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Guidelines for centers performing DBS: 1. The neurologist i.e. movement disorder specialist and its team should be able to select the right patients. If not strictly selected you run the risk of complications, poor response and adverse events after surgery. 2. The neurosurgeon should be able to place the electrodes in the subthalamic nucleus (STN) without exception. 3. There should be no serious complication at surgery. If properly selected patients are operated on, the risk of acute complications is very low. Example: don't take aspirine at least 10 days prior to surgery. (Don't forget to tell your doctor, when you take this medication!) 4. The anti-Parkinson meds should be significantly reduced. If you still require the same amount of anti-Parkinson meds. after surgery, the procedure is a failure!!! You were either not a good candidate or the electrodes were not placed correctly or the stim. settings are way out. 5. Your neurologist i.e. movement disorder specialist should be able to adjust stim. parameters and it should always be the same person adjusting the parameters. No residents, no nurses!! The centers should be required to give their complication rates and succes rates, but unfortunately this seems to be a Utopia. The neurologist or neurosurgeon should take the time to explain the procedure, what to expect and the number of visits after surgery for proper adjustments. Good luck everyone out there. Chris van der Linden, M.D. Movement Disorder Center St. Lucas Hospital Ghent Ghent BELGIUM