Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up
Identifieur interne : 001596 ( Main/Corpus ); précédent : 001595; suivant : 001597Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up
Auteurs : S. Bannier ; C. Montaurier ; P P Derost ; M. Ulla ; J-J Lemaire ; Y. Boirie ; B. Morio ; F. DurifSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2009-05.
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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DOI: 10.1136/jnnp.2008.158576
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Montaurier</name><affiliation><mods:affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</mods:affiliation></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><mods:affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</mods:affiliation></affiliation></author><author><name sortKey="Ulla, M" sort="Ulla, M" uniqKey="Ulla M" first="M" last="Ulla">M. 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Bannier</name><affiliation><mods:affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</mods:affiliation></affiliation></author><author><name sortKey="Montaurier, C" sort="Montaurier, C" uniqKey="Montaurier C" first="C" last="Montaurier">C. Montaurier</name><affiliation><mods:affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</mods:affiliation></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><mods:affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</mods:affiliation></affiliation></author><author><name sortKey="Ulla, M" sort="Ulla, M" uniqKey="Ulla M" first="M" last="Ulla">M. Ulla</name><affiliation><mods:affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</mods:affiliation></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><mods:affiliation>CHU Clermont-Ferrand, Department of Neurosurgery, Gabriel Montpied Hospital, Clermont-Ferrand, France</mods:affiliation></affiliation></author><author><name sortKey="Boirie, Y" sort="Boirie, Y" uniqKey="Boirie Y" first="Y" last="Boirie">Y. Boirie</name><affiliation><mods:affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Univ Clermont 1, UFR Medecine, UMR1019, Unite de Nutrition Humaine, CRNH Auvergne, CHRU, Clermont-Ferrand, France</mods:affiliation></affiliation></author><author><name sortKey="Morio, B" sort="Morio, B" uniqKey="Morio B" first="B" last="Morio">B. Morio</name><affiliation><mods:affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</mods:affiliation></affiliation></author><author><name sortKey="Durif, F" sort="Durif, F" uniqKey="Durif F" first="F" last="Durif">F. Durif</name><affiliation><mods:affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</mods:affiliation></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></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></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></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>S Bannier</name><affiliations><json:string>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</json:string><json:string>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</json:string></affiliations></json:item><json:item><name>C Montaurier</name><affiliations><json:string>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</json:string></affiliations></json:item><json:item><name>P P Derost</name><affiliations><json:string>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</json:string><json:string>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</json:string></affiliations></json:item><json:item><name>M Ulla</name><affiliations><json:string>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</json:string><json:string>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</json:string></affiliations></json:item><json:item><name>J-J Lemaire</name><affiliations><json:string>CHU Clermont-Ferrand, Department of Neurosurgery, Gabriel Montpied Hospital, Clermont-Ferrand, France</json:string></affiliations></json:item><json:item><name>Y Boirie</name><affiliations><json:string>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</json:string><json:string>Univ Clermont 1, UFR Medecine, UMR1019, Unite de Nutrition Humaine, CRNH Auvergne, CHRU, Clermont-Ferrand, France</json:string></affiliations></json:item><json:item><name>B Morio</name><affiliations><json:string>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</json:string></affiliations></json:item><json:item><name>F Durif</name><affiliations><json:string>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</json:string><json:string>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Research papers</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Drugs: CNS (not psychiatric)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item></subject><language><json:string>eng</json:string></language><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.</abstract><qualityIndicators><score>6.847</score><pdfVersion>1.2</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>3</keywordCount><abstractCharCount>1689</abstractCharCount><pdfWordCount>3847</pdfWordCount><pdfCharCount>24028</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>256</abstractWordCount></qualityIndicators><title>Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term 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récupérées via GROBID" name="ISTEX-API (INIST-CNRS)"></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2008-12-05</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up</title><author><persName><forename type="first">S</forename><surname>Bannier</surname></persName><affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</affiliation></author><author><persName><forename type="first">C</forename><surname>Montaurier</surname></persName><affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</affiliation></author><author><persName><forename type="first">P P</forename><surname>Derost</surname></persName><affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</affiliation></author><author><persName><forename type="first">M</forename><surname>Ulla</surname></persName><affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</affiliation></author><author><persName><forename type="first">J-J</forename><surname>Lemaire</surname></persName><affiliation>CHU Clermont-Ferrand, Department of Neurosurgery, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation></author><author><persName><forename type="first">Y</forename><surname>Boirie</surname></persName><affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, UMR1019, Unite de Nutrition Humaine, CRNH Auvergne, CHRU, Clermont-Ferrand, France</affiliation></author><author><persName><forename type="first">B</forename><surname>Morio</surname></persName><affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</affiliation></author><author><persName><forename type="first">F</forename><surname>Durif</surname></persName><affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2009-05"></date><biblScope unit="volume">80</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="484">484</biblScope></imprint></monogr><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></fileDesc><profileDesc><creation><date>2008-12-05</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>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.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Drugs: CNS (not psychiatric)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Parkinson's disease</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2008-12-05">Created</change><change when="2009-05">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2016-3-14">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/327CA4D34FE5A489CBE4780436CC36CF412A764E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-id journal-id-type="publisher-id">jnnp</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jn158576</article-id><article-id pub-id-type="doi">10.1136/jnnp.2008.158576</article-id><article-id pub-id-type="other">jnnp;80/5/484</article-id><article-id pub-id-type="other">jnnp;jnnp.2008.158576</article-id><article-id pub-id-type="pmid">19060023</article-id><article-id pub-id-type="other">484</article-id><article-id pub-id-type="other">jnnp.2008.158576</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Research papers</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Drugs: CNS (not psychiatric)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Parkinson's disease</subject></subj-group></article-categories><title-group><article-title>Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up</article-title><alt-title alt-title-type="running-head">Research paper</alt-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Bannier</surname><given-names>S</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Montaurier</surname><given-names>C</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Derost</surname><given-names>P P</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Ulla</surname><given-names>M</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Lemaire</surname><given-names>J-J</given-names></name><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Boirie</surname><given-names>Y</given-names></name><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Morio</surname><given-names>B</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Durif</surname><given-names>F</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff2">2</xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</addr-line></aff><aff id="aff3"><label>3</label><addr-line>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</addr-line></aff><aff id="aff4"><label>4</label><addr-line>Univ Clermont 1, UFR Medecine, UMR1019, Unite de Nutrition Humaine, CRNH Auvergne, CHRU, Clermont-Ferrand, France</addr-line></aff><aff id="aff5"><label>5</label><addr-line>CHU Clermont-Ferrand, Department of Neurosurgery, Gabriel Montpied Hospital, Clermont-Ferrand, France</addr-line></aff><author-notes><corresp>S Bannier, Hopital Gabriel Montpied, Clermont-Ferrand, France; <email xlink:type="simple">stephaniebannier@gmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><month>5</month><year>2009</year></pub-date><pub-date pub-type="epub-original"><day>5</day><month>12</month><year>2008</year></pub-date><pub-date pub-type="epub"><day>5</day><month>12</month><year>2008</year></pub-date><volume>80</volume><volume-id pub-id-type="other">80</volume-id><volume-id pub-id-type="other">80</volume-id><issue>5</issue><issue-id pub-id-type="other">jnnp;80/5</issue-id><issue-id pub-id-type="other">5</issue-id><issue-id pub-id-type="other">80/5</issue-id><fpage>484</fpage><history><date date-type="received"><day>18</day><month>7</month><year>2008</year></date><date date-type="rev-recd"><day>15</day><month>10</month><year>2008</year></date><date date-type="accepted"><day>31</day><month>10</month><year>2008</year></date></history><permissions><copyright-statement>2009 BMJ Publishing Group</copyright-statement><copyright-year>2009</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-80-484.pdf"></self-uri><abstract><sec><title>Objective:</title><p>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.</p></sec><sec><title>Methods:</title><p>We used dual <italic>x</italic> 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.</p></sec><sec><title>Results:</title><p>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).</p></sec><sec><title>Conclusion:</title><p>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.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up</title></titleInfo><name type="personal"><namePart type="given">S</namePart><namePart type="family">Bannier</namePart><affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C</namePart><namePart type="family">Montaurier</namePart><affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P P</namePart><namePart type="family">Derost</namePart><affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Ulla</namePart><affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J-J</namePart><namePart type="family">Lemaire</namePart><affiliation>CHU Clermont-Ferrand, Department of Neurosurgery, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Y</namePart><namePart type="family">Boirie</namePart><affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, UMR1019, Unite de Nutrition Humaine, CRNH Auvergne, CHRU, Clermont-Ferrand, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B</namePart><namePart type="family">Morio</namePart><affiliation>INRA, Centre Clermont-Ferrand Theix, Unite de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">F</namePart><namePart type="family">Durif</namePart><affiliation>CHU Clermont-Ferrand, Department of Neurology, Gabriel Montpied Hospital, Clermont-Ferrand, France</affiliation><affiliation>Univ Clermont 1, UFR Medecine, Clermont-Ferrand, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Drugs: CNS (not psychiatric)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Parkinson's disease</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2009-05</dateIssued><dateCreated encoding="w3cdtf">2008-12-05</dateCreated><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><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.</abstract><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID">jnnp</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>80</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>484</start></extent></part></relatedItem><identifier type="istex">327CA4D34FE5A489CBE4780436CC36CF412A764E</identifier><identifier type="DOI">10.1136/jnnp.2008.158576</identifier><identifier type="href">jnnp-80-484.pdf</identifier><identifier type="ArticleID">jn158576</identifier><identifier type="PMID">19060023</identifier><identifier type="local">jnnp;80/5/484</identifier><accessCondition type="use and reproduction" contentType="copyright">2009 BMJ Publishing Group</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/327CA4D34FE5A489CBE4780436CC36CF412A764E/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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