title: Deep brain stimulation of the subthalamic nucleus regulates postabsorptive glucose metabolism in patients with Parkinson's disease.
abstract: OBJECTIVE
  Subthalamic nucleus-deep brain stimulation (STN-DBS) is an alternative treatment for patients with uncontrolled symptoms of Parkinson's disease (PD), but it has other nonmotor impact. Because STN-DBS alters the energy expenditure in humans, we hypothesized that STN-DBS may affect postabsorptive glucose metabolism in patients with PD.
  
  
  METHODS
  Endogenous glucose production (EGP) and whole-body glucose disposal rates (GDRs) were assessed in the postabsorptive state during a primed continuous iv infusion of D-[6,6-(2)H2]glucose for 5 hours in 8 STN-DBS-treated patients with PD, without (Stim-OFF) and during STN-DBS (Stim-ON) treatment. EGP and GDR in PD patients were compared with glucose kinetics of 8 matched healthy control subjects. Plasma concentrations of insulin, glucagon, and free fatty acids were also determined.
  
  
  RESULTS
  EGP and GDR were higher in PD patients in Stim-OFF conditions than in the control group (2.62 ± 0.09 vs 2.27 ± 0.10 mg/kg·min, P < .05). Despite no significant changes in blood glucose throughout the kinetic study, a significant and consistent 22% decrease in EGP occurred in PD patients during Stim-ON (2.04 ± 0.07 mg/kg(-1)·min(-1); P < .01), and whole-body glucose kinetics in Stim-ON patients were no more different from those of the control subjects (P = NS). No difference in insulin, glucagon, or free fatty acid concentrations was observed in the patients between Stim-OFF and Stim-ON conditions.
  
  
  CONCLUSIONS
  Deep brain stimulation in patients with PD affects EGP glucose disposal, suggesting that a cross talk between the central nervous system and peripheral tissues may regulate glucose homeostasis.
authors: Unité de Nutrition Humaine, BP 10448, Clermont Université, Clermont-Ferrand, France.
authors: Marie
authors: M
authors: Batisse-Lignier
authors: Isabelle
authors: I
authors: Rieu
authors: Christelle
authors: C
authors: Guillet
authors: Estelle
authors: E
authors: Pujos
authors: Béatrice
authors: B
authors: Morio
authors: Jean-Jacques
authors: JJ
authors: Lemaire
authors: Franck
authors: F
authors: Durif
authors: Yves
authors: Y
authors: Boirie
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D046690:Deep Brain Stimulation; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000378:metabolism / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D005947:Glucose