title: Modulation of nutritional state in Parkinsonian patients  with bilateral subthalamic nucleus stimulation.
abstract: Chronic bilateral subthalamic stimulation (DBS-STN) provides considerable clinical benefits in Parkinson disease patients, with improvement in primary symptoms and resolution of side effects of chronic pharmacological treatment. Apart from its therapeutic effects on PD symptoms, DBS-STN also appears to induce weight gain, which may itself induce critical metabolic disorders and limit the benefits of surgery. No data are available in literature showing the efficacy of a nutritional intervention to prevent rapid and/or excessive weight gain after DBSSTN. Fifty-seven PD patients were included in this study and were divided into two groups: Group 1 comprised 16 patients with a nutritional intervention immediately after surgery (1 week after); Group 2 comprised 41 patients with a nutritional intervention in a later period after surgery (mean time of 2.5 ± 1.6 years). Weight, body mass index (BMI), percentage of fat mass, levodopa daily dose (LDD) and part III of the Unified Parkinson's disease rating scale (UPDRS) were studied before and after an individualized and structured nutritional intervention. Three months after nutritional intervention, Group 1 had a mean BMI (24.1 ± 2.99), that was not significantly different (p = 0.114) from BMI before intervention, with stability of the weight and in percentage of fat mass. In Group 2 all the patients gained weight, reaching to 13.17 ± 10%; a total of 63% of patients became overweight (BMI 25 kg/m(2)). Three months after nutritional intervention, Group 2 had a mean BMI (24.80 ± 2.45) that was significantly (p = 0.03) different from BMI before intervention (26.75 ± 2.99), although percentage of fat mass was higher in women. With this study, we have conclude that nutritional intervention adequate to patient-age, disease characteristics, medical therapy with L-dopa and physical activity, is effective incontrolling weight after DBS-STN surgery.
authors.affiliation: Department of Neurology, Faculty of Medicine, University of Porto, Hospital de São João, São João Hospital, Alameda Hernani Monteiro, 4202-451 Porto, Portugal. jguimraes9@hotmail.com
authors.forename: Joana
authors.initials: J
authors.lastname: Guimarães
authors.forename: Eduarda
authors.initials: E
authors.lastname: Matos
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Rosas
authors.forename: Augusta
authors.initials: A
authors.lastname: Vieira-Coelho
authors.forename: Nuno
authors.initials: N
authors.lastname: Borges
authors.forename: Flora
authors.initials: F
authors.lastname: Correia
authors.forename: Rui
authors.initials: R
authors.lastname: Vaz
authors.forename: Carolina
authors.initials: C
authors.lastname: Garrett
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000379:methods; D004035:Diet Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009765:Obesity / Q000178:diet therapy / Q000209:etiology* / Q000503:physiopathology; D010300:Parkinson Disease / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology; D011446:Prospective Studies; D020531:Subthalamic Nucleus / Q000502:physiology / Q000601:surgery*