Improving quality of life in Parkinson’s Disease through care and DBS surgery
Resource persons: Dr Phua Chun Seng, Consultant Neurologist and Physician /Dr Kalai Arasu Muthusamy, Consultant Neurosurgeon
Parkinson’s disease is the second most common neurodegenerative condition globally, and its impact is expected to rise significantly in the coming decades. In Malaysia, cases are expected to rise five-fold by 2040 from an estimated 20,000 in 2018, highlighting the need for greater awareness, early diagnosis, and timely care.
Parkinson’s disease is more than just a tremor. Affecting millions worldwide, it is a progressive neurological disorder that disrupts movement, independence, and daily life, rather than simply an inevitable consequence of ageing.
While Parkinson’s disease remains a lifelong condition, advances in care are changing how patients experience the journey. What was once seen as a gradual and inevitable decline is now being changed by approaches that offer greater control, independence, and quality of life.
Malaysia’s SJMC successfully performed its first DBS surgery in late March 2026, symbolizing a step forward in expanding access to specialised neurological care in Malaysia.
Timely medical assessment
Dr Phua Chun Seng
“Parkinson’s is not just about tremors,” explains Dr Phua. “It is a condition that can affect how a person moves, thinks, and functions in daily life.”
While tremors are a recognizable sign, they are not present in all patients. The condition is defined by motor symptoms like muscle stiffness and slowness of movement, often starting on one side of the body.
As the condition progresses, symptoms begin to interfere with daily tasks such as walking or dressing, while later stages may bring balance issues or falls. Parkinson’s can also affect mental wellbeing, with fatigue, anxiety, low mood, and difficulty concentrating being common experiences.
Individuals are encouraged to seek medical attention if symptoms persist or change over time. Early assessment allows for more accurate diagnosis and timely management of the condition.
“Raising awareness is important because many people still do not fully understand Parkinson’s,” Dr Phua adds. “Some patients delay seeking medical treatment due to stigma or misconceptions. Early diagnosis allows us to manage the condition more effectively and support patients throughout their journey.”
Beyond medication and the DBS option
While medication remains the main treatment, particularly in the early stages, managing Parkinson’s disease is rarely straightforward. Over time, many patients begin to experience fluctuations in how well their medication works.
One such option is DBS, which is considered for patients experiencing significant motor fluctuations despite medication, but who still respond well to levodopa, the main medication uses to treat Parkinson’s symptoms. Patient selection is important, with factors such as overall health, cognitive function, and age carefully considered.
Patients are generally considered more suitable for DBS at a younger age (under 70 years old) as outcomes tend to be more consistent, although suitability ultimately depends on overall health, cognitive function, and response to medication.
DBS is an advanced therapy that delivers controlled electrical stimulation to specific areas of the brain involved in movement. Unlike earlier surgical techniques, it does not destroy brain tissue, and its settings can be adjusted or reversed over time, allowing treatment to be tailored as symptoms change.
For suitable patients, DBS can be life-changing. Dr Phua recalls a patient in his late 50s who had lived with Parkinson’s for more than a decade. Daily activities, from dressing to eating, had become increasingly difficult, and tremors made simple tasks like writing or handling objects nearly impossible.
“After undergoing DBS, he was able to regain independence in many aspects of his life,” Dr Phua shares. “He could eat and dress on his own again, return to gardening, and even enjoy better sleep. It made a meaningful difference to his confidence and quality of life.”
“Studies have shown that DBS can improve quality of life by up to 70% in suitable patients,” Dr Phua adds.
Addressing fears around brain surgery
Dr Kalai Arasu Muthusamy
Despite its benefits, the idea of brain surgery can be daunting for many patients. Concerns about safety, risks, and long-term effects often create hesitation.
“Modern neurosurgical approaches are designed to be highly precise and minimally invasive. The procedure typically involves a small incision of about 2cm, with electrodes placed in highly targeted areas of the brain measuring just a few millimeters,” explains Dr Kalai. “They are aimed at managing symptoms, while helping patients regain independence and function in their daily lives.”
“It is important for patients to understand that DBS is not a cure. It does not stop the disease from progressing, but it can significantly reduce symptoms such as tremors, rigidity, and slowness of movement,” he added.
Unlike older surgical approaches, DBS is non-destructive and reversible. The stimulation can be adjusted over time, and the device can even be turned off or removed if necessary.
“When performed by an experienced team, DBS is considered a safe and standard procedure with a low risk of complications. The mortality rate for elective brain surgeries in top hospitals is less than 1%,” says Dr Kalai.
More precise, personalized care
The treatment of Parkinson’s disease has evolved significantly over the years, moving from more invasive approaches to increasingly refined and adaptable methods of care.
“Previously, management relied heavily on medication,” explains Dr Kalai. “In certain cases, older surgical techniques involved creating permanent changes in specific areas of the brain to control symptoms. While these could be effective, they were irreversible and carried a higher risk of long-term side effects.”
Today, advances in medical technology have transformed how the condition is managed. Rather than relying on one-time, destructive procedures, modern approaches focus on neuromodulation and precision-based treatment strategies that are designed to be both adjustable and responsive to a patient’s needs over time.
“Current techniques allow us to target specific areas of the brain involved in movement control, such as the subthalamic nucleus (STN) or globus pallidus interna (GPi), with a high level of accuracy,” he says. “With the support of enhanced Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) imaging, as well as intraoperative monitoring methods like microelectrode recording, we can customise treatment more precisely while reducing the risk of complications.”
Similarly, unlike earlier surgical approaches, modern therapies can be adjusted over time to reflect the patient’s changing condition.
“This level of adaptability is important because Parkinson’s disease progresses differently in each individual,” Dr Kalai adds. “Being able to fine-tune treatment allows us to better manage symptoms while supporting long-term quality of life.”
Collaborative care
Successful Parkinson’s disease management requires a multidisciplinary approach. Neurologists, neurosurgeons, and other healthcare professionals work closely together to ensure patients receive comprehensive care at every stage of their journey.
Patients being considered for advanced treatment undergo careful evaluation to determine suitability. Factors such as diagnosis, response to medication, cognitive health, and overall expectations all play an important role in decision-making.
“It is important for patients to have open discussions with their care team,” Dr Kalai shares. “Understanding the benefits, risks, and expected outcomes helps them make informed decisions about their treatment.”
Even after intervention, care continues through long-term follow-up, ensuring that treatment remains effective as the condition progresses.
Category: Top Story
