title: Long-term outcome of young onset Parkinson's disease after subthalamic stimulation--a cross-sectional study.
abstract: OBJECTIVE
  Age of onset is considered a poor prognostic factor for subthalamic deep brain stimulation (STN-DBS) outcome in the case of Parkinson's disease (PD). The goal of current study is to identify the long-term impact of STN-DBS for young onset PD (YOPD) patients.
  
  
  METHODS
  17 YOPD patients with a mean disease onset at 32.3 years were prospectively followed up at 1, 2, 5 and 7 years after STN-DBS. Unified Parkinson's disease rating scale (UPDRS) was evaluated in 4 combinations of Med/DBS on/off.
  
  
  RESULTS
  UPDRS part II-IV improved significantly 7 years after operation. While a slowly progressive worsening of levodopa response on part III, synergistic effect of medication and stimulation consistently improves motor disabilities. STN-DBS could remarkably reduce levodopa equivalent daily dose at 7 years. The morbidity rates were low. However, these patients seem to have more transient stimulation dyskinesia (47.1%) and dopamine dysregulation syndrome (11.8%) after surgery.
  
  
  CONCLUSIONS
  STN-DBS remains effective to improve motor disabilities over 7 years for YOPD and is a safe procedure concerning cognitive outcome and morbidity. However, stimulation dyskinesia and dopamine dysregulation syndrome deserve attention for the causal relationship between DBS surgery and behavioral outcomes.
authors.affiliation: Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Department of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Sheng-Tzung
authors.initials: ST
authors.lastname: Tsai
authors.forename: Hsiang-Yi
authors.initials: HY
authors.lastname: Hung
authors.forename: Tsung-Cheng
authors.initials: TC
authors.lastname: Hsieh
authors.forename: Sheng-Huang
authors.initials: SH
authors.lastname: Lin
authors.forename: Shinn-Zong
authors.initials: SZ
authors.lastname: Lin
authors.forename: Shin-Yuan
authors.initials: SY
authors.lastname: Chen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D017668:Age of Onset; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003071:Cognition / Q000502:physiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D010300:Parkinson Disease / Q000188:drug therapy / Q000628:therapy*; D011379:Prognosis; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Deep brain stimulation; Subthalamic nucleus; Young onset Parkinson's disease