Objective: Describe motor and non-motor symptoms, complications and treatment in patients with early-onset Parkinson’s disease (EOPD)

Background: PD usually affecting people over age 60, clinically characterized by motor and non-motor symptoms and variable progression. EOPD occurs between 21 and 50 years. This subgroup is more likely to have genetic cause and more commonly exhibit dystonia, gait and posture features and levodopa-induced dyskinesias.

Method: A cross-sectional, descriptive study search in electronic database at Rosales National Hospital from January 1 to December 31, 2022. Inclusion criteria: patients with PD, any gender who started symptoms between 21 and 50 years. Exclusion criteria: drug-induced parkinsonism, brain lesions or incomplete records.Collected clinical data about onset of motor and non-motor symptoms, treatment, neuroimaging and complications. The ethics committee reviewed and approved protocol.

Results: Of 654 PD patients, 54 had EOPD, incidence of 8.2% (female to male ratio 30:70). Average age of onset for motor symptoms was 42.7+- 4.8 years, men at 36.5+-2.9 years and women at 45+-2.6 years. The mean time from the onset of motor symptoms to diagnosis and treatment was 2.5+-1.8 years. All presented cardinal symptoms of PD, with tremors (60%), rigidity (40%), gait disturbances (80%) and balance problems (42.5%). The right side was predominantly affected in 65%. Hoehn and Yahr rating scale average was 2.5+-0.5. Non-motor symptoms was anxiety(55%), depression(50%), insomnia(59%), urinary disturbances(15%), constipation(0.07%), cervical and/or lumbar spine pain(52%), cognitive impairment(17%), fatigue(14%) and sexual dysfunction(0.04%). All patients responded positively to Levodopa/Carbidopa (250/25 mg), used 5,5+-3,6 years, mean dose 845+-246 mg. 26% of patients presented motor fluctuations and 29.6% dyskinesias. Other medication were biperiden (65%) and amantadine sulfate (61%). All patients have neuroimaging. None reported family history of PD. There is no data of exposure to heavy metals or pesticides.

Conclusion: The incidence of EOPD aligns with previous reports (5-10%). In this series, all patients developed classic motor features and showed levodopa response. A third of the patients developed motor fluctuations and dyskinesias. Remarkably, neuropsychiatric symptoms were frequent (anxiety and depression). Identifying these individuals is an opportunity to investigate genetic background of EOPD in an underrepresented population.

References: 1. Mehanna R, Smilowska K, Fleisher J, Post B, Hatano T, Pimentel Piemonte ME, Kumar KR, McConvey V, Zhang B, Tan EK, Savica R; International Parkinson and Movement Disorder Society Task Force on Early Onset Parkinson’s Disease. Age Cutoff for Early-Onset Parkinson’s Disease: Recommendations from the International Parkinson and Movement Disorder Society Task Force on Early Onset Parkinson’s Disease. Mov Disord Clin Pract. 2022 Sep 10;9(7):869-878. doi: 10.1002/mdc3.13523. PMID: 36247919; PMCID: PMC9547138.Klepac N, Habek M, Adamec I, Barušić AK, Bach I, Margetić E, Lušić I. An update on the management of young-onset Parkinson’s disease. Degener Neurol Neuromuscul Dis. 2013 Oct 4;2:53-62. doi: 10.2147/DNND.S34251. PMID: 30890879; PMCID: PMC6065598.
2. Camerucci E, Stang CD, Hajeb M, Turcano P, Mullan AF, Martin P, Ross OA, Bower JH, Mielke MM, Savica R. Early-Onset Parkinsonism and Early-Onset Parkinson’s Disease: A Population-Based Study (2010-2015). J Parkinsons Dis. 2021;11(3):1197-1207. doi: 10.3233/JPD-202464. PMID: 33720851; PMCID: PMC8355040.
3. Riboldi GM, Frattini E, Monfrini E, Frucht SJ, Di Fonzo A. A Practical Approach to Early-Onset Parkinsonism. J Parkinsons Dis. 2022;12(1):1-26. doi: 10.3233/JPD-212815. PMID: 34569973; PMCID: PMC8842790
4. Puschmann A. New Genes Causing Hereditary Parkinson’s Disease or Parkinsonism. Curr Neurol Neurosci Rep. 2017 Sep;17(9):66. doi: 10.1007/s11910-017-0780-8. PMID: 28733970; PMCID: PMC5522513.
5. Kolicheski A, Turcano P, Tamvaka N, McLean PJ, Springer W, Savica R, Ross OA. Early-Onset Parkinson’s Disease: Creating the Right Environment for a Genetic Disorder. J Parkinsons Dis. 2022;12(8):2353-2367. doi: 10.3233/JPD-223380. PMID: 36502340; PMCID: PMC9837689.

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