Abstract
1·8 billion people of diverse ethnicities and cultures live in the Western Pacific Region. The increasing longevity of populations in this region is a major contributor to the exponential increase in Parkinson's disease prevalence worldwide. Differences exist between Parkinson's disease in the Western Pacific Region and in Europe and North America that might provide important insights into our understanding of the disease and approaches to management. For example, some genetic factors (such as LRRK2 mutations or variants) differ, environmental exposures might play differential roles in modulating the risk of Parkinson's disease, and fewer dyskinesias are reported, with some differences in the profile of non-motor symptoms and comorbidities. Gaps in awareness of the disease and inequitable access to treatments pose challenges. Further improvements in infrastructure, clinical governance, and services, and concerted collaborative efforts in training and research, including greater representation of the Western Pacific Region in clinical trials, will improve care of patients with Parkinson's disease in this region and beyond.
| Original language | English |
|---|---|
| Journal | The Lancet Neurology |
| Volume | 18 |
| Issue number | 9 |
| Pages (from-to) | 865-879 |
| Number of pages | 15 |
| ISSN | 1474-4422 |
| DOIs | |
| Publication status | Published - 09.2019 |
Funding
S-YL reports lecturing honoraria from the Asian Oceanian Association of Neurology, Chinese Neuroscience Society, Chinese University of Hong Kong, Head Foundation Singapore, International Association of Parkinsonism and Related Disorders, International Parkinson and Movement Disorder Society, Ipsen, Japan International Parkinson Disease and Movement Disorder Symposium, Korean Movement Disorders Society, Lundbeck, Medtronic, Novartis, Taiwan Movement Disorder Society, and UCB; and consultation fees from Lundbeck. AHT reports lecturing honoraria from Novartis, and grants from the University of Malaya Faculty Research Grant, University of Malaya BKP Research Grant, and Toray Science Foundation Science and Technology Grant. CK reports personal fees from Centogene and Biogen. LCST reports lecturing honoraria from the International Parkinson and Movement Disorder Society, Sichuan Medical Association, and Eisai China. RR reports lecturing honoraria from the International Parkinson and Movement Disorder Society, the International Association of Parkinsonism and Related Disorders, Asian and Oceanian Congress of Neurology; and is the overall principal investigator for the Asian Botulinum Toxin Early Post-Stroke Clinical Trials (ABCDE and ONTIME) sponsored by Ipsen. RB reports royalties from Wiley-Blackwell and Springer Publications; honoraria from Britannia, Lundbeck, Novartis, Boehringer-Ingelheim, and Abbott Pharmaceuticals; research funding from the Thailand Research Fund, Newton Fund-UK, The Neurological Society of Thailand, Chulalongkorn University Research Unit Grant, the Ratchadapiseksompoj Faculty Grant, and the Thai Red Cross Development Grant. Y-RW reports lecturing honoraria from the International Parkinson and Movement Disorder Society, the International Association of Parkinsonism and Related Disorders, the Asian Oceanian Association of Neurology, Takamatsu Symposium in Tokyo, the Korean Movement Disorder Society, the Philippine Movement Disorder Society, the Hong Kong Movement Disorder Society and UCB, Novartis, Boehringer-Ingelheim, Medtronic, Allergan, and Servier; and research funding from the Ministry of Science and Technology and Chang Gung Memorial Hospital, Linkuo. H-FS reports lecturing honoraria from the International Association of Parkinsonism and Related Disorders, International Parkinson and Movement Disorder Society, Asian and Oceanian Association of Neurology and Korean Neurological Association, Taiwan Movement Disorder Society, the Neurologist Branch of the Chinese Medical Doctor Association and Parkinson and Movement Disorders Society of China, Sichuan Medical Association, Lundbeck, Medtronic, Novartis, Boehringer-Ingelheim, Eisai China, UCB, Allergan, GlaxoSmithKline, and Sanofi China. AHE reports reimbursement of travel expenses to scientific meetings or honoraria for lecturing or consultation from UCB, Teva, Abbott, Stada, Allergan and Abbvie; and holds shares in CSL and Global Kinetics Corporation. PKP reports lecturing honoraria from the International Parkinson and Movement Disorder Society and the Asian Oceanian Association of Neurology; and grants to his institute from the Indian Council of Medical Research, Department of Science and Technology, Department of Biotechnology, and the Science and Engineering Research Board, India. NH reports grants from the Japan Agency for Medical Research and Development, the Japan Society for the Promotion of Science, the Ministry of Education, Culture, Sports, Science and Technology Japan, and the Ministry of Health, Labour and Welfare; personal fees from the International Parkinson and Movement Disorder Society, GSK KK, Acorda Therapeutics, Sanofi KK, Pfizer Japan, Alexion Pharmaceuticals, Mylan NV, MSD KK, and Lundbeck Japan; personal fees and other support from Dai-Nippon Sumitomo Pharma, Otsuka Pharmaceutical, Takeda Pharmaceutical, Kyowa Hakko-Kirin, Nippon Boehringer Ingelheim, FP Pharmaceutical Corporation, Eisai, Kissei Pharmaceutical Company, Nihon Medi-Physics, Novartis Pharma KK, Biogen Idec Japan, AbbVie, Medtronic, Astellas Pharma, and Daiichi Sankyo; non-financial support from IBM Japan; non-financial support and other support from Boston Scientific Japan; other support from Ono Pharmaceutical, Mitsubishi Tanabe Pharma, Zaiho, Hydrogen Health Medical Laboratory, ABIST, Melodian, Daiwa, Bayer Yakuhin, Nihon Pharmaceutical, Asahi Kasei Medical, MiZ, Mitsubishi Tanabe Pharma, OHARA Pharmaceutical, Meiji Seika Pharma, and Hisamitsu Pharmaceutical. BJ reports grants from Peptron, Ipsen Korea, and AbbVie Korea; lecturing honoraria from the Asian Oceanian Association of Neurology, the Chinese Neuroscience Society, the International Association of Parkinsonism and Related Disorders, the International Parkinson and Movement Disorder Society, the Japan International Parkinson Disease and Movement Disorder Symposium, the Taiwan Movement Disorder Society, the Taiwan Neurology Society, the World Federation of Neurology, the Japanese Movement Disorder Society, the Japanese Society of Neurology, and UCB; and honoraria for editorial duties for the Journal of Clinical Neuroscience. E-KT has received honoraria for editorial duties for the European Journal of Neurology and Parkinsonism and Related Disorders. AEL has served as an advisor for AbbVie, Acorda, Biogen, Bristol Myers Squibb, Janssen, Sun Pharma, Kallyope, Merck, Paladin, Theravance, and Corticobasal Degeneration Solutions; received honoraria from Sun Pharma, Medichem, Medtronic, AbbVie and Sunovion; received grants from Brain Canada, Canadian Institutes of Health Research, Corticobasal Degeneration Solutions, Edmond J Safra Philanthropic Foundation, Michael J Fox Foundation, the Ontario Brain Institute, National Parkinson Foundation, Parkinson Society Canada, and W Garfield Weston Foundation; and received publishing royalties from Elsevier, Saunders, Wiley-Blackwell, Johns Hopkins Press, and Cambridge University Press. AAA and CTT declare no competing interests. We gratefully acknowledge the following individuals for providing data or insights from their respective countries or territories, or areas of expertise: Mandy Auyeung (Hong Kong), Samleng Chan (Cambodia), Victor SC Fung (Australia), Taku Hatano (Japan), Seong-Beom Koh (Parkinson's disease epidemiology in South Korea), Minh Le (Vietnam), Woong-Woo Lee (Parkinson's disease epidemiology in South Korea), Angus Macleod (Parkinson's disease epidemiology and mortality), Connie Marras (University of Toronto, ON, Canada) (Parkinson's disease epidemiology in North America), Victor McConvey (Australia; Allied health care), Vincent Chung Tong Mok (Hong Kong), Elena Moro (DBS), Weerasak Muangpaisan (Parkinson's disease epidemiology), Emma Nichols (Institute for Health Metrics and Evaluation; Global Burden of Disease), Yasushi Osaki (Parkinson's disease epidemiology in Japan), Eric Roberts (Public Health Institute, CA, USA, and the Parkinson's Foundation P4 group; Parkinson's disease epidemiology), Mark Simpson (New Zealand), Yu Sun (Parkinson's disease epidemiology in Taiwan), Frandy Susatia (Indonesia), Tran Ngoc Tai (Vietnam), Yeremia Tatang (Indonesia), Wesley Thevathasan (DBS in Australia), Bayasgalan Tserensodnom (Mongolia), and Somchit Vorachit (Laos). S-YL and AHT obtained funding from the University of Malaya Parkinson's Disease and Movement Disorders Research Program Fund (PV035-2017) for M G Rudakewich (Synapse Visuals, Edmonton, AB, Canada) to produce figures 1 and 2. E-KT acknowledges support from the National Medical Research Council, Singapore (STaR and Singapore Parkinson's Disease Programme Grant [SPARK 1 & 2]). Funding sources had no involvement in the writing of the manuscript or the decision to submit for publication.
Research Areas and Centers
- Research Area: Medical Genetics
