Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up
Identifieur interne : 002051 ( Main/Exploration ); 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
Affiliations:
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<term>Body Weight (physiology)</term>
<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>
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<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Body Composition</term>
<term>Body Weight</term>
<term>Subthalamic Nucleus</term>
<term>Weight Gain</term>
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<term>Subthalamic Nucleus</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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