Please select the eligibility criteria that correspond to the clinical trial below.
Title: Safety and Tolerability of Neurostimulation in Early Stage Parkinson's Disease
Brief Summary: Bilateral subthalamic nucleus deep brain stimulation (B-STN DBS) is one of the most effective surgical treatments for PD patients suffering from levodopa-induced motor complications. The relatively low incidence of permanent adverse effects and the potential for neuroprotection and alteration of the natural course of PD suggest a highly favorable benefit-to-risk ratio of this procedure. Since neuroprotection is best applied early in the disease course when there are more surviving neurons, we believe that further investigation of this procedure is warranted. The proposed pilot study will provide the necessary data to substantiate the safety and tolerability of the procedure as well as provide data for the design of a full-scale, multicenter trial to investigate the hypothesis that B-STN DBS is a safe and effective treatment to slow the progression of PD.


Options:
A: Inclusion Criteria:

* Patients must have a clinical diagnosis of probable idiopathic PD.
* Demonstrated response to dopaminergic therapy, defined as demonstrating at least 30% improvement in parkinsonian motor signs, based upon the UPDRS motor examination subscore, following the administration of their dopamine agonist (DA) drug(s) during the screening neurological examination.
* Hoehn and Yahr (H\&Y) stage II when OFF medication.
* No contraindications to surgery.
* Age between 50 and 75 years old.
* Available for follow-up for four years.
* Informed Consent: The subject understands the risks, benefits, and alternatives to the study procedures and participation in the study.
* MRI within normal range for age.
* Levodopa or dopamine agonist therapy for greater than six months but less than or equal to four years.

Exclusion Criteria:

* Evidence of an alternative diagnosis or secondary parkinsonism, as suggested by features unusual early in the clinical course: Prominent postural instability, freezing phenomena, or hallucinations unrelated to medications in the first 3 years after symptom onset; dementia preceding motor symptoms; supranuclear gaze palsy (other than restriction of upward gaze) or slowing of vertical saccades in the first year; severe, symptomatic dysautonomia unrelated to medications; documentation of a condition known to produce parkinsonism and plausibly connected to the subject's symptoms (such as suitably located focal brain lesions or neuroleptic use within the past 6 months)
* Uncontrolled medical condition or clinically significant medical disease that would increase the risk of developing pre- or postoperative complications (e.g., significant cardiac or pulmonary disease, uncontrolled hypertension).
* Evidence of dementia
* Major psychiatric disorder
* Previous brain operation or injury.
* Active participation in another clinical trial for the treatment of PD.
* Patients who have demand cardiac pacemakers or implantable cardioverter defibrillators (ICD's).
* Patients who have medical conditions that require repeat MRI scans or diathermy treatments.
* Evidence of existing dyskinesias or motor fluctuations.
B: Inclusion Criteria:

* German speaking male/female subjects
* age:60-80
* AD assessed by DSM-IV, ICD-10 and NINCDS-ADRDA-Scale
* no Lewy-Body-dementia or other form of dementia
* MMST \>18 and \<26
* stable psychopharmacological medication
* no psychotic symptoms, no suicidal tendency
* education for at least 8 years
* written informed consent of the patient
* consent of at least two family members
* no contraindication regarding PET-examination
* no contraindication regarding anesthesia or stereotactic operation

Exclusion Criteria:

* legal accommodation
* clinical co-morbidity
* contraindication of MRT examination
* psychotic symptoms last six months
* aggressive behavior or suicidal tendency
* verbal IQ \<85
* stereotactic operation in previous history
* neoplastic neurological diseases
* serious organic disease
C: Inclusion Criteria:

* Tourette's syndrome (DSM IV)
* inducing a disability in the social and personal life
* No improvement with medical treatment
* Severe self suffering

Exclusion Criteria:

* Cognitive impairment (MMS \< 24)
* Depression
D: Inclusion Criteria:

* Age \> 18 years
* Proficiency in the German language
* Long lasting heroin addiction (fulfilled diagnostic-criteria according to DSM-IV,ICD-10)
* At least one detoxication-treatment without a long-term period of abstinence has already taken place
* Long-term inpatient treatment to support abstinence have occurred
* Free patient's decision / Informed Consent (existing comprehensive ability in meaning, methodology and execution of the study and ability of acceptance)
* If prior medication, stable dosage of psychopharmacological drugs over the last three months, which shall, after checking be retained during the study
* Substitution treatment with constant dose within the last three months before study inclusion

Exclusion Criteria:

* Hospitalization by PsychKG
* Clinical relevant psychiatric comorbidity (schizophrenic psychoses, bipolar affective diseases, severe personality disorder)
* Contraindications of a MRI-examination, e.g. implanted cardiac pacemaker/ heart defibrillator
* Current and in the last six months existent paranoid-hallucinated symptomatology
* Foreign aggressiveness in the last six months
* Verbal IQ \< 85 (evaluated with the German Mehrfachauswahl-Intelligenz-Test (MWT-A/B))
* Stereotactic respectively neurosurgical intervention in the past
* Neoplastical neurological diseases
* Contraindications of a stereotactic operation, e.g. increased bleeding-disposition, cerebrovascular diseases (e.g. arteriovenous malfunction, aneurysms, systemic vascular diseases)
* Serious and instable organic diseases (e.g. instable coronal heart disease)
* tested positively for HIV
* pregnancy and/or lactation

Answer: A