Duration of symptoms prior to surgery, UPDRS-III OFF MEDICATION, UPDRS-III ON MEDICATION, pre-operative dopamine agonist usage, Hoehn and Yahr Seratrodast Staging OFF MEDICATION, or Hoehn and Yahr Staging ON MEDICATION. Although the DDS patients had a higher mean pre-operative medication consumption relative to the ICD group, this difference was not significant. These observations are consistent with the body of literature on this subject. Also, in the DDS pre-operative group, we observed that all of the patients within the DDS subgroup were male. This observation suggests a strong predisposition to DDS among men and is supported by previous literature. A male predominance has recently also been suggested for certain subtypes of ICDs. The previously unappreciated prevalence of these Parkinsonrelated behavioral disorders and the profound detrimental effect that they have on the quality of life of patients and their caregivers have resulted in a new appreciation among clinicians and researchers of the critical need for an effective treatment for ICD and DDS. Unfortunately, our understanding of these disorders is limited and their clinical management remains quite challenging. Decreasing or completely discontinuing a patients’dopaminergic medications may reduce the impulsivity observed in ICDs and may also aid in mitigating the pathological medication usage seen in DDS. This approach, however, predictably exacerbates Parkinsonian motor symptoms. When these measures fail, psychotherapeutic interventions may potentially be implemented with some symptomatic improvement. Cognitive behavioral therapy has also been shown to have some efficacy in treating ICDs, such as pathological gambling. Objective research on the efficacy of psychiatric drugs, particularly for ICDs, is limited. Selective reuptake inhibitors and neuroleptics such as clozapine and risperidone have been shown to help control ICDs, while valproic acid and lithium have been shown to improve ICDs on a more case-specific basis. Larger studies are needed to verify these potential pharmacologic effects. Clinicians have been recently interested in studying the effects of DBS on ICDs and/or DDS, especially since these entities have proven to be Xanthohumol difficult to address pharmacologically. Some studies suggest that DBS improves DDS, while others indicate that DBS has no effect. To complicate matters, while some studies indicate that DBS may be an effective therapy for ICDs, others suggest that it promotes their development. All of these previously published studies included only a handful of patients. Well-designed, prospective studies will be required to elucidate the true effects of stimulation in various basal ganglia targets and to determine whether DBS improves, unmasks existing, or precipitates new DDS or ICDs. We suspect, based on the current analysis, that the story is complex and will require a much larger sample size to adequately sort out.