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I must congratulate the authors for their honest report on the side effects of DBS. However, I believe we should have more centers including their adverse events. In our view, the adverse events directly related to the surgery reported by the authors and seem to be high. Out of 140 patients (35 GPi, 4 VIM and 101 STN) we had three bleeds (one cortical, one subcortical and one brainstem at the level of the oculomotor nucleus, two patients recovered and the cortical bleed patient died three months later due to pneumonia but with partial recovery of the hemiparesis) and 10 asymptomatic bleeds along the trajectory of the electrodes evidenced by post-op MRI scans. Only five headaches (ventriculography is not used in our center). 27 transient (less than 24 hours post-op) confusion. Three with longer duration confusion but with full recovery, two of whom had delusions. Three lead erosion; one infection at the level of the pulse generator. Our complication rate appears to be low compared to that reported at the AAN. However, I may be biased and "overlook" certain side effects. Therfore, to increase the objectivity of reports on side effects, adverse events due to surgery should be examined and reported by an independent evaluation where the evaluators have no ties with the hospital and or surgical department. Many centers should be evaluated for their adverse events in such a way. The patients should be informed about all the aspects of the surgical procedure at a particular center, before they even consider the procedure at that particular hospital. If the hospital does't have the figures the surgery should not be done. Only when many centers have such a report one can honestly tell what the real adverse event figurtes are. This proposal, however, in my view is an utopia. Only patient advocate groups can make a change and put pressure on goverment, the medical community for positive changes. Chris van der Linden, M.D. Movement Disorder Center St. Lucas Hospital Ghent Belgium ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn