Challenging the Traditional Paradigm: Clinical and Functional Outcomes of Early versus Very-Early Subthalamic Deep Brain Stimulation in Parkinson's Disease.

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IntroductionSubthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for advanced Parkinson's disease (PD). While traditionally reserved for later stages, growing evidence suggests earlier intervention may offer benefits. This study compares outcomes of early versus very-early DBS in a single-center cohort.MethodsThis retrospective study included 65 PD patients undergoing STN-DBS (2015-2025), grouped as very-early (ResultsMean age was 62.45 ± 8.79 years; 69.2% were male. Both groups showed significant postoperative improvement in H&Y (p ConclusionBoth very-early and early STN-DBS provide significant short-term motor benefits, though some decline occurs over time. Very-early DBS was associated with greater postoperative medication reduction and more favorable early functional outcomes, while long-term motor outcomes remained comparable between groups. However, differences in baseline medication burden may have contributed to the observed LEDD reduction patterns.

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