Objective: To investigate the prevalence of early-onset Parkinson’s disease (EOPD) among patients attending the movement disorder clinic at a tertiary hospital in Oman. We also aim to describe the clinical and epidemiological characteristics of this patient group.

Background: Parkinson’s disease (PD) is the second most frequent neurodegenerative disorder after Alzheimer’s disease[1]. The incidence of PD increases with age; however, some patients develop it earlier. The term early-onset Parkinson’s disease refers to patients with a phenotype resembling classic PD starting between 21 and 50 years old [2,3]. EOPD is usually characterized by greater stiffness and fewer tremors, and it progresses more slowly, with frequent levodopa-induced dyskinesia [4]. Characterizing EOPD is essential for guiding therapeutic interventions, which may differ from those for classic PD, as it occurs at the most productive time of an individual’s life.

Method: This is a cross-sectional, retrospective, observational study of patients with PD with onset before age 50 years. Patients who had additional neurologic features incompatible with idiopathic PD, such as pyramidal signs, supranuclear gaze palsy, or cerebellar ataxia, were excluded. Other conditions with secondary Parkinsonism were also excluded, such as Wilson’s disease, encephalitis, and drug-induced Parkinsonism. Data were extracted from electronic medical records of all PD patients attending the movement disorder clinic from 2006 to 2025.

Results: 74 patients fulfilled the criteria for EOPD out of 770 PD ( 9.6%). The mean age of onset was 37 years (15-49), with male gender constituting (60.8%). Tremor was the most frequent initial symptom (60.3%). The most common subtype of PD was tremor-predominant (47.30%), followed by the akinetic-rigid subtype. Dystonia was present in 29 (39.2%), with the lower limb being the most frequent location 13 (45%). 16 ( 21%) of patients were very sensitive to levodopa. The mean onset of motor fluctuations was 5.4 years (1-13). Genetic testing was performed in 23 (31.1%) patients, of whom 10 (43.4%) were positive.

Conclusion: The prevalence of EOPD in the studied group is high. The majority of EOPD has a tremor-predominant PD subtype. Early motor fluctuations and lower-limb dystonia are frequently observed in this study, similar to prior studies of EOPD [3-5].

References: 1. Elbaz, A., Elbaz, A., Carcaillon, L., Kab, S., Kab, S., & Moisan, F. (2015). Epidemiology of Parkinson’s disease.. Revue neurologique, 172 1, 14-26.
2. Mehanna, R., Śmiłowska, K., Fleisher, J., Post, B., Hatano, T., Piemonte, M., Kumar, K., McConvey, V., Zhang, B., Tan, E., & Savica, R. (2022). 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. Movement Disorders Clinical Practice, 9.
3. Schrag A, Schott JM. Epidemiological, clinical, and genetic characteristics of early-onset parkinsonism. The Lancet Neurology. 2006 Apr 1;5(4):355–63.
4. Schrag A, Ben‐Shlomo Y, Brown R, David Marsden C, Quinn N. Young‐onset Parkinson’s disease revisited—clinical features, natural history, and mortality. Movement Disorders. 1998 Nov;13(6):885–94.
5. Kostic, V., Przedborski, S., Flaster, E., & Šternić, N. (1991). Early development of levodopa‐induced dyskinesias and response fluctuations in young‐onset Parkinson’s disease. Neurology, 41, 202 – 202.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-profile-of-early-onset-parkinsons-disease-in-a-tertiary-hospital-in-oman/