• Shen-Yang Lim, Ai Huey Tan, Azlina Ahmad-Annuar, Christine Klein, Tan Louis C S LCS Department of Neurology, National Neuroscience Institute, Singapore., Raymond L Rosales, Roongroj Bhidayasiri, Yih-Ru Wu, Hui-Fang Shang, Andrew H Evans, Pramod K Pal, Nobutaka Hattori, Chong Tin Tan, Beomseok Jeon, Eng-King Tan, and Anthony E Lang.
• Division of Neurology, Department of Medicine, and the Mah Pooi Soo and Tan Chin Nam Centre for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: sylim@ummc.edu.my.
• Lancet Neurol. 2019 Sep 1; 18 (9): 865-879.

Abstract1·8 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.Copyright © 2019 Elsevier Ltd. All rights reserved.

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