Inclusion criteria:  Parkinson disease (UKPDSSB criteria) Patient with fluctuations and/or dyskinesia , who need treatment with deep brain stimulation, apomorphin pump or duodopa pump MOCA >20 patient >21 years of age patient who has signed protocol acceptation  Exclusion criteria:  patient who did not give his acceptation for the protocol patient with another parkinsonian syndrome than Parkinson' s disease MOCA<20 Patient who does not need second line treatment