Background: Patients with young onset Parkinson's disease (YOPD) are often candidates for subthalamic nucleusedeep brain stimulation (STNeDBS). Nevertheless, few data have been reported on the long term STNeDBS clinical outcome of YOPD versus nonyoung 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 STNeDBS 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 STNeDBS treated patients, YOPD was associated with a medium to long term lower incidence of stimulation and medication resistant symptoms.

Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?

MEROLA, Aristide;Zibetti M;Artusi CA;RIZZI, Laura;LANOTTE, Michele Maria Rosario;RIZZONE, Mario Giorgio;LOPIANO, Leonardo
2012-01-01

Abstract

Background: Patients with young onset Parkinson's disease (YOPD) are often candidates for subthalamic nucleusedeep brain stimulation (STNeDBS). Nevertheless, few data have been reported on the long term STNeDBS clinical outcome of YOPD versus nonyoung 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 STNeDBS 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 STNeDBS treated patients, YOPD was associated with a medium to long term lower incidence of stimulation and medication resistant symptoms.
2012
83
251
257
Merola A; Zibetti M; Artusi CA; Marchisio A; Ricchi V; Rizzi L; Angrisano S; Arduino N; Lanotte M; Rizzone M; Lopiano L
File in questo prodotto:
File Dimensione Formato  
JNNP2012.pdf

Accesso riservato

Tipo di file: PDF EDITORIALE
Dimensione 266.3 kB
Formato Adobe PDF
266.3 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
JNNP 2012 OA.pdf

Accesso aperto

Tipo di file: POSTPRINT (VERSIONE FINALE DELL’AUTORE)
Dimensione 680.98 kB
Formato Adobe PDF
680.98 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/119420
Citazioni
  • ???jsp.display-item.citation.pmc??? 12
  • Scopus 24
  • ???jsp.display-item.citation.isi??? 25
social impact