Objective: To assess outcomes after deep brain stimulation (DBS) in patient with young-onset Parkinson’s disease (PD).

Background: DBS is a surgical procedure which effectively treats patients Parkinson’s disease related symptoms who are deemed medically refractory. By determining whether young onset PD patients have differing risks of long-term side effects after DBS, we will be able to better counsel patients regarding DBS related outcomes.

Method: All PD patients who underwent DBS at Mayo Clinic, Rochester between 2006 and 2021 (n=893) were retrospectively reviewed. Baseline demographic and clinical data was extracted, and DBS programming sessions were reviewed. Young-onset PD was defined as symptom-onset ≤age 55.

Results: Of 893, 114 (13%) young onset PD patients (median age 57, 38% female) received DBS, and were compared to 17 patients (median age 64.5, 25% female) with symptom onset > age 55. Young-onset PD patients were more likely to have pre-operative dystonia (p=0.0346) and dyskinesia (p=0.0007). Young onset patients were more likely to be evaluated for DBS due to medication intolerance (p=0.0299), and incomplete medication response (p=0.0056). Young onset patients were not more likely to be evaluated for DBS due to motor fluctuation as compared to older patients (p=0.2341). Surgical targets for 113 (90%) patients was subthalamic nucleus, all others were a combination of globus pallidus interna, and thalamus. There was an increased risk for cognitive impairment post-DBS in patients with young-onset PD (p=0.0343). Duration of PD symptoms prior to DBS and age at which DBS was performed was not associated with an increased risk of cognitive impairment (p=0.4830, p=0.5690). There was no significant difference in stimulation induced dyskinesia or mood related change (p=0.8656, p=0.0636).  Patients with young onset PD did not have an increased risk of death (p=0.5982). Duration of symptoms prior to DBS was not associated with earlier retirement or disability benefits (p=0.5446, p=0.2048).

Conclusion: Patients with young onset Parkinson’s disease are more likely to be evaluated for DBS due to medication intolerance and incomplete medication response. Young onset PD patients who undergo DBS are more likely to develop cognitive impairment. Having DBS earlier in the disease course is not associated with later age of retirement or change in likelihood of receiving disability benefits.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/outcomes-after-deep-brain-stimulation-dbs-surgery-in-patients-with-young-onset-parkinsons-disease/