Effects of deep brain stimulation in relatively young-onset multiple system atrophy Parkinsonism.
OBJECTIVE
The aim of this study was to analyze outcomes after 1 year of bilateral STN deep brain stimulation (DBS) in relatively young-onset patients with multiple system atrophy-Parkinsonism (MSA-P).


BACKGROUND
The efficacy of DBS has been demonstrated in idiopathic Parkinson's disease. However, the experience with DBS in relatively young-onset MSA-P is limited and controversial.


METHODS
Information about the demographic and clinical data from five MSA patients treated with STN DBS was entered into a database and analyzed.


RESULTS
Five patients with relatively young-onset MSA (mean age at onset 42.2±2.2 years, 3 women, 2 men) have been treated with bilateral STN stimulators, the mean duration between DBS surgery and disease onset was 7.0±3.5 years. All of the patients had dyskinesia and postural instability, and subjective benefit from levodopa. During the 6 months after surgery, the clinical status of three patients improved with a decrease of dyskinesia. However, by 1 year, the symptoms reappeared and progressed in all patients. Overall, the mean "off" medication UPDRS-III score worsened 23.5±15.3 1 year after surgery and the levodopa dosage was not reduced.


CONCLUSIONS
This data does not support the use of STN DBS for relatively young-onset MSA-P.
Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China.
Xiao-Ying
XY
Zhu
Parkinson's Disease Center and Movement Disorder Clinic, Department of Neurology, Baylor College of Medicine, Houston 77030, TX, USA.
Tian-Hong
TH
Pan
Department of Neurology, University of Texas Health Science Center Houston, Houston, TX, USA.
William G
WG
Ondo
Parkinson's Disease Center and Movement Disorder Clinic, Department of Neurology, Baylor College of Medicine, Houston 77030, TX, USA.
Joohi
J
Jimenez-Shahed
Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China. Electronic address: yunchw@medmail.com.cn.
Yun-Cheng
YC
Wu
D000328:Adult; D017668:Age of Onset; D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D008297:Male; D019578:Multiple System Atrophy / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D020734:Parkinsonian Disorders / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D012189:Retrospective Studies; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult
Deep brain stimulation; Multiple system atrophy; Parkinson's disease; Subthalamic nucleus; Young-onset