• Aristide Merola, Maurizio Zibetti, Carlo Alberto Artusi, Alice Marchisio, Valeria Ricchi, Laura Rizzi, Serena Angrisano, Nichy Arduino, Michele Lanotte, Mario Rizzone, and Leonardo Lopiano.
• Department of Neuroscience, University of Turin, Turin, Italy. aristidemerola@hotmail.com
• J. Neurol. Neurosurg. Psychiatr. 2012 Mar 1;83(3):251-7.

BackgroundPatients 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.AimIn 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 MethodsMean 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.ResultsYOPD 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.ConclusionIn 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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