Golbe L I
Department of Neurology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08903.
Neurology. 1991 Feb;41(2 ( Pt 1)):168-73. doi: 10.1212/wnl.41.2_part_1.168.
Young-onset Parkinson's disease (YOPD) is arbitrarily defined as that which produces initial symptoms between the ages of 21 and 39, inclusive. The special problems and concerns of the patient with YOPD present as much of a challenge and opportunity for the clinician as the disease itself does for the researcher. In contrast to juvenile parkinsonism, which is a heterogeneous group of clinicopathologic entities presenting (also arbitrarily) before age 21, YOPD appears to be the same nosologic entity as older-onset PD. It comprises approximately 5% of referral populations in Western countries and about 10% in Japan. Its annual incidence relative to the population at risk is about 1/10 that of PD at age sixty. YOPD tends to have more gradual progression of parkinsonian signs and symptoms, earlier appearance of levodopa-related dyskinesias and levodopa-dose-related motor fluctuations, and frequent presence of dystonia as an early or presenting sign. Studies conflict with regard to the suspected greater familial frequency and lesser frequency of dementia than in older-onset PD.
早发型帕金森病（YOPD）被随意定义为在21岁至39岁（含）之间出现初始症状的帕金森病。早发型帕金森病患者的特殊问题和担忧，对临床医生来说既是挑战也是机遇，就如同该疾病对研究人员而言一样。与青少年帕金森综合征不同，青少年帕金森综合征是一组异质性的临床病理实体（同样也是随意定义），在21岁之前出现，而早发型帕金森病似乎与晚发型帕金森病是同一疾病分类实体。在西方国家，它约占转诊人群的5%，在日本约占10%。相对于有患病风险的人群，其年发病率约为60岁时帕金森病发病率的1/10。早发型帕金森病往往帕金森体征和症状进展更为缓慢，左旋多巴相关异动症和左旋多巴剂量相关运动波动出现更早，且常常以肌张力障碍作为早期或首发症状。关于早发型帕金森病与晚发型帕金森病相比，家族发病率是否更高以及痴呆发病率是否更低，各项研究结果存在冲突。
