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Inclusion criteria for BILATERAL DBS STN: - Advanced Parkinson's disease - Initially good response to levodopa, followed by poorer response and side effects such as motor fluctuations and dyskinesias. - Gait disturbances and freezing. - All other symptoms may be present, including tremor. Exclusion criteria: - dementia as shown clinically or by means of a neuropsychological test - psychiatric disorders, not related to anti-Parkinson medication - systemic disorders, like cardiac failure, severe hypertension, lung disease etc. - abnormal MRI scan, but small white matter changes and some atrophy accepted - wheelchair bound or bedridden while "on" - bleeding disorders Aspirine should be withdrawn at least 10 days before surgery. Definition of advanced Parkinson's disease may be choosen somewhat arbitrarely. For example, patients who are still working may be quite well when at home and while visiting the neurologist, but while working under stress may exhibit side effects or poorer response to anti-Parkinson meds. These patients may, by having STN surgery, be able to go back to work. A small percentage of patients may not tolerate levodopa and dopamine agonists even though the clinical response may be excellent. Although these patients are in an earlier stage of the disease, they may be perfect candidates for STN surgery. STN surgery always bilateral. When having surgery, the parameters of stimulation and the anti-Parkisnon medication should be adjusted while in the hospital, so a hospital stay of at least 10 days after operation is recommended. Only have surgery in experienced centers with a neurosurgeon experienced with the stereotactic technique and the presence of a movement disorder specialist. For any further info please don't hesitate to contact me. Best regards, Chris van der Linden, M.D.