Sirs: The dopamine systems do not only control movement but also play a major role in reward and motivation . Parkinson disease (PD) patients on high dopaminergic treatment might occasionally develop behavioural disorders characterised by an increase of dopamine intake and a constant search for pleasure . Such patients also show a tendency for hypomanic and compulsive behavioural disorders such as gambling in casinos, displaying hypersexual behaviour, spending too much money on shopping, gaining weight because of excessive eating or drinking. Subthalamic stimulation in PD has been shown to mimic the psychotropic activity of levodopa .Here we report a patient who developed a change in artistic expression after subthalamic stimulation. This 65-year-old architect with a 16-year history of PD was suffering from severe motor fluctuations. Mood fluctuated in parallel with his motor state while on a daily dosage of 1500mg levodopa, 15 mg ropinirole, 1 mg cabergoline and 10 mg selegiline. As an architect he was frequently painting and before surgery his themes were exclusively architectural.
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