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Dear listmembers, I would like to react briefly on the concern regarding the mental change after STN surgery. I am just summarizing in short the findings of 99 patients I am involved with who had STN surgery under my supervision. Most older patients (16 patients > 70 yrs) had temporary confusional episodes immediately after surgery lasting for up to 24 hours. Two patients, who had some minimal evidence of dementia before surgery further deteriorated after surgery and now need continuous medical assistance, but their motor problems continue to be much better after surgery. 4 older patients have become demented. Although they did not show evidence of dementia, they experienced some episodic confusional states before surgery. 4 male patients developed hypersexuality. 1 female and 6 male patients became hypomanic. 7 patients have mild depression. 2 patients have delusions. Most patients, who had hallucinations before surgery due to chronic anti-Parkinson medication, stopped having hallucinations. Despite dramatic motor improvements, 2 patients committed suicide. Thus, out of 99 patients, 23 patients had some kind of persistent mental change, but in almost all patients there was a significant reduction of motor problems. How to avoid post-op problems: Strict selection criteria. A normal MMSE dementia test with a score 26 or higher (from a scale 0 - 30) Only subtle changes on neurpsychological testing. Consider older age (over 70) as a risk factor, however, not for lack of motor response. Confusional states before surgery may be a risk factor. A thorough psychiatric evaluation is mandatory. For all of you off course a happy and above all healthy 2001. Chris van der Linden, M.D. Movement Disorder Center St. Lucas Hospital Ghent Belgium