Objective: To evaluate clinical outcomes in patients with Early-Onset Parkinson’s Disease (EOPD) treated with deep brain stimulation (DBS)

Background: EOPD is defined as Parkinson’s disease (PD) with onset of cardinal motor symptoms between 21 and 50 years of age. DBS is a well-established intervention for PD patients with motor symptoms refractory to optimal medical therapy. While recent evidence supports the earlier application of DBS in the disease course, specific data on its efficacy in the EOPD population remains limited.

Method: A systematic search was conducted according to PRISMA guidelines [figure 1] across PubMed, EMBASE, Web of Science, and Scopus from inception to February 10, 2025. Studies evaluating DBS outcomes in EOPD patients were included, with no restrictions on language or age. Primary outcomes included the mean change in the UPDRS III score, Levodopa equivalent daily dose (LEDD), and PDQ-39 score following surgery. Risk of bias was assessed using the ROBINS-I for non-randomized studies, and JBI tool for case reports or case series. A random-effects meta-analysis was performed for mean differences (MD), with heterogeneity assessed using the I² statistic.

Results: A total of 3,987 studies were screened, and 68 studies were selected (24 cohort studies, 4 case-control studies, and 40 case reports or case series). Overall, 2,219 patients with EOPD were evaluated, of whom 805 underwent DBS. Most patients developed symptoms between 30-40 years of age and received DBS between 50-60 years of age. The subthalamic nucleus was the most commonly targeted brain region across the studies (55/68). DBS therapy was associated with a mean decrease in the UPDRS-III OFF score of -21.03 points (9 studies; 264 patients; 95% CI: -29.03 to -13.03; I² = 87%)  [figure 2], a reduction in LEDD of -539.83 mg/day (9 studies; 261 patients; 95% CI: -708.49 to -371.16; I² = 70%)  [figure 3], and an improvement in PDQ-39 scores of -10.16 points (3 studies; 90 patients; 95% CI: -30.63 to 10.30; I² = 78%)  [figure 4] during follow-up compared to baseline. The overall quality assessment revealed a medium to high risk of bias among the included studies.

Conclusion: DBS in patients with EOPD is associated with significant improvements in motor  function (UPDRS-III) and medication burden (LEDD). However, its impact on quality of life (PDQ-39) appears to be limited.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-for-early-onset-parkinsons-disease-a-systematic-review-and-meta-analysis/