Clinical Features of Young-onset Parkinson's Disease

ABSTRACT

BACKGROUND: The term 'young-onset Parkinson's disease (YOPD)' refers to patients who have developed parkison-ian symptoms or signs between the ages of 21 and 40, and the term 'old onset Parkinson's disease (OOPD)' refers to those with onset after the age of 65. Patients with YOPD may show clinical features different from those with OOPD. METHODS: We compared the clinical features and courses of Parkinson's disease between 27 patients with YOPD and 31 patients with OOPD. RESULTS: YOPD more frequently affected male patients. Patients with YOPD more frequently had family members also affected by Parkinson's disease. Rest tremor was the most frequent initial symptom in both YOPD and OOPD. Other initial symptoms included akinesia-rigidity and dystonia, but occurred more frequently in patients with YOPD than OOPD. Patients with YOPD developed levodopa induced motor complications more frequent-ly but had much less hallucinations and delusions. The disease progression of YOPD was slower than the progression of OOPD. CONCLUSIONS: Patients with YOPD may develop clinical features and courses different from those of OOPD because they have neuronal degeneration relatively confined to the substantia nigra with changes in the central pharma-cokinetics and pharmacodynamics.