

We identified all PD patients referred for neuropsychological assessment as part of their initial pre-surgical DBS workup between January 1, 2011 and March 27, 2019. Retrospective chart review was then conducted. Cross-sectional analysis using t-tests and linear regression model was performed.

Results One hundred seventy-two DBS candidates were identified for review (mean age 66.0, SD=9.6, 34% female). Sixty-six percent identified the US as their origin country, 69 percent identified English as their dominant language, and 74 percent were non-Hispanic white. Forty percent had a commercial insurance plan at time of surgery. The overall linear regression model including race, insurance type, and gender showed these variables were significant predictors of UPDRS-III score “off” medication at the time of pre-surgical evaluation (F=8.05, p<0.001). When analyzed separately, race (p<0.001) and insurance type (p=0.035) were significant independent predictors of the UPDRS-III score, however gender alone was not. Patients with commercial insurance plans had lower UPDRS-III scores and non-Hispanic white patients had lower UPDRS-III scores at time of evaluation.

Conclusions Non-Hispanic white PD patients and those with commercial insurance plans are more likely to be referred for DBS at an earlier stage of disease compared to other racial/ethnic groups.

Authors/Disclosures
Risako Shirane, MD, MSc (Yale University) PRESENTER	Dr. Shirane has nothing to disclose.
	No disclosure on file
Eileen Moran, MD	No disclosure on file
Vicki Shanker, MD, F�鶹��ýӳ�� (Icahn School of Medicine at Mount Sinai)	Dr. Shanker has received personal compensation in the range of $0-$499 for serving as a Consultant for The Insighters.
Christina Palmese	Christina Palmese has nothing to disclose.

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