丘脑底核与苍白球 internus 深部脑刺激的体重变化：来自 COMPARE 帕金森病深部脑刺激队列的结果。
Weight changes in subthalamic nucleus vs globus pallidus internus deep brain stimulation: results from the COMPARE Parkinson disease deep brain stimulation cohort.
机构信息
Department of Neurology, University of Florida Movement Disorders Center McKnight Brain Institute, Gainesville, Florida 32611, USA.
出版信息
Neurosurgery. 2011 May;68(5):1233-7; discussion 1237-8. doi: 10.1227/NEU.0b013e31820b52c5.
BACKGROUND
Parkinson's patients, on average, gain weight after deep brain stimulation (DBS).
OBJECTIVE
To determine potential differences in weight gain when comparing the subthalamic nucleus and the globus pallidus internus target.
METHODS
A retrospective analysis was performed on the prospective, randomized cohort of National Institutes of Health COMPARE trial DBS patients who received unilateral subthalamic nucleus or globus pallidus internus DBS. Baseline weights were recorded before DBS surgery and at 6, 12, and 18 months postoperatively. Relationships between weight change and changes in Beck Depression Inventory score, Unified Parkinson's Disease Rating Scale (UPDRS) motor score (part III) (also the dyskinesia duration and disability subscores from UPDRS IV), and Hoehn-Yahr stage were determined via Spearman's rank-order correlation coefficients. Regression analyses were performed to investigate the effects of potential factors on weight change over time.
RESULTS
Patients in the COMPARE DBS cohort gained a significant amount of weight, a mean of 4.86 lb (standard deviation = 8.73) (P = .001), but there was no significant difference between subthalamic nucleus and globus pallidus internus targets (weight gain of 4.29 ± 6.79 and 5.38 ± 10.32 lb, respectively; P = .68). Weight gain did not correlate with Beck Depression Inventory score change, UPDRS motor score, dyskinesia duration, dyskinesia disability change, or the Hoehn-Yahr stage (P = .62, .21, and .31, respectively). No specific variable was associated with weight gain, and there were no differences in binge eating post-surgery in either target.
CONCLUSION
There were significant changes in weight over time after DBS therapy. However, neither Beck Depression Inventory score change nor UPDRS score change or dyskinesia was correlated with weight gain. No significant factor was associated with the weight change.
背景
帕金森病患者在接受深部脑刺激（DBS）后平均体重增加。
目的
比较丘脑底核和苍白球 internus 靶点时，确定体重增加的潜在差异。
方法
对国立卫生研究院 COMPARE 试验 DBS 患者的前瞻性、随机队列进行回顾性分析，这些患者接受了单侧丘脑底核或苍白球 internus DBS。在 DBS 手术前和手术后 6、12 和 18 个月记录基线体重。通过 Spearman 秩相关系数确定体重变化与贝克抑郁量表评分变化、统一帕金森病评定量表（UPDRS）运动评分（第三部分）（UPDRS IV 的运动障碍持续时间和残疾亚评分）和 Hoehn-Yahr 分期之间的关系。进行回归分析以调查潜在因素对随时间变化的体重变化的影响。
结果
COMPARE DBS 队列中的患者体重显著增加，平均增加 4.86 磅（标准差=8.73）（P=0.001），但丘脑底核和苍白球 internus 靶点之间没有显著差异（体重增加分别为 4.29±6.79 和 5.38±10.32 磅；P=0.68）。体重增加与贝克抑郁量表评分变化、UPDRS 运动评分、运动障碍持续时间、运动障碍残疾变化或 Hoehn-Yahr 分期均无相关性（P=0.62、0.21 和 0.31）。没有特定变量与体重增加相关，两个靶点手术后均无暴食行为差异。
结论
DBS 治疗后体重随时间发生显著变化。然而，贝克抑郁量表评分变化或 UPDRS 评分变化或运动障碍均与体重增加无关。没有与体重变化相关的显著因素。
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