Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?
Identifieur interne : 001C79 ( Main/Corpus ); précédent : 001C78; suivant : 001C80Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?
Auteurs : Aristide Merola ; Maurizio Zibetti ; Carlo Alberto Artusi ; Alice Marchisio ; Valeria Ricchi ; Laura Rizzi ; Serena Angrisano ; Nichy Arduino ; Michele Lanotte ; Mario Rizzone ; Leonardo LopianoSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2012-03.
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. Aim 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). Materials and 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. Conclusion 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.
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DOI: 10.1136/jnnp-2011-300470
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Alberto Artusi</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Marchisio, Alice" sort="Marchisio, Alice" uniqKey="Marchisio A" first="Alice" last="Marchisio">Alice Marchisio</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Ricchi, Valeria" sort="Ricchi, Valeria" uniqKey="Ricchi V" first="Valeria" last="Ricchi">Valeria Ricchi</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Rizzi, Laura" sort="Rizzi, Laura" uniqKey="Rizzi L" first="Laura" last="Rizzi">Laura Rizzi</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Angrisano, Serena" sort="Angrisano, Serena" uniqKey="Angrisano S" first="Serena" last="Angrisano">Serena Angrisano</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Arduino, Nichy" sort="Arduino, Nichy" uniqKey="Arduino N" first="Nichy" last="Arduino">Nichy Arduino</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Lanotte, Michele" sort="Lanotte, Michele" uniqKey="Lanotte M" first="Michele" last="Lanotte">Michele Lanotte</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Rizzone, Mario" sort="Rizzone, Mario" uniqKey="Rizzone M" first="Mario" last="Rizzone">Mario Rizzone</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Lopiano, Leonardo" sort="Lopiano, Leonardo" uniqKey="Lopiano L" first="Leonardo" last="Lopiano">Leonardo Lopiano</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:BEF3A34B003D8B6CA9677F2C131AC5E3F9C82716</idno><date when="2012" year="2012">2012</date><idno type="doi">10.1136/jnnp-2011-300470</idno><idno type="url">https://api.istex.fr/document/BEF3A34B003D8B6CA9677F2C131AC5E3F9C82716/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">001C79</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?</title><author><name sortKey="Merola, Aristide" sort="Merola, Aristide" uniqKey="Merola A" first="Aristide" last="Merola">Aristide Merola</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: aristidemerola@hotmail.com</mods:affiliation></affiliation></author><author><name sortKey="Zibetti, Maurizio" sort="Zibetti, Maurizio" uniqKey="Zibetti M" first="Maurizio" last="Zibetti">Maurizio Zibetti</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Artusi, Carlo Alberto" sort="Artusi, Carlo Alberto" uniqKey="Artusi C" first="Carlo Alberto" last="Artusi">Carlo Alberto Artusi</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Marchisio, Alice" sort="Marchisio, Alice" uniqKey="Marchisio A" first="Alice" last="Marchisio">Alice Marchisio</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Ricchi, Valeria" sort="Ricchi, Valeria" uniqKey="Ricchi V" first="Valeria" last="Ricchi">Valeria Ricchi</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Rizzi, Laura" sort="Rizzi, Laura" uniqKey="Rizzi L" first="Laura" last="Rizzi">Laura Rizzi</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Angrisano, Serena" sort="Angrisano, Serena" uniqKey="Angrisano S" first="Serena" last="Angrisano">Serena Angrisano</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Arduino, Nichy" sort="Arduino, Nichy" uniqKey="Arduino N" first="Nichy" last="Arduino">Nichy Arduino</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Lanotte, Michele" sort="Lanotte, Michele" uniqKey="Lanotte M" first="Michele" last="Lanotte">Michele Lanotte</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Rizzone, Mario" sort="Rizzone, Mario" uniqKey="Rizzone M" first="Mario" last="Rizzone">Mario Rizzone</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author><author><name sortKey="Lopiano, Leonardo" sort="Lopiano, Leonardo" uniqKey="Lopiano L" first="Leonardo" last="Lopiano">Leonardo Lopiano</name><affiliation><mods:affiliation>Department of Neuroscience, University of Turin, Turin, Italy</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-03">2012-03</date><biblScope unit="volume">83</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="251">251</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">BEF3A34B003D8B6CA9677F2C131AC5E3F9C82716</idno><idno type="DOI">10.1136/jnnp-2011-300470</idno><idno type="href">jnnp-83-251.pdf</idno><idno type="ArticleID">jnnp-2011-300470</idno><idno type="PMID">22180646</idno><idno type="local">jnnp;83/3/251</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="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. Aim 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). Materials and 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. Conclusion 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.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>Aristide Merola</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string><json:string>E-mail: aristidemerola@hotmail.com</json:string></affiliations></json:item><json:item><name>Maurizio Zibetti</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item><json:item><name>Carlo Alberto Artusi</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item><json:item><name>Alice Marchisio</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item><json:item><name>Valeria Ricchi</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item><json:item><name>Laura Rizzi</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item><json:item><name>Serena Angrisano</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item><json:item><name>Nichy Arduino</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item><json:item><name>Michele Lanotte</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item><json:item><name>Mario Rizzone</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item><json:item><name>Leonardo Lopiano</name><affiliations><json:string>Department of Neuroscience, University of Turin, Turin, Italy</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Movement disorders</value></json:item></subject><language><json:string>eng</json:string></language><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. Aim 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). Materials and 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. Conclusion 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.</abstract><qualityIndicators><score>8.056</score><pdfVersion>1.4</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>1</keywordCount><abstractCharCount>1617</abstractCharCount><pdfWordCount>4736</pdfWordCount><pdfCharCount>32944</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>235</abstractWordCount></qualityIndicators><title>Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease 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Group Ltd</publisher><availability><p>BMJ</p></availability><date>2011-12-16</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?</title><author corresp="yes"><persName><forename type="first">Aristide</forename><surname>Merola</surname></persName><email>aristidemerola@hotmail.com</email><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Maurizio</forename><surname>Zibetti</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Carlo Alberto</forename><surname>Artusi</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Alice</forename><surname>Marchisio</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Valeria</forename><surname>Ricchi</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Laura</forename><surname>Rizzi</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Serena</forename><surname>Angrisano</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Nichy</forename><surname>Arduino</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Michele</forename><surname>Lanotte</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Mario</forename><surname>Rizzone</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author><author><persName><forename type="first">Leonardo</forename><surname>Lopiano</surname></persName><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-03"></date><biblScope unit="volume">83</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="251">251</biblScope></imprint></monogr><idno type="istex">BEF3A34B003D8B6CA9677F2C131AC5E3F9C82716</idno><idno type="DOI">10.1136/jnnp-2011-300470</idno><idno type="href">jnnp-83-251.pdf</idno><idno type="ArticleID">jnnp-2011-300470</idno><idno type="PMID">22180646</idno><idno type="local">jnnp;83/3/251</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011-12-16</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>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. Aim 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). Materials and 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. Conclusion 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.</p></abstract></profileDesc><revisionDesc><change when="2011-12-16">Created</change><change when="2012-03">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/BEF3A34B003D8B6CA9677F2C131AC5E3F9C82716/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-id journal-id-type="publisher-id">jnnp</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><abbrev-journal-title>J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jnnp-2011-300470</article-id><article-id pub-id-type="doi">10.1136/jnnp-2011-300470</article-id><article-id pub-id-type="other">jnnp;83/3/251</article-id><article-id pub-id-type="other">jnnp;jnnp-2011-300470</article-id><article-id pub-id-type="pmid">22180646</article-id><article-id pub-id-type="other">251</article-id><article-id pub-id-type="other">jnnp-2011-300470</article-id><article-categories><subj-group subj-group-type="heading"><subject>Movement disorders</subject></subj-group><series-title>Research paper</series-title></article-categories><title-group><article-title>Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Merola</surname><given-names>Aristide</given-names></name></contrib><contrib contrib-type="author"><name><surname>Zibetti</surname><given-names>Maurizio</given-names></name></contrib><contrib contrib-type="author"><name><surname>Artusi</surname><given-names>Carlo Alberto</given-names></name></contrib><contrib contrib-type="author"><name><surname>Marchisio</surname><given-names>Alice</given-names></name></contrib><contrib contrib-type="author"><name><surname>Ricchi</surname><given-names>Valeria</given-names></name></contrib><contrib contrib-type="author"><name><surname>Rizzi</surname><given-names>Laura</given-names></name></contrib><contrib contrib-type="author"><name><surname>Angrisano</surname><given-names>Serena</given-names></name></contrib><contrib contrib-type="author"><name><surname>Arduino</surname><given-names>Nichy</given-names></name></contrib><contrib contrib-type="author"><name><surname>Lanotte</surname><given-names>Michele</given-names></name></contrib><contrib contrib-type="author"><name><surname>Rizzone</surname><given-names>Mario</given-names></name></contrib><contrib contrib-type="author"><name><surname>Lopiano</surname><given-names>Leonardo</given-names></name></contrib></contrib-group><aff>Department of Neuroscience, University of Turin, Turin, Italy</aff><author-notes><corresp><label>Correspondence to</label> Dr A Merola, Department of Neuroscience, University of Turin, Via Cherasco 15, Torino 10126, Italy; <email>aristidemerola@hotmail.com</email></corresp></author-notes><pub-date pub-type="epub-original"><day>16</day><month>12</month><year>2011</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>16</day><month>12</month><year>2011</year></pub-date><volume>83</volume><volume-id pub-id-type="other">83</volume-id><volume-id pub-id-type="other">83</volume-id><issue>3</issue><issue-id pub-id-type="other">jnnp;83/3</issue-id><issue-id pub-id-type="other">3</issue-id><issue-id pub-id-type="other">83/3</issue-id><fpage>251</fpage><history><date date-type="received"><day>8</day><month>5</month><year>2011</year></date><date date-type="rev-recd"><day>30</day><month>8</month><year>2011</year></date><date date-type="accepted"><day>11</day><month>10</month><year>2011</year></date></history><permissions><copyright-statement>© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-83-251.pdf"></self-uri><abstract><sec><title>Background</title><p>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.</p></sec><sec><title>Aim</title><p>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).</p></sec><sec><title>Materials and methods</title><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Conclusion</title><p>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.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><partName>Research paper</partName><title>Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><partName>Research paper</partName><title>Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?</title></titleInfo><name type="personal" displayLabel="corresp"><namePart type="given">Aristide</namePart><namePart type="family">Merola</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><affiliation>E-mail: aristidemerola@hotmail.com</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maurizio</namePart><namePart type="family">Zibetti</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carlo Alberto</namePart><namePart type="family">Artusi</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alice</namePart><namePart type="family">Marchisio</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Valeria</namePart><namePart type="family">Ricchi</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Laura</namePart><namePart type="family">Rizzi</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Serena</namePart><namePart type="family">Angrisano</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nichy</namePart><namePart type="family">Arduino</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michele</namePart><namePart type="family">Lanotte</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mario</namePart><namePart type="family">Rizzone</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Leonardo</namePart><namePart type="family">Lopiano</namePart><affiliation>Department of Neuroscience, University of Turin, Turin, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2012-03</dateIssued><dateCreated encoding="w3cdtf">2011-12-16</dateCreated><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><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. Aim 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). Materials and 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. Conclusion 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.</abstract><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID">jnnp</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>83</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>251</start></extent></part></relatedItem><identifier type="istex">BEF3A34B003D8B6CA9677F2C131AC5E3F9C82716</identifier><identifier type="DOI">10.1136/jnnp-2011-300470</identifier><identifier type="href">jnnp-83-251.pdf</identifier><identifier type="ArticleID">jnnp-2011-300470</identifier><identifier type="PMID">22180646</identifier><identifier type="local">jnnp;83/3/251</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2012, Published by the BMJ Publishing Group Limited. 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