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Research paper
Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?
  1. Aristide Merola,
  2. Maurizio Zibetti,
  3. Carlo Alberto Artusi,
  4. Alice Marchisio,
  5. Valeria Ricchi,
  6. Laura Rizzi,
  7. Serena Angrisano,
  8. Nichy Arduino,
  9. Michele Lanotte,
  10. Mario Rizzone,
  11. Leonardo Lopiano
  1. Department of Neuroscience, University of Turin, Turin, Italy
  1. Correspondence to Dr A Merola, Department of Neuroscience, University of Turin, Via Cherasco 15, Torino 10126, Italy; aristidemerola{at}hotmail.com

Abstract

Background Patients with young onset Parkinson's disease (YOPD) are often candidates for subthalamic nucleus–deep brain stimulation (STN–DBS). Nevertheless, few data have been reported on the long term STN–DBS clinical outcome of YOPD versus non-young onset Parkinson's disease (n-YOPD) patients.

Aim In this study, the issue of whether YOPD might represent a long term positive predictive factor for STN–DBS was addressed, comparing follow-up data for 20 YOPD and 40 n-YOPD patients (20 treated after <15 years of disease duration and 20 treated after ≥15 years of disease duration).

Materials and methods Mean scores for the Unified Parkinson's Disease Rating Scale (UPDRS) sections were compared 1 year, 5 years and, for 34 patients (12 YOPD and 22 n-YOPD), ≥7 years after surgery. Furthermore, a Cox proportional hazard regression model was used to determine the influence of age at PD onset, clinical phenotype, disease duration and duration of motor complications on the development of stimulation and medication resistant symptoms.

Results YOPD patients showed a lower incidence of stimulation and medication resistant symptoms and a lower mortality rate; also, the tremor dominant clinical phenotype was associated with a lower risk of developing dementia, hallucinations and constipation. No significant differences in UPDRS scores were observed between n-YOPD patients treated after <15 years of PD and those treated after ≥15 years of PD.

Conclusion In this series of STN–DBS treated patients, YOPD was associated with a medium to long term lower incidence of stimulation and medication resistant symptoms.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval All subjects who took part in the study gave informed consent to be anonymously included in this publication. However, ethics committee approval was not requested because no experimental evaluations were performed; this study simply reports retrospective clinical data collected during ordinary clinical evaluations, which were performed in accordance with the principles of good clinical practice.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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