Objective: To evaluate the clinical outcomes and safety of ablative surgery for Parkinson’s disease at Indonesia’s national tertiary referral neurological center.

Background: Deep brain stimulation (DBS) is the standard surgical therapy for advanced Parkinson’s disease (PD). However, limited access to DBS in many low- and middle-income countries has sustained the role of ablative procedures, although contemporary real-world outcome data from Southeast Asia remain scarce.

Method: We conducted a retrospective cohort study of PD patients who underwent ablative surgery between 2019 and 2025 at the National Brain Center Hospital, Jakarta, Indonesia. Postoperative outcomes were assessed at 6–12 months. Changes in levodopa equivalent daily dose (LEDD) were analyzed using the Wilcoxon signed-rank test, and clinical improvement was evaluated using the Clinical Global Impression–Improvement (CGI-I) scale.

Results: Twenty-five patients underwent ablative surgery. At 6–12 months postoperatively, mean LEDD decreased from 486 ± 222 mg/day to 385 ± 200 mg/day, corresponding to a 22.3% reduction (p < 0.001). Both thalamotomy and pallidotomy were associated with reductions in LEDD, with no significant difference between procedures (p = 0.74). The mean age at surgery was 53 ± 11 years, with a mean disease duration of 7 ± 4.1 years. Tremor-dominant subtype accounted for 56% of cases. Thalamotomy and pallidotomy were performed in 56% and 44% of patients, respectively, with 80% unilateral procedures. Based on CGI-I, 21 patients (84%) were classified as responders, and 24 patients (96%) demonstrated at least minimal clinical improvement (median score 2, IQR 1–2). One patient (4%) experienced clinical worsening. Acute complications occurred in 8 patients and were mostly mild and transient, while persistent complications were observed in 1 patient (4%).

Conclusion: Ablative surgery was associated with meaningful clinical improvement and reduced dopaminergic medication requirements in patients with Parkinson’s disease. These findings support the continued clinical value of ablative procedures as an accessible surgical strategy in regions where access to deep brain stimulation remains limited.

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-outcomes-and-safety-of-ablative-surgery-for-parkinsons-disease-in-resource-limited-settings-a-cohort-from-indonesia/