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Dear Jane, Out of 50 patients we have performed three STN stimulations on MSA patients (two from Holland and on from Belgium.). Theoretically we thought it wouldn't work, but the famliy and the patients insisted, because there was no alternative. All three patients had one specific form of MSA without the presence of dementia, hypotension, cerebellar disturbances (problems with your balance, not related to parkinsonism) or serious eye movement problems . None responded to medication. The diagnosis is called Multiple System Atrophy (MSA) of the striatonigral type. All patients improved after surgery with respect to the stiffness and slowness. The voice has not changed. Initially, we found some gait improvement, but this was not sustained and worsened in two patients 6 months after surgery. Yet, they feel better because they can use their hands better and have become more independent, regardless of the gait problem. When switsching off the stimulation, the patients worsen dramatically and are totally dependent. Thus, there is certainly a response, but the gait may not be influenced by the stimulation. Therefore, it may be worth while to further investigate the STN or other form of DBS in MSA of the striatonigral type. Regards, Chris van der Linden, M.D.