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000277792 037__ $$aDZNE-2025-00470
000277792 041__ $$aEnglish
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000277792 1001_ $$00000-0003-1209-9573$$aDy Closas, Alfand Marl F$$b0
000277792 245__ $$aNew insights from a Malaysian real-world deep brain stimulation cohort.
000277792 260__ $$aAmsterdam$$bIOS Press$$c2025
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000277792 520__ $$aBackgroundThe 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.
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000277792 650_7 $$2Other$$aAsia
000277792 650_7 $$2Other$$aEARLYSTIM
000277792 650_7 $$2Other$$aGBA1
000277792 650_7 $$2Other$$aLRRK2
000277792 650_7 $$2Other$$aParkinson's disease
000277792 650_7 $$2Other$$aaccess to care
000277792 650_7 $$2Other$$adeep brain stimulation
000277792 650_7 $$2Other$$adystonia
000277792 650_7 $$2Other$$agenetics
000277792 650_7 $$2Other$$asubthalamic nucleus
000277792 650_7 $$0EC 3.2.1.45$$2NLM Chemicals$$aGlucosylceramidase
000277792 650_7 $$046627O600J$$2NLM Chemicals$$aLevodopa
000277792 650_7 $$0EC 3.2.1.45$$2NLM Chemicals$$aGBA protein, human
000277792 650_2 $$2MeSH$$aHumans
000277792 650_2 $$2MeSH$$aDeep Brain Stimulation
000277792 650_2 $$2MeSH$$aMale
000277792 650_2 $$2MeSH$$aFemale
000277792 650_2 $$2MeSH$$aMiddle Aged
000277792 650_2 $$2MeSH$$aParkinson Disease: therapy
000277792 650_2 $$2MeSH$$aRetrospective Studies
000277792 650_2 $$2MeSH$$aAged
000277792 650_2 $$2MeSH$$aMalaysia
000277792 650_2 $$2MeSH$$aSubthalamic Nucleus
000277792 650_2 $$2MeSH$$aAdult
000277792 650_2 $$2MeSH$$aGlobus Pallidus
000277792 650_2 $$2MeSH$$aGlucosylceramidase
000277792 650_2 $$2MeSH$$aLevodopa: administration & dosage
000277792 650_2 $$2MeSH$$aCohort Studies
000277792 7001_ $$aTan, Ai Huey$$b1
000277792 7001_ $$aTay, Yi Wen$$b2
000277792 7001_ $$aHor, Jia Wei$$b3
000277792 7001_ $$00000-0003-2434-2147$$aToh, Tzi Shin$$b4
000277792 7001_ $$aLim, Jia Lun$$b5
000277792 7001_ $$00009-0002-6074-9163$$aLew, Choey Yee$$b6
000277792 7001_ $$00000-0001-9791-8106$$aCham, Chun Yoong$$b7
000277792 7001_ $$aYim, Carolyn Chue Wai$$b8
000277792 7001_ $$00000-0002-5755-9572$$aChee, Kok Yoon$$b9
000277792 7001_ $$aNg, Chong Guan$$b10
000277792 7001_ $$00000-0002-3210-4491$$aLit, Lei Cheng$$b11
000277792 7001_ $$00000-0001-8077-4265$$aAnuar, Anis Nadhirah Khairul$$b12
000277792 7001_ $$aLange, Lara M$$b13
000277792 7001_ $$0P:(DE-2719)9001362$$aFang, Zih-Hua$$b14
000277792 7001_ $$aCiga, Sara Bandres$$b15
000277792 7001_ $$aLohmann, Katja$$b16
000277792 7001_ $$aKlein, Christine$$b17
000277792 7001_ $$aAhmad-Annuar, Azlina$$b18
000277792 7001_ $$00000-0001-6149-9149$$aMuthusamy, Kalai Arasu$$b19
000277792 7001_ $$00000-0002-6942-2522$$aLim, Shen-Yang$$b20
000277792 773__ $$0PERI:(DE-600)2599550-9$$a10.1177/1877718X241297715$$gVol. 15, no. 1, p. 1877718X241297715$$n1$$p1877718X241297715$$tJournal of Parkinson's Disease$$v15$$x1877-7171$$y2025
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