Department of Neurophysiology, University Hospital of Rennes, Rennes, France.
Mov Disord. 2009 Oct 30;24(14):2149-55. doi: 10.1002/mds.22765.
To compare body mass index (BMI) and daily energy intake (DEI) after subthalamic versus pallidal deep brain stimulation (DBS). Weight gain following DBS in Parkinson's disease patients remains largely unexplained and no comparison of subthalamic and pallidal (GPi) stimulation has yet been performed. BMI and DEI, dopaminergic drug administration and motor scores were recorded in 46 patients with PD before STN (n = 32) or GPi (n = 14) DBS and 3 and 6 months after. At M6, BMI had increased by an average of 8.4% in the STN group and 3.2% in the GPi group. BMI increased in 28 STN and 9 GPi patients. This increase was significantly higher in the STN group (P < 0.048) and the difference remained significant after adjustment for reduced dopaminergic medication; 28.6% of GPi patients were overweight at 6 months (14.3% preoperatively) versus 37.5% of STN patients (21.9% preoperatively). Changes in BMI were negatively correlated with changes in dyskinesia in the GPi-DBS group. Food intake did not change in the two groups, either quantitatively or qualitatively. Frequent weight gain, inadequately explained by motor improvement or reduced dopaminergic drug dosage, occurred in subthalamic DBS patients. The difference between groups suggests additional factors in the STN group, such as homeostatic control center involvement.
比较苍白球内侧核（GPi）与丘脑底核（STN）脑深部电刺激（DBS）术后患者的体重指数（BMI）和每日能量摄入（DEI）。帕金森病（PD）患者 DBS 后体重增加的原因仍未完全阐明，尚未对 STN 和 GPi 刺激进行比较。本研究对 46 例 PD 患者（STN 组 32 例，GPi 组 14 例）术前、术后 3 个月和 6 个月的 BMI、DEI、多巴胺能药物治疗和运动评分进行了记录。在 STN 组，BMI 平均增加了 8.4%，而在 GPi 组则增加了 3.2%。STN 组 28 例和 GPi 组 9 例患者 BMI 增加。STN 组的 BMI 增加明显高于 GPi 组（P < 0.048），调整多巴胺能药物治疗减少后，差异仍有统计学意义；6 个月时，GPi 组 28.6%的患者超重（术前 14.3%），而 STN 组为 37.5%（术前 21.9%）。GPi-DBS 组的 BMI 变化与异动症的变化呈负相关。两组患者的饮食摄入无论是数量还是质量均未发生变化。STN-DBS 患者出现了不明原因的体重明显增加，不能用运动改善或多巴胺能药物剂量减少来解释。两组之间的差异表明 STN 组存在其他因素，如参与体内平衡控制中心。
