Parkinson's Disease Also Threatens Young People

Parkinson's disease, commonly known as "tremor disease" in the public, has become increasingly prevalent in recent years. Prof. Dr. Hüseyin Hayri Kertmen, Brain and Nerve Surgery Specialist at Acıbadem Maslak Hospital, states that "Parkinson's disease is characterized by symptoms such as tremor, slowness of movement, muscle rigidity and balance problems. Recent observations show that the disease, which is typically diagnosed around 50–55 years of age, also emerges at younger ages." Prof. Dr. Kertmen emphasizes that an encouraging development is the ability to apply more flexible approaches in the surgical treatment of the disease thanks to rapid advances in medical technology, and he explained the innovations brought by the advanced technology era, providing important warnings and recommendations.

Parkinson's disease, which progresses through cell degeneration in the brain and ranks second in frequency after Alzheimer's, can now affect people at younger ages. Prof. Dr. Hüseyin Hayri Kertmen, Brain and Nerve Surgery Specialist at Acıbadem Maslak Hospital, notes that this condition is defined as 'early-onset Parkinson's disease' and states: "Today, approximately 5–10% of Parkinson's patients show disease onset before age 40. Genetic factors play an important role in early-onset Parkinson's disease. Additionally, environmental factors such as certain pesticides, exposure to heavy metals and air pollution can cause the disease to appear at earlier ages."

Earlier diagnosis is possible today
Prof. Dr. Kertmen, noting that advances in medical technology and increased public awareness in recent years have made it possible to diagnose the disease earlier and more accurately, states: "The first and most important treatment of Parkinson's is medication therapy. In the early years of the disease, medications containing dopamine, particularly because they generally produce very good results, are called the 'honeymoon period' by the public. However, over time, the duration of action of medications shortens; the need to take medication more frequently during the day arises. In some patients, involuntary excessive movements related to medication can develop, dose-end deteriorations can occur, and quality of life deteriorates significantly. In these cases, surgical treatment becomes an option for patients whose tremor cannot be controlled."

The main objective is to reduce dependence on others and improve quality of life
Emphasizing that surgical treatment (brain pacemaker) is not a method applied immediately to every patient, and that applying surgery at an earlier stage in suitable patients provides very significant benefits, Prof. Dr. Kertmen explains: "In this way, the patient's dependence on others decreases and quality of life increases significantly. In most patients, the need for medication decreases, while in some it becomes unnecessary. The treatment process is readjusted according to the patient's clinical condition. With regular check-ups after surgery, pacemaker adjustments and making exercise and physical therapy a part of daily life, it becomes possible for patients to live independently, with skills such as being able to feed themselves, button their clothes and walk more safely."

Long waiting periods for brain pacemaker are no longer necessary
Prof. Dr. Hüseyin Hayri Kertmen notes that the old understanding that "one must wait for years for a brain pacemaker" has been replaced today by a more flexible approach based on patient-specific and scientific data: "When the diagnosis is clear and the benefits obtained from medications decrease, suitable patients no longer need to wait for years for brain pacemaker surgery. However, the decision for surgery should be made by an experienced team, particularly including neurology and brain surgery, while taking into account the patient's general condition, mental and psychological characteristics. The fundamental objective here is not to rush, but to identify the right timing that will provide maximum benefit to the patient."

Five important innovations in Parkinson's surgery
Prof. Dr. Kertmen, noting that thanks to significant technological advances in recent years in the surgical treatment of Parkinson's disease, particularly brain pacemaker (Deep Brain Stimulation) applications have become both more precise and capable of offering patient-specific solutions compared to the past, lists 5 important innovations as follows:

• With steerable electrodes used today, treatment efficacy increases while side effects such as speech disorders decrease.
• With smart (adaptive) brain pacemaker systems, treatment becomes more balanced, more personalized and more effective.
• Thanks to advances in surgical techniques, most patients are no longer required to remain awake during surgery.
• Using advanced imaging methods, electrodes can be placed with millimeter precision in the target area while the patient is under general anesthesia, making the surgery process more comfortable for the patient.
• With new-generation rechargeable and long-lasting battery systems, the frequency of battery replacement has been significantly reduced. These wirelessly rechargeable batteries can be used for 10–15 years and greatly reduce the need for patients to undergo surgery again.