Deep brain stimulation provides lasting reduction in medication needs for patients with Parkinson disease in Singapore

Our recently published study in the Journal of Neurology showed that medication dosage was reduced by an average of 32% within the first year after DBS, and remained stable at a reduced dose for 10 years. The types of medication taken could also be simplified.

‍

What was not known about deep brain stimulation in the asian population?

It has been shown that deep brain stimulation (DBS) can decrease a patient’s need for medications and improve quality of life. However, most of the published studies have been shorter than 3 years. In reality, Parkinson disease treatment needs to be life-long.

A small minority of studies which investigated the long-term benefits of DBS were performed in Western populations, and have substantiated the long-term economic and medical benefits of DBS.

Difference in medical management among Western and Asian patients, as well as inter-ethnic differences in drug metabolism, therapeutic responses and adverse effects meant that we needed to be certain if these benefits would also apply to local Asian patients. We studied the medication requirements of patients with Parkinson Disease in Singapore before and after deep brain stimulation (DBS) surgery.

‍

Is deep brain stimulation outcome different in asian population?

Our study shows that the medication reduction benefits of DBS observed in Western populations similarly applies to patients in Singapore.

“Importantly, these effects can be sustained for many years after DBS is done,” explained Dr Nicolas Kon, senior author on the study and a neurosurgeon at Mount Elizabeth Hospital, Singapore who performs DBS surgery.

‍

Conclusion

The study is the first in Singapore and Asia to show that deep brain stimulation leads to a lasting reduction in both the dose and complexity of Parkinson disease medication. The reduction in medication also provides lasting cost savings which can offset the upfront cost of surgery.

There is also relief from medication-related side effects such as blood pressure fluctuations or uncontrollable movements of the arms and legs (dyskinesia). Patients can usually feel an immediate effect when DBS is switched. They can move around more easily and do those things that they have not been able to do prior to DBS.

‍

References

• Longitudinal medication profile and cost savings in Parkinson’s disease patients after bilateral subthalamic nucleus deep brain stimulation” in Journal of Neurology. Published online 04 May 2020 doi:10.1007/s00415-020-09741-3 External link
• For a list of all academic publications

‍