Journal Article

DZNE-2025-00470

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png New insights from a Malaysian real-world deep brain stimulation cohort.

Dy Closas, A. M. F. ; Tan, A. H. ; Tay, Y. W. ; Hor, J. W. ; Toh, T. S. ; Lim, J. L. ; Lew, C. Y. ; Cham, C. Y. ; Yim, C. C. W. ; Chee, K. Y. ; Ng, C. G. ; Lit, L. C. ; Anuar, A. N. K. ; Lange, L. M. ; Fang, Z.-H.DZNE* ; Ciga, S. B. ; Lohmann, K. ; Klein, C. ; Ahmad-Annuar, A. ; Muthusamy, K. A. ; Lim, S.-Y.

2025
IOS Press Amsterdam

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Please use a persistent id in citations: doi:10.1177/1877718X241297715

Abstract: BackgroundThe availability of deep brain stimulation (DBS), a highly efficacious treatment for several movement disorders, remains low in developing countries, with scarce data available on utilization and outcomes.ObjectiveWe characterized the DBS cohort and outcomes at a Malaysian quaternary medical center.MethodsA retrospective chart review was done on DBS-related surgery at the University of Malaya, including clinico-demographic, genetics, and outcomes data focusing on post-operative medication reduction and complications.Results149 Parkinson's disease (PD) patients underwent DBS targeting the subthalamic nucleus. Six had globus pallidus internus DBS (primarily for dystonia). Only 16.1% of patients were government-funded. Of the 133 PD patients operated in the past decade (2013-2022), 25 (18.8%) had disease duration <5 years. At 6-12 months post-DBS, median levodopa-equivalent daily dose (LEDD) reduction was 440.5 [418.9] mg/day, corresponding to a reduction of ≥50% and ≥30% in 42.2% and 69.8% of patients, respectively. LEDD reductions were larger in the early-onset and short-duration subgroups. Three patients (1.9% of 155) had symptomatic intracranial hemorrhage, resulting in stroke in two. Pathogenic monogenic or GBA1 variants were detected in 12/76 (16%) of patients tested, mostly comprising the 'severe' GBA1 variant p.L483P (12%).ConclusionsThis is the largest report on DBS from Southeast Asia. The procedures were effective, and complication rates on par with international norms. Our study found a high frequency of GBA1-PD; and included a substantial number of patients with short-duration PD, who had good outcomes. It also highlights regional inequities in access to device-aided therapy.

Keyword(s): Humans (MeSH) ; Deep Brain Stimulation (MeSH) ; Male (MeSH) ; Female (MeSH) ; Middle Aged (MeSH) ; Parkinson Disease: therapy (MeSH) ; Retrospective Studies (MeSH) ; Aged (MeSH) ; Malaysia (MeSH) ; Subthalamic Nucleus (MeSH) ; Adult (MeSH) ; Globus Pallidus (MeSH) ; Glucosylceramidase (MeSH) ; Levodopa: administration & dosage (MeSH) ; Cohort Studies (MeSH) ; Asia ; EARLYSTIM ; GBA1 ; LRRK2 ; Parkinson's disease ; access to care ; deep brain stimulation ; dystonia ; genetics ; subthalamic nucleus ; Glucosylceramidase ; Levodopa ; GBA protein, human

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Contributing Institute(s):

1. Genome Biology of Neurodegenerative Diseases (AG Heutink)

Research Program(s):

1. 354 - Disease Prevention and Healthy Aging (POF4-354) (POF4-354)

Appears in the scientific report 2025

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