Long-term outcome of young onset Parkinson’s disease after
subthalamic stimulation—A cross-sectional study
Sheng-Tzung Tsai a,b, Hsiang-Yi Hunga,b, Tsung-Cheng Hsiehc, Sheng-Huang Linb,d, Shinn-Zong Line, Shin-Yuan Chena,b,∗
a b s t r a c t
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.
