Q: What problems can occur after surgery if the target of the brain pacemaker is not accurate? Drs.: Inaccurate targeting will affect the effectiveness of the treatment; moreover, when the brain pacemaker does not achieve its own satisfactory effect, it will also cause some side effects due to electrical stimulation, such as speech impairment, dizziness, blurred vision, numbness of limbs, convulsions, pain, etc. However, the greatest advantage of the pacemaker is that it is reversible, unlike disruption, where the damage to the nucleus accumbens is irreversible. Therefore, some patients can find a new control mode through postoperative modulation to solve the problem of deviated stimulation targets; or re-surgery to locate the targets. Q: Can some patients’ symptoms such as speech impairment and incontinence be controlled after surgery? Drs: First of all, for speech impairment, it is important to determine what is causing it. If the speech impairment is due to Parkinson’s disease, when the surgical target is ideal and the post-operative regulation is appropriate, at least 50% of the patients’ speech problems can be improved. If the target is not ideal or the patient is very symptomatic during post-operative modulation, the intensity of stimulation needs to be increased, which incidentally affects the surrounding nuclei, thus causing language problems. This situation cannot be improved by modulation, but can only be avoided if possible. Secondly, for fecal incontinence, usually surgery or modulation does not cause fecal incontinence, but when Parkinson’s disease reaches an advanced stage, patients are prone to fecal incontinence, and patients with advanced Parkinson’s disease are no longer suitable for surgery, so post-operative modulation cannot improve fecal incontinence either. Q: What advice do you have for Parkinson’s patients? Drs: Parkinson’s patients should first have a clear diagnosis. After a period of reasonable medication, if the medication is really unsatisfactory, or if it cannot meet the needs of daily life or work, or if the side effects of the medication are too great, surgery can be considered. As the concept of brain pacemakers has gradually become popular, some people think that they will benefit sooner if they do it. It is true that patients with a five-year history of the disease will have better results with a pacemaker than those with a ten-year history of the disease. However, it should not be done too early, because if the surgery is done too early, the effect of the drugs is not yet fully developed, and the surgery is after all an invasive operation with certain risks.