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Background: Stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson disease (PD) and is currently performed after a mean disease duration of 14 years, when severe motor complications have resulted in marked loss of quality of life. We examined whether surgery at an early stage would maintain quality of life as well as improve motor function.

Methods: Twenty patients with PD of short duration (time elapsed since first symptom ± SD: 6.8 ± 1.0 years) with mild to moderate motor signs (Unified Parkinson's Disease Rating Scale III “off” medication: 29 ± 12) who responded well to levodopa treatment were included in pairs, matched for age, duration and severity of disease, and impairment in socioprofessional functioning. Patients were prospectively randomized to undergo bilateral subthalamic nucleus stimulation (n = 10) or receive optimized medical treatment (n = 10 …