Profile and outcomes of Parkinson's disease deep brain stimulation in a public tertiary center in Brazil: retrospective cohort.

Background: Deep brain stimulation (DBS) is an established surgical therapy for advanced Parkinson's disease (PD), but, in Latin America, access remains restricted, and local data are limited. Objective: To describe the demographic, clinical, and procedural profile, as well as the treatment outcomes and perioperative complications, of patients undergoing DBS at a Brazilian reference center. Methods: We conducted a retrospective observational study including 101 patients with PD who underwent bilateral DBS implantation between 2012 and 2024 at Hospital de Clínicas de Porto Alegre, Brazil, within the public healthcare system. Results: The mean age at surgery was of 62.2 years; 63.4% of the patients were male. The mean ages at symptom onset, diagnosis, DBS indication, and surgery were of 43.1, 45.7, 54.5, and 56.7 years respectively. On average, the patients presented 10.9 years of disease duration when surgery was performed. Motor fluctuations (53.5%) and dyskinesias (41.6%) were the most common indications. The subthalamic nucleus (STN) was the predominant target (97%). Mild complications included wound infection (7.9%), while severe complications, such as lead migration, intracranial hemorrhage, or deep infection occurred in 6.9%. Levodopa equivalent daily dose (LEDD) was the primary outcome used to assess postoperative change; it was significantly reduced by ∼ 25% after DBS, from 1,885.6 to 1,406.7 mg at 12 months (Wilcoxon Conclusion: In the cohort of the present study, DBS was safe and enabled a sustained reduction in dopaminergic medication during follow-up. Despite these benefits, delays in surgery, limited access through the public health system, and device-availability issues continue to limit broader implementation, highlighting persistent structural inequalities in Latin America.