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001     277792
005     20250423100223.0
024 7 _ |a 10.1177/1877718X241297715
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024 7 _ |a 1877-7171
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024 7 _ |a 1877-718X
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037 _ _ |a DZNE-2025-00470
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Dy Closas, Alfand Marl F
|0 0000-0003-1209-9573
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245 _ _ |a New insights from a Malaysian real-world deep brain stimulation cohort.
260 _ _ |a Amsterdam
|c 2025
|b IOS Press
336 7 _ |a article
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336 7 _ |a Journal Article
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520 _ _ |a 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.
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650 _ 7 |a Asia
|2 Other
650 _ 7 |a EARLYSTIM
|2 Other
650 _ 7 |a GBA1
|2 Other
650 _ 7 |a LRRK2
|2 Other
650 _ 7 |a Parkinson's disease
|2 Other
650 _ 7 |a access to care
|2 Other
650 _ 7 |a deep brain stimulation
|2 Other
650 _ 7 |a dystonia
|2 Other
650 _ 7 |a genetics
|2 Other
650 _ 7 |a subthalamic nucleus
|2 Other
650 _ 7 |a Glucosylceramidase
|0 EC 3.2.1.45
|2 NLM Chemicals
650 _ 7 |a Levodopa
|0 46627O600J
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650 _ 7 |a GBA protein, human
|0 EC 3.2.1.45
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650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Deep Brain Stimulation
|2 MeSH
650 _ 2 |a Male
|2 MeSH
650 _ 2 |a Female
|2 MeSH
650 _ 2 |a Middle Aged
|2 MeSH
650 _ 2 |a Parkinson Disease: therapy
|2 MeSH
650 _ 2 |a Retrospective Studies
|2 MeSH
650 _ 2 |a Aged
|2 MeSH
650 _ 2 |a Malaysia
|2 MeSH
650 _ 2 |a Subthalamic Nucleus
|2 MeSH
650 _ 2 |a Adult
|2 MeSH
650 _ 2 |a Globus Pallidus
|2 MeSH
650 _ 2 |a Glucosylceramidase
|2 MeSH
650 _ 2 |a Levodopa: administration & dosage
|2 MeSH
650 _ 2 |a Cohort Studies
|2 MeSH
700 1 _ |a Tan, Ai Huey
|b 1
700 1 _ |a Tay, Yi Wen
|b 2
700 1 _ |a Hor, Jia Wei
|b 3
700 1 _ |a Toh, Tzi Shin
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700 1 _ |a Lim, Jia Lun
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700 1 _ |a Lew, Choey Yee
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700 1 _ |a Cham, Chun Yoong
|0 0000-0001-9791-8106
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700 1 _ |a Yim, Carolyn Chue Wai
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700 1 _ |a Chee, Kok Yoon
|0 0000-0002-5755-9572
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700 1 _ |a Ng, Chong Guan
|b 10
700 1 _ |a Lit, Lei Cheng
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700 1 _ |a Anuar, Anis Nadhirah Khairul
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700 1 _ |a Lange, Lara M
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700 1 _ |a Fang, Zih-Hua
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700 1 _ |a Ciga, Sara Bandres
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700 1 _ |a Lohmann, Katja
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700 1 _ |a Klein, Christine
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700 1 _ |a Ahmad-Annuar, Azlina
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700 1 _ |a Muthusamy, Kalai Arasu
|0 0000-0001-6149-9149
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700 1 _ |a Lim, Shen-Yang
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773 _ _ |a 10.1177/1877718X241297715
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