Article,
Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up.
Journal of neurology, neurosurgery, and psychiatry, 80 (5): 484--8 (2009)
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/m(2)
3 months after surgery and 2.02 (0.36) kg/m(2) 16 months after surgery.
For women, the mean increases in BMI at the same evaluation times
were 1.04 (0.30) kg/m(2) and 2.11 (0.49) kg/m(2). 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 öff" 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.
