title: Weight Gain following Pallidal Deep Brain Stimulation: A PET Study.
abstract: The mechanisms behind weight gain following deep brain stimulation (DBS) surgery seem to be multifactorial and suspected depending on the target, either the subthalamic nucleus (STN) or the globus pallidus internus (GPi). Decreased energy expenditure following motor improvement and behavioral and/or metabolic changes are possible explanations. Focusing on GPi target, our objective was to analyze correlations between changes in brain metabolism (measured with PET) and weight gain following GPi-DBS in patients with Parkinson's disease (PD). Body mass index was calculated and brain activity prospectively measured using 2-deoxy-2[18F]fluoro-D-glucose PET four months before and four months after the start of GPi-DBS in 19 PD patients. Dopaminergic medication was included in the analysis to control for its possible influence on brain metabolism. Body mass index increased significantly by 0.66 ± 1.3 kg/m2 (p = 0.040). There were correlations between weight gain and changes in brain metabolism in premotor areas, including the left and right superior gyri (Brodmann area, BA 6), left superior gyrus (BA 8), the dorsolateral prefrontal cortex (right middle gyrus, BAs 9 and 46), and the left and right somatosensory association cortices (BA 7). However, we found no correlation between weight gain and metabolic changes in limbic and associative areas. Additionally, there was a trend toward a correlation between reduced dyskinesia and weight gain (r = 0.428, p = 0.067). These findings suggest that, unlike STN-DBS, motor improvement is the major contributing factor for weight gain following GPi-DBS PD, confirming the motor selectivity of this target.
authors.affiliation: "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.|Department of Neurophysiology, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Sauleau
authors.affiliation: "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.|Department of Neurology, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Drapier
authors.affiliation: "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.
authors.forename: Joan
authors.initials: J
authors.lastname: Duprez
authors.affiliation: "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.|Department of Neurology, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Houvenaghel
authors.affiliation: "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Dondaine
authors.affiliation: Department of Neurosurgery, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.|"MediCIS" laboratory (UMR 1099 LTSI), INSERM, University of Rennes 1, Avenue Léon Bernard, Rennes, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Haegelen
authors.affiliation: "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.|Department of Psychiatry, Rennes University Hospital, avenue du Général Leclerc, Rennes, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Drapier
authors.affiliation: Department of Neurosurgery, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Jannin
authors.affiliation: "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.|Department of Psychiatry, Rennes University Hospital, avenue du Général Leclerc, Rennes, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Robert
authors.affiliation: "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.|Department of Oncology, Eugene Marquis Center, Avenue de la Bataille Flandres-Dunkerque, Rennes, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Le Jeune
authors.affiliation: "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.|Department of Neurology, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Vérin
mesh_terms: D015992:Body Mass Index; D046690:Deep Brain Stimulation; D005260:Female; D005917:Globus Pallidus / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000378:metabolism / Q000628:therapy; D049268:Positron-Emission Tomography; D015430:Weight Gain