Long-term comparison of subthalamic nucleus stimulation between patients with young-onset and late-onset Parkinson’s disease

AbstractObjectivesThe aim of this study was to compare the long-term effectiveness of subthalamic nucleus deep brain stimulation (STN-DBS) between patients with young-onset Parkinson’s disease (YOPD) and late-onset Parkinson’s disease (LOPD).Materials and MethodsTwenty-one YOPD patients with a mean age at onset of 32.8 ± 6.9 years and another 69 LOPD patients with a mean age at onset of 53.2 ± 6.9 years undergoing STN-DBS were followed. The mean durations of follow-up for those who were followed for more than 3 years were 57.22 ± 14.54 months in the YOPD group and 46.77 ± 13.84 months in the late onset group.ResultsMotor disabilities and activities of daily living in patients with LOPD and YOPD significantly improved after the operation. However, YOPD patients showed significantly less improvement in Unified Parkinson’s Disease Rating Scale Part II (p = 0.001) and Part III (p = 0.031), rigidity (p = 0.033), and axial (p = 0.046) scores than late onset patients more than 3 years after surgery. YOPD patients had higher scores for rigidity (p = 0.007) and bradykinesia (p = 0.044) than LOPD patients at the final post-surgery follow-up. Late onset PD patients had more postoperative hypophonia, whereas EOPD patients displayed more stimulation dyskinesia. The effects of STN-DBS on psychiatric complications and cerebral bleeding were similar in both groups.ConclusionYOPD patients and LOPD patients had similar benefits and risks from medication-related complications with STN-DBS. The YOPD group had relatively less improvement from acute deep brain stimulation than the LOPD group during long-term follow-up, which could possibly be explained by different disease evolutions and underlying pathophysiology in these two groups