Deep Brain Stimulation (DBS), a method aiming to alleviate disease symptoms by delivering electrical currents to specific brain areas using thin electrodes, is now successfully employed in treating movement disorders like Parkinson's disease, essential tremor, and dystonia. What misconceptions surround Parkinson's, movement disorders, and DBS? This week let's address common misunderstandings based on your inquiries.

*Parkinson's disease only affects the elderly. FALSE*

While Parkinson's disease typically manifests after the age of 60, a notable minority, approximately 5 to 10% of patients, begin experiencing symptoms between the ages of 20 and 50. In cases where the onset occurs at a younger age, genetic factors play a pivotal role and warrant thorough investigation. Individuals with a family history of Parkinson's disease, particularly if a parent or sibling is affected, face an increased risk of developing the condition.Inherited Parkinson's disease usually starts at a younger age and affects approximately 5% of all Parkinson's patients.

*Any hand tremor is a symptom of Parkinson's disease. FALSE*

Hand tremors are one of the symptoms of Parkinson's disease. However, it is not correct to say that anyone with a hand tremor has Parkinson's disease. In Parkinson's, tremors typically occur at rest, like when arms are resting or hanging by the sides while walking. When patients with these tremors are asked to raise their arms, the tremors stop. Certain features, such as one-sided tremors resembling 'counting coins', slow movements, lack of arm swinging while walking, forward-leaning posture, reduced facial expressions ('mask face'), small steps, and diminished gaze, could suggest early-stage Parkinson's and warrant consultation with a neurologist specializing in movement disorders, particularly in elderly patients.

*Deep Brain Stimulation cannot be performed for elderly patients. FALSE*

The eligibility for Deep Brain Stimulation (DBS) surgery is not solely determined by age. Various factors including medication response, mental state, and brain anatomy are considered in the decision-making process. It's crucial to assess whether the patient will benefit from DBS, if they are a suitable candidate, and if alternative treatments exist. Just as it is possible to recommend and perform surgery on an 85-year-old patient who meets these conditions and has no obstacles to surgery, it is also possible not to recommend surgery to a 60-year-old patient who does not meet these conditions. Of course, even if surgery is recommended, the patient will be evaluated by the anesthesia and cardiology specialists to see whether they can undergo the surgery or not. However, since these surgeries are performed under local anesthesia and by talking to the patient, and at the last stage, the patient is put to sleep for about half an hour while the neurostimulator is being placed, if there is no major obstacle, the patient is usually allowed to have surgery even if they are old,

*Having children after Deep Brain Stimulation surgery is impossible. FALSE*

Fundamentally, we can say that DBS does not pose any obstacles to having children. People, who have not received an adequate response from medical treatment but have regained their health with DBS treatment, can have children with close follow-up.

*No other treatment can be applied to the patient in the future after DBS. FALSE*

Deep Brain Stimulation is a controllable, programmable and adjustable technology. If necessary, the electrical settings can be changed or reduced, the neurostimulator can be turned off or removed. There is no harm in applying new treatments to the patient in many cases, including the development of a more effective treatment method in the future.

*Patients experience pain during Deep Brain Stimulation surgery. FALSE*

During Deep Brain Stimulation(DBS) surgery, which is performed using the "awake surgery" principle and local anesthesia, patients only feel the pain of a total of 6 injections. While the patients are kept awake during the surgery, the electrical activities of the cells in the brain responsible for the disease are monitored, and the physiological maps of the patients' brains can be created by observing their responses to low-current stimuli. The surgery is completed painlessly, with the patient talking and fully conscious.

*Practicing sports is prohibited after surgery. FALSE*

There is no change in the normal daily life of patients with DBS. Patients can engage in many sports, including swimming, tennis, running, and cycling, except for heavy sports that could cause head trauma.

*Patients with DBS cannot benefit from medical imaging methods. FALSE*

Today's technology, in centers with sufficient knowledge and equipment, allows all kinds of Magnetic Resonance Imaging (MRI) scans to be performed on these patients with appropriate settings.

*Neurostimulators have a short lifespan and need to be changed frequently. FALSE*

In the past, non-rechargeable neurostimulators were utilized and their lifespan in Parkinson's patients was between 4-6 years. This period could be even shorter in Dystonia patients who require higher electrical current. Recent technological advances have introduced rechargeable neurostimulators lasting up to 20-25 years, alongside devices capable of adjusting current direction and intensity. These innovations not only enhance treatment success but also eliminate the need for frequent neurostimulator replacements.

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