From the Guidelines
Young individuals with Parkinson's disease often exhibit similar characteristics to those with the typical late-onset form, including resting tremor, bradykinesia, and rigidity.
Characteristics of Young-Onset Parkinson's Disease
- The clinical presentation is related to progressive degeneration of the dopaminergic neurons in the substantia nigra projecting to the striatum 1.
- Young individuals with Parkinson's disease may also experience autonomic dysfunction, behavioral changes, and dementia 1.
- Early-onset Parkinson's disease is associated with 22q11.2 deletion syndrome, with an increased risk of developing Parkinson's disease, particularly before the age of 50 1.
Diagnostic Considerations
- Correctly diagnosing a Parkinsonian syndrome on clinical features alone can be challenging, and imaging remains an essential diagnostic tool in the evaluation of a patient presenting with Parkinsonian symptoms 1.
- Dopaminergic imaging may assist in differentiating drug-induced from neurodegenerative parkinsonism when diagnostic uncertainty exists 1.
Management
- Treatment of Parkinson's disease in young individuals is largely indistinguishable from idiopathic Parkinson's disease, with a focus on managing motor symptoms and related complications 1.
- Periodic neurological assessment for signs of parkinsonism should be considered, especially in adults presenting with changes in motor functioning 1.
From the Research
Characteristics of Parkinson's Disease in Young Individuals
The characteristics of Parkinson's disease in young individuals, also known as young-onset Parkinson's disease (YOPD), are distinct from those of late-onset Parkinson's disease. Some key features of YOPD include:
- Slower disease progression 2, 3
- Greater incidence and earlier appearance of levodopa-induced motor complications, such as motor fluctuations and dyskinesias 2, 3, 4, 5
- More frequent family history of Parkinson's disease 5, 6
- Earlier onset of motor complications 4, 5
- More frequent presence of dystonia as an early or presenting sign 5
- Greater frequency of symptoms other than tremor as the initial symptom 6
- Higher frequency of depression 6
- Lower frequency of treatment-related dyskinesia or dystonia with advancing age at onset 6
Clinical Features and Epidemiology
YOPD presents unique motor and non-motor features that differentiate it from late-onset Parkinson's disease. The clinical features and epidemiology of YOPD have been reviewed in several studies 2, 3, 5. These studies suggest that YOPD has a significant impact on the quality of life of patients, affecting their family, social, and professional life 3.
Age of Onset and Disease Progression
The age of onset of Parkinson's disease can affect the clinical features and disease progression. Studies have shown that YOPD tends to have a more gradual progression of parkinsonian signs and symptoms 5. The definition of YOPD has been arbitrarily defined as Parkinson's disease with an age of onset between 21 and 40 years 2, 3, 4, 5, although some studies suggest that an age of onset of 49 years or less may be a more appropriate definition 6.