Objective: The study aims to determine the outcomes of all PD patients who underwent DBS in the Philippine Movement Disorder Surgery Center (PMDSC), in terms of objective motor improvement and reduction in PD medication dosage. The current practices of the PMDSC, one of only two institutions doing DBS in the country, is also documented. 

Background: Deep brain stimulation (DBS) is an established treatment modality for Parkinson Disease (PD). Currently, there is no local data on the practices and outcomes of DBS for PD.

Methods:

This is a mixed methods research utilizing interviews and review of records. A retrospective, longitudinal and observational study of all patients (n=17) who underwent DBS for PD in the PMDSC was done. The primary outcome of change in the motor component score of the Unified Parkinson Disease Rating Scale (UPDRS) was determined through review of patient records spanning the pre-DBS period until their most recent follow-up. The practices of the DBS center was documented by doing a questionnaire guided interview of the center’s staff and sifting through official records.

Results: There was a statistically significant reduction in the UPDRS score of patients  3 months (51.8%; p=0.003), 6 months (29.5%; p=0.003) and 3 years (66.7%; p=0.067) after the surgery in the off-medication state. A statistically significant decrease in the dosage of PD medications was also seen until the second year of follow-up (52.3%; p<0.001). Adverse effects included attempted suicide in one patient and a device related infection in the other. Established in 2005, the PMDSC, housed in a private tertiary center, has done 17 DBS surgeries for PD. The great majority of the procedures were purely out-of-pocket expenses.

Conclusions:

This is the first study that tackles the local experience of DBS for PD. DBS for PD improves the UPDRS motor score and reduces PD medication dosage. The practice and outcomes of Institution A are at par with international centers featured in earlier studies for DBS in PD.

References: Krack P, Batir A, Van Blercom N, et al. Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N. Engl. J. Med. 2003;349(20):1925-1934.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-dbs-for-parkinson-disease-in-the-philippines-outcomes-and-practice-of-the-first-dbs-center/