Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up
Identifieur interne : 002051 ( Main/Curation ); précédent : 002050; suivant : 002052Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up
Auteurs : S. Bannier [France] ; C. Montaurier [France] ; P P Derost [France] ; M. Ulla [France] ; J-J Lemaire [France] ; Y. Boirie [France] ; B. Morio [France] ; F. Durif [France]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2009-05.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Absorptiometry, Photon, Body Composition (physiology), Body Weight (physiology), Deep Brain Stimulation (adverse effects), Deep brain stimulation, Female, Follow-Up Studies, Humans, Long term, Male, Middle Aged, Nervous system diseases, Neurosurgical Procedures, Obesity (etiology), Overweight, Overweight (etiology), Parkinson Disease (complications), Parkinson Disease (surgery), Parkinson Disease (therapy), Parkinson disease, Subthalamic Nucleus (physiology), Subthalamic Nucleus (surgery), Subthalamic nucleus, Treatment Outcome, Weight Gain (physiology).
- MESH :
- adverse effects : Deep Brain Stimulation.
- complications : Parkinson Disease.
- etiology : Obesity, Overweight.
- physiology : Body Composition, Body Weight, Subthalamic Nucleus, Weight Gain.
- surgery : Parkinson Disease, Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Absorptiometry, Photon, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neurosurgical Procedures, Treatment Outcome.
Abstract
Objective: To assess the occurrence of weight gain in patients with Parkinson’s disease, with an average 16 months of follow-up after subthalamic nucleus deep brain stimulation. Methods: We used dual x ray absorptiometry to evaluate changes in body weight and body composition in 22 patients with Parkinson’s disease (15 men and seven women) before surgery, 3 months after surgery and on average 16 months after surgery. Results: No patient was underweight before surgery and 50% were overweight. By contrast, 68% were overweight or obese 3 months after surgery and 82% after 16 months (p<0.001). For men, the mean increase in body mass index (BMI) was 1.14 (0.23) kg/m2 3 months after surgery and 2.02 (0.36) kg/m2 16 months after surgery. For women, the mean increases in BMI at the same evaluation times were 1.04 (0.30) kg/m2 and 2.11 (0.49) kg/m2. This weight gain was mainly secondary to an increase in fat mass in both men and women. Three months after surgery, acute subthalamic deep brain stimulation induced an improvement in parkinsonian symptoms (evaluated by the Unified Parkinson Disease Rating Scale (UPDRS) part III) by 60.7 (2.9)% in the “off” dopa condition and a dramatic improvement of motor complications (dyskinesia duration: 82.8 (12.8)%, p<0.0001; off period duration: 92.7 (18.8)%, p<0.0001). Conclusion: Although subthalamic nucleus deep brain stimulation significantly improved parkinsonian symptoms and motor complications, many patients became overweight or obese. This finding highlights the necessity to understand the underlying mechanisms and to provide a diet management with a physical training schedule appropriate for patients with Parkinson’s disease.
Url:
DOI: 10.1136/jnnp.2008.158576
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<term>Deep Brain Stimulation (adverse effects)</term>
<term>Deep brain stimulation</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Long term</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Nervous system diseases</term>
<term>Neurosurgical Procedures</term>
<term>Obesity (etiology)</term>
<term>Overweight</term>
<term>Overweight (etiology)</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (surgery)</term>
<term>Parkinson Disease (therapy)</term>
<term>Parkinson disease</term>
<term>Subthalamic Nucleus (physiology)</term>
<term>Subthalamic Nucleus (surgery)</term>
<term>Subthalamic nucleus</term>
<term>Treatment Outcome</term>
<term>Weight Gain (physiology)</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Obesity</term>
<term>Overweight</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Body Composition</term>
<term>Body Weight</term>
<term>Subthalamic Nucleus</term>
<term>Weight Gain</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term>
<term>Subthalamic Nucleus</term>
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<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term>
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<keywords scheme="MESH" xml:lang="en"><term>Absorptiometry, Photon</term>
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<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurosurgical Procedures</term>
<term>Treatment Outcome</term>
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<term>Maladie de Parkinson</term>
<term>Noyau sousthalamique</term>
<term>Pathologie du système nerveux</term>
<term>Stimulation cérébrale profonde</term>
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<front><div type="abstract">Objective: To assess the occurrence of weight gain in patients with Parkinson’s disease, with an average 16 months of follow-up after subthalamic nucleus deep brain stimulation. Methods: We used dual x ray absorptiometry to evaluate changes in body weight and body composition in 22 patients with Parkinson’s disease (15 men and seven women) before surgery, 3 months after surgery and on average 16 months after surgery. Results: No patient was underweight before surgery and 50% were overweight. By contrast, 68% were overweight or obese 3 months after surgery and 82% after 16 months (p<0.001). For men, the mean increase in body mass index (BMI) was 1.14 (0.23) kg/m2 3 months after surgery and 2.02 (0.36) kg/m2 16 months after surgery. For women, the mean increases in BMI at the same evaluation times were 1.04 (0.30) kg/m2 and 2.11 (0.49) kg/m2. This weight gain was mainly secondary to an increase in fat mass in both men and women. Three months after surgery, acute subthalamic deep brain stimulation induced an improvement in parkinsonian symptoms (evaluated by the Unified Parkinson Disease Rating Scale (UPDRS) part III) by 60.7 (2.9)% in the “off” dopa condition and a dramatic improvement of motor complications (dyskinesia duration: 82.8 (12.8)%, p<0.0001; off period duration: 92.7 (18.8)%, p<0.0001). Conclusion: Although subthalamic nucleus deep brain stimulation significantly improved parkinsonian symptoms and motor complications, many patients became overweight or obese. This finding highlights the necessity to understand the underlying mechanisms and to provide a diet management with a physical training schedule appropriate for patients with Parkinson’s disease.</div>
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<placeName><region type="region">Auvergne-Rhône-Alpes</region>
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<settlement type="city">Clermont-Ferrand</settlement>
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<affiliation wicri:level="3"><inist:fA14 i1="04"><s1>CHU Clermont-Ferrand, Department of Neurosurgery, Gabriel Montpied Hospital</s1>
<s2>Clermont-Ferrand</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
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<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne</s1>
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<sZ>7 aut.</sZ>
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<settlement type="city">Clermont-Ferrand</settlement>
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<s2>Clermont-Ferrand</s2>
<s3>FRA</s3>
<sZ>6 aut.</sZ>
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<country>France</country>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
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<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne</s1>
<s2>Clermont-Ferrand</s2>
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<sZ>2 aut.</sZ>
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<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Durif, F" sort="Durif, F" uniqKey="Durif F" first="F." last="Durif">F. Durif</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital</s1>
<s2>Clermont-Ferrand</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
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<sZ>8 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
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<s2>Clermont-Ferrand</s2>
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</inist:fA14>
<country>France</country>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
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<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Journal of neurology, neurosurgery and psychiatry</title>
<title level="j" type="abbreviated">J. neurol. neurosurg. psychiatry</title>
<idno type="ISSN">0022-3050</idno>
<imprint><date when="2009">2009</date>
</imprint>
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<seriesStmt><title level="j" type="main">Journal of neurology, neurosurgery and psychiatry</title>
<title level="j" type="abbreviated">J. neurol. neurosurg. psychiatry</title>
<idno type="ISSN">0022-3050</idno>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation</term>
<term>Long term</term>
<term>Nervous system diseases</term>
<term>Overweight</term>
<term>Parkinson disease</term>
<term>Subthalamic nucleus</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term>
<term>Pathologie du système nerveux</term>
<term>Surcharge pondérale</term>
<term>Noyau sousthalamique</term>
<term>Long terme</term>
<term>Stimulation cérébrale profonde</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Objective: To assess the occurrence of weight gain in patients with Parkinson's disease, with an average 16 months of follow-up after subthalamic nucleus deep brain stimulation. Methods: We used dual x ray absorptiometry to evaluate changes in body weight and body composition in 22 patients with Parkinson's disease (15 men and seven women) before surgery, 3 months after surgery and on average 16 months after surgery. Results: No patient was underweight before surgery and 50% were overweight. By contrast, 68% were overweight or obese 3 months after surgery and 82% after 16 months (p<0.001). For men, the mean increase in body mass index (BMI) was 1.14 (0.23) kg/m<sup>2</sup>
3 months after surgery and 2.02 (0.36) kg/m<sup>2</sup>
16 months after surgery. For women, the mean increases in BMI at the same evaluation times were 1.04 (0.30) kg/m<sup>2</sup>
and 2.11 (0.49) kg/m<sup>2</sup>
. This weight gain was mainly secondary to an increase in fat mass in both men and women. Three months after surgery, acute subthalamic deep brain stimulation induced an improvement in parkinsonian symptoms (evaluated by the Unified Parkinson Disease Rating Scale (UPDRS) part III) by 60.7 (2.9)% in the "off" dopa condition and a dramatic improvement of motor complications (dyskinesia duration: 82.8 (12.8)%, p<0.0001; off period duration: 92.7 (18.8)%, p<0.0001). Conclusion: Although subthalamic nucleus deep brain stimulation significantly improved parkinsonian symptoms and motor complications, many patients became overweight or obese. This finding highlights the necessity to understand the underlying mechanisms and to provide a diet management with a physical training schedule appropriate for patients with Parkinson's disease.</div>
</front>
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<author><name sortKey="Montaurier, C" sort="Montaurier, C" uniqKey="Montaurier C" first="C" last="Montaurier">C. Montaurier</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Derost, P P" sort="Derost, P P" uniqKey="Derost P" first="P P" last="Derost">P P Derost</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>Univ Clermont 1, UFR Medecine, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ulla, M" sort="Ulla, M" uniqKey="Ulla M" first="M" last="Ulla">M. Ulla</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>Univ Clermont 1, UFR Medecine, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lemaire, J J" sort="Lemaire, J J" uniqKey="Lemaire J" first="J-J" last="Lemaire">J-J Lemaire</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>CHU Clermont-Ferrand, Department of Neurosurgery, Gabriel Montpied Hospital, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Boirie, Y" sort="Boirie, Y" uniqKey="Boirie Y" first="Y" last="Boirie">Y. Boirie</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>Univ Clermont 1, UFR Medecine, UMR1019, Unite de Nutrition Humaine, CRNH Auvergne, CHRU, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Morio, B" sort="Morio, B" uniqKey="Morio B" first="B" last="Morio">B. Morio</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Durif, F" sort="Durif, F" uniqKey="Durif F" first="F" last="Durif">F. Durif</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>Univ Clermont 1, UFR Medecine, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title>
<title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title>
<idno type="ISSN">0022-3050</idno>
<idno type="eISSN">1468-330X</idno>
<imprint><publisher>BMJ Publishing Group Ltd</publisher>
<date type="published" when="2009-05">2009-05</date>
<biblScope unit="volume">80</biblScope>
<biblScope unit="issue">5</biblScope>
<biblScope unit="page" from="484">484</biblScope>
</imprint>
<idno type="ISSN">0022-3050</idno>
</series>
<idno type="istex">327CA4D34FE5A489CBE4780436CC36CF412A764E</idno>
<idno type="DOI">10.1136/jnnp.2008.158576</idno>
<idno type="href">jnnp-80-484.pdf</idno>
<idno type="ArticleID">jn158576</idno>
<idno type="PMID">19060023</idno>
<idno type="local">jnnp;80/5/484</idno>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">0022-3050</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Absorptiometry, Photon</term>
<term>Body Composition (physiology)</term>
<term>Body Weight (physiology)</term>
<term>Deep Brain Stimulation (adverse effects)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurosurgical Procedures</term>
<term>Obesity (etiology)</term>
<term>Overweight (etiology)</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (surgery)</term>
<term>Parkinson Disease (therapy)</term>
<term>Subthalamic Nucleus (physiology)</term>
<term>Subthalamic Nucleus (surgery)</term>
<term>Treatment Outcome</term>
<term>Weight Gain (physiology)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Deep Brain Stimulation</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Obesity</term>
<term>Overweight</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Body Composition</term>
<term>Body Weight</term>
<term>Subthalamic Nucleus</term>
<term>Weight Gain</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term>
<term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Absorptiometry, Photon</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurosurgical Procedures</term>
<term>Treatment Outcome</term>
</keywords>
</textClass>
<langUsage><language ident="en">en</language>
</langUsage>
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</teiHeader>
<front><div type="abstract">Objective: To assess the occurrence of weight gain in patients with Parkinson’s disease, with an average 16 months of follow-up after subthalamic nucleus deep brain stimulation. Methods: We used dual x ray absorptiometry to evaluate changes in body weight and body composition in 22 patients with Parkinson’s disease (15 men and seven women) before surgery, 3 months after surgery and on average 16 months after surgery. Results: No patient was underweight before surgery and 50% were overweight. By contrast, 68% were overweight or obese 3 months after surgery and 82% after 16 months (p<0.001). For men, the mean increase in body mass index (BMI) was 1.14 (0.23) kg/m2 3 months after surgery and 2.02 (0.36) kg/m2 16 months after surgery. For women, the mean increases in BMI at the same evaluation times were 1.04 (0.30) kg/m2 and 2.11 (0.49) kg/m2. This weight gain was mainly secondary to an increase in fat mass in both men and women. Three months after surgery, acute subthalamic deep brain stimulation induced an improvement in parkinsonian symptoms (evaluated by the Unified Parkinson Disease Rating Scale (UPDRS) part III) by 60.7 (2.9)% in the “off” dopa condition and a dramatic improvement of motor complications (dyskinesia duration: 82.8 (12.8)%, p<0.0001; off period duration: 92.7 (18.8)%, p<0.0001). Conclusion: Although subthalamic nucleus deep brain stimulation significantly improved parkinsonian symptoms and motor complications, many patients became overweight or obese. This finding highlights the necessity to understand the underlying mechanisms and to provide a diet management with a physical training schedule appropriate for patients with Parkinson’s disease.</div>
</front>
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