title: Comparison of weight gain and energy intake after subthalamic versus pallidal stimulation in Parkinson's disease.
abstract: To compare body mass index (BMI) and daily energy intake (DEI) after subthalamic versus pallidal deep brain stimulation (DBS). Weight gain following DBS in Parkinson's disease patients remains largely unexplained and no comparison of subthalamic and pallidal (GPi) stimulation has yet been performed. BMI and DEI, dopaminergic drug administration and motor scores were recorded in 46 patients with PD before STN (n = 32) or GPi (n = 14) DBS and 3 and 6 months after. At M6, BMI had increased by an average of 8.4% in the STN group and 3.2% in the GPi group. BMI increased in 28 STN and 9 GPi patients. This increase was significantly higher in the STN group (P < 0.048) and the difference remained significant after adjustment for reduced dopaminergic medication; 28.6% of GPi patients were overweight at 6 months (14.3% preoperatively) versus 37.5% of STN patients (21.9% preoperatively). Changes in BMI were negatively correlated with changes in dyskinesia in the GPi-DBS group. Food intake did not change in the two groups, either quantitatively or qualitatively. Frequent weight gain, inadequately explained by motor improvement or reduced dopaminergic drug dosage, occurred in subthalamic DBS patients. The difference between groups suggests additional factors in the STN group, such as homeostatic control center involvement.
authors.affiliation: Department of Neurophysiology, University Hospital of Rennes, Rennes, France. paul.sauleau@chu-rennes.fr
authors.forename: Paul
authors.initials: P
authors.lastname: Sauleau
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Leray
authors.forename: Tiphaine
authors.initials: T
authors.lastname: Rouaud
authors.forename: Sophie
authors.initials: S
authors.lastname: Drapier
authors.forename: Dominique
authors.initials: D
authors.lastname: Drapier
authors.forename: Sophie
authors.initials: S
authors.lastname: Blanchard
authors.forename: Gwenolla
authors.initials: G
authors.lastname: Drillet
authors.forename: Julie
authors.initials: J
authors.lastname: Péron
authors.forename: Marc
authors.initials: M
authors.lastname: Vérin
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D015992:Body Mass Index; D046690:Deep Brain Stimulation; D003704:Dementia / Q000209:etiology / Q000523:psychology; D015259:Dopamine Agents / Q000627:therapeutic use; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D005917:Globus Pallidus / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D010300:Parkinson Disease / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome; D015430:Weight Gain / Q000502:physiology*
chemical_list: D000978:Antiparkinson Agents; D015259:Dopamine Agents