Comparison of weight gain and energy intake after subthalamic versus pallidal stimulation in Parkinson's disease.
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.
Sauleau
Paul
P
Department of Neurophysiology, University Hospital of Rennes, Rennes, France. paul.sauleau@chu-rennes.fr
Leray
Emmanuelle
E
Rouaud
Tiphaine
T
Drapier
Sophie
S
Drapier
Dominique
D
Blanchard
Sophie
S
Drillet
Gwenolla
G
Péron
Julie
J
Vérin
Marc
M
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*
D000978:Antiparkinson Agents; D015259:Dopamine Agents