RT Journal Article
SR Electronic
T1 Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 251
OP 257
DO 10.1136/jnnp-2011-300470
VO 83
IS 3
A1 Merola, Aristide
A1 Zibetti, Maurizio
A1 Artusi, Carlo Alberto
A1 Marchisio, Alice
A1 Ricchi, Valeria
A1 Rizzi, Laura
A1 Angrisano, Serena
A1 Arduino, Nichy
A1 Lanotte, Michele
A1 Rizzone, Mario
A1 Lopiano, Leonardo
YR 2012
UL http://jnnp.bmj.com/content/83/3/251.abstract
AB 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.