Deep Brain Stimulation for Parkinson's Disease-the Developing World's Perspective.

Area of Science:

• Neurology
• Neurosurgery
• Movement Disorders

Background:

• Deep brain stimulation (DBS) is a key therapy for advanced Parkinson's disease (PD) with motor complications.
• Access to DBS is limited in developing regions.
• Understanding patient selection for DBS is crucial.

Purpose of the Study:

• To determine the proportion of Parkinson's disease patients with motor complications who are candidates for DBS.
• To identify characteristics of patients willing to undergo DBS surgery.
• To analyze factors influencing DBS uptake and eligibility.

Main Methods:

• Retrospective analysis of 1017 patients with PD motor complications from 2016-2020.
• Collection of demographic, clinical, and socioeconomic data.
• Assessment of patient willingness, surgical candidacy, and final uptake for DBS.

Main Results:

• Out of 223 eligible patients, only 78 (35%) opted for DBS surgery.
• Willing patients had higher socioeconomic status, were older, and had longer PD duration and more severe symptoms.
• 37 patients were disqualified during pre-operative assessment, with only 41 (18%) ultimately receiving DBS.

Conclusions:

• Less than one-fifth of eligible Parkinson's disease patients ultimately undergo DBS.
• Patients often delay seeking surgical treatment until late disease stages.
• Delayed decisions result in a high rate of pre-operative disqualification, emphasizing the need for timely clinical guidance.