Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease : long term follow-up
Identifieur interne : 000600 ( PascalFrancis/Checkpoint ); précédent : 000599; suivant : 000601Overweight 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 and psychiatry [ 0022-3050 ] ; 2009.
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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.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease : long term follow-up</title><author><name sortKey="Bannier, S" sort="Bannier, S" uniqKey="Bannier S" first="S." last="Bannier">S. Bannier</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><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Univ Clermont 1, UFR Medecine</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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></author><author><name sortKey="Montaurier, C" sort="Montaurier, C" uniqKey="Montaurier C" first="C." last="Montaurier">C. Montaurier</name><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><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><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="Derost, P P" sort="Derost, P P" uniqKey="Derost P" first="P. P." last="Derost">P. P. Derost</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><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Univ Clermont 1, UFR Medecine</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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></author><author><name sortKey="Ulla, M" sort="Ulla, M" uniqKey="Ulla M" first="M." last="Ulla">M. Ulla</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><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Univ Clermont 1, UFR Medecine</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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></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"><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><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"><inist:fA14 i1="03"><s1>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Univ Clermont 1, UFR Medecine, UMR1019, Unite de Nutrition Humaine, CRNH Auvergne, CHRU</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>6 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="Morio, B" sort="Morio, B" uniqKey="Morio B" first="B." last="Morio">B. Morio</name><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><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><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><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Univ Clermont 1, UFR Medecine</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0196356</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0196356 INIST</idno><idno type="RBID">Pascal:09-0196356</idno><idno type="wicri:Area/PascalFrancis/Corpus">000732</idno><idno type="wicri:Area/PascalFrancis/Curation">000C53</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000600</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000600</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease : long term follow-up</title><author><name sortKey="Bannier, S" sort="Bannier, S" uniqKey="Bannier S" first="S." last="Bannier">S. Bannier</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><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Univ Clermont 1, UFR Medecine</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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></author><author><name sortKey="Montaurier, C" sort="Montaurier, C" uniqKey="Montaurier C" first="C." last="Montaurier">C. Montaurier</name><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><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><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="Derost, P P" sort="Derost, P P" uniqKey="Derost P" first="P. P." last="Derost">P. P. Derost</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><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Univ Clermont 1, UFR Medecine</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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></author><author><name sortKey="Ulla, M" sort="Ulla, M" uniqKey="Ulla M" first="M." last="Ulla">M. Ulla</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><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Univ Clermont 1, UFR Medecine</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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></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"><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><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"><inist:fA14 i1="03"><s1>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Univ Clermont 1, UFR Medecine, UMR1019, Unite de Nutrition Humaine, CRNH Auvergne, CHRU</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>6 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="Morio, B" sort="Morio, B" uniqKey="Morio B" first="B." last="Morio">B. Morio</name><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><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><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><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Univ Clermont 1, UFR Medecine</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><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></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></series></biblStruct></sourceDesc><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></seriesStmt></fileDesc><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></textClass></profileDesc></teiHeader><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></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0022-3050</s0></fA01><fA02 i1="01"><s0>JNNPAU</s0></fA02><fA03 i2="1"><s0>J. neurol. neurosurg. psychiatry</s0></fA03><fA05><s2>80</s2></fA05><fA06><s2>5</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease : long term follow-up</s1></fA08><fA11 i1="01" i2="1"><s1>BANNIER (S.)</s1></fA11><fA11 i1="02" i2="1"><s1>MONTAURIER (C.)</s1></fA11><fA11 i1="03" i2="1"><s1>DEROST (P. P.)</s1></fA11><fA11 i1="04" i2="1"><s1>ULLA (M.)</s1></fA11><fA11 i1="05" i2="1"><s1>LEMAIRE (J.-J.)</s1></fA11><fA11 i1="06" i2="1"><s1>BOIRIE (Y.)</s1></fA11><fA11 i1="07" i2="1"><s1>MORIO (B.)</s1></fA11><fA11 i1="08" i2="1"><s1>DURIF (F.)</s1></fA11><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><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ></fA14><fA14 i1="02"><s1>Univ Clermont 1, UFR Medecine</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ></fA14><fA14 i1="03"><s1>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></fA14><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></fA14><fA14 i1="05"><s1>Univ Clermont 1, UFR Medecine, UMR1019, Unite de Nutrition Humaine, CRNH Auvergne, CHRU</s1><s2>Clermont-Ferrand</s2><s3>FRA</s3><sZ>6 aut.</sZ></fA14><fA20><s1>484-488</s1></fA20><fA21><s1>2009</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>6015</s2><s5>354000184920830060</s5></fA43><fA44><s0>0000</s0><s1>© 2009 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>28 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>09-0196356</s0></fA47><fA60><s1>P</s1><s3>PR</s3></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Journal of neurology, neurosurgery and psychiatry</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>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.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Maladie de Parkinson</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Surcharge pondérale</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Overweight</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Sobrecarga ponderal</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Noyau sousthalamique</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Subthalamic nucleus</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Núcleo subtalámico</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Long terme</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Long term</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Largo plazo</s0><s5>11</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Stimulation cérébrale profonde</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Deep brain stimulation</s0><s4>CD</s4><s5>96</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Encéphale</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Encephalon</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Système nerveux central</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Central nervous system</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervioso central</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>42</s5></fC07><fN21><s1>145</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>France</li></country><region><li>Auvergne (région administrative)</li><li>Auvergne-Rhône-Alpes</li></region><settlement><li>Clermont-Ferrand</li></settlement></list><tree><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Bannier, S" sort="Bannier, S" uniqKey="Bannier S" first="S." last="Bannier">S. Bannier</name></region><name sortKey="Bannier, S" sort="Bannier, S" uniqKey="Bannier S" first="S." last="Bannier">S. Bannier</name><name sortKey="Boirie, Y" sort="Boirie, Y" uniqKey="Boirie Y" first="Y." last="Boirie">Y. Boirie</name><name sortKey="Boirie, Y" sort="Boirie, Y" uniqKey="Boirie Y" first="Y." last="Boirie">Y. Boirie</name><name sortKey="Derost, P P" sort="Derost, P P" uniqKey="Derost P" first="P. P." last="Derost">P. P. Derost</name><name sortKey="Derost, P P" sort="Derost, P P" uniqKey="Derost P" first="P. P." last="Derost">P. P. Derost</name><name sortKey="Durif, F" sort="Durif, F" uniqKey="Durif F" first="F." last="Durif">F. Durif</name><name sortKey="Durif, F" sort="Durif, F" uniqKey="Durif F" first="F." last="Durif">F. Durif</name><name sortKey="Lemaire, J J" sort="Lemaire, J J" uniqKey="Lemaire J" first="J.-J." last="Lemaire">J.-J. Lemaire</name><name sortKey="Montaurier, C" sort="Montaurier, C" uniqKey="Montaurier C" first="C." last="Montaurier">C. Montaurier</name><name sortKey="Morio, B" sort="Morio, B" uniqKey="Morio B" first="B." last="Morio">B. Morio</name><name sortKey="Ulla, M" sort="Ulla, M" uniqKey="Ulla M" first="M." last="Ulla">M. Ulla</name><name sortKey="Ulla, M" sort="Ulla, M" uniqKey="Ulla M" first="M." last="Ulla">M. Ulla</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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