title: Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?
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.
  
  
  OBJECTIVE
  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).
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neuroscience, University of Turin, Turin, Italy. aristidemerola@hotmail.com
authors.forename: Aristide
authors.initials: A
authors.lastname: Merola
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zibetti
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Artusi
authors.forename: Alice
authors.initials: A
authors.lastname: Marchisio
authors.forename: Valeria
authors.initials: V
authors.lastname: Ricchi
authors.forename: Laura
authors.initials: L
authors.lastname: Rizzi
authors.forename: Serena
authors.initials: S
authors.lastname: Angrisano
authors.forename: Nichy
authors.initials: N
authors.lastname: Arduino
authors.forename: Michele
authors.initials: M
authors.lastname: Lanotte
authors.forename: Mario
authors.initials: M
authors.lastname: Rizzone
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lopiano
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D017668:Age of Onset; D000368:Aged; D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult