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Regarding DBS STN at my Movement Disorder Center in Ghent, Belgium: we implant STN in one day on both sides, relying heavily on the clinical response (especially cessation of rigidity and tremor if present) from test-stimulation during surgery. Two external stimulators are than connected to the electrodes and the stimulation is started immediately; if a good response remains present for several days and the response wears off when the stimulation is switched off the definite pulse generators are implanted under general anaesthesia. We use Itrel III so the patients are able to adjust the voltage, if necessary at home; Itrel II (with the magnete) should not be used, because of the sometimes uncertainty about the fact whether the stimulation is switched off or on (using a radio is sometimes not reliable) and the different settings of the normal stim or the magnetic stim. In addition, the use of Itrel II requires more frequent visits to the physician. The parametes should once in while be checked and if necessary corrected by a physician, specializd in the field and NOT by a nurse or a physician' s assistant. In one center somewhere in the world I heard that a nurse adjusts the parameters and one of the DBS patients told me he was on 6.0 Volts, which is at least 3.0 V too high and will give no response or side effects. It was not surprising that this patient was not responding. A DBS patient should after surgery stay in-hospital for at least a week and checked every day for the response and to make the necessary adjustments. Although this is very time consuming, if this is not very well controlled, the DBS STN results will be a failure. For any more info, I'll be happy to answer any questions regarding DBS STN. Regards, Chris van der Linden