Inserm U897, Department of Neurology, University Hospital and Bordeaux-2 University, 146, rue Léo-Saignat, 33076 Bordeaux cedex, France.
Rev Neurol (Paris). 2012 Feb;168(2):173-6. doi: 10.1016/j.neurol.2011.04.006. Epub 2011 Oct 21.
Deep brain stimulation of the subthalamic nucleus (STN-DBS) constitutes the mainstay treatment in advanced Parkinson's disease (PD) with motor fluctuations. Despite its efficacy on motor signs and quality of life, emergent adverse events have been recently reported. Among them, weight gain (WG) is a recognized adverse event of subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD). Also, WG is poorly known at the long-term and predisposing factors have not yet been identified. We conducted a cross-sectional study of WG in 47 STN-DBS PD patients between 1999-2006. Data on disease history, motor status and dopaminergic drug treatment were retrospectively collected at surgery and 1 year post-surgery. Weight at disease diagnosis and at surgery, as well as the current weight and height were gathered by an autoquestionnaire. Moreover, the weight before surgery was obtained and verified in medical files in more than 90% of our patients. Sixty-six patients who underwent surgery between 1999-2006 were included, but six were deceased, four refused to participate and nine were lost for follow-up. So, 47 (71%) were retained in our analysis. A total of 78.7% of patients gained weight. On average 4.7 years follow up after surgery, the mean weight gain was +7.2±8.1kg compared to the preoperative assessment (p<0.001) and the mean BMI gain was +2.7±3.0kg/m(2) compared to pre-surgery values (p<0.001). The patients gained more weight after surgery than they had lost during disease evolution before surgery. Women and patients with a more severe UPDRS-III "off" drug score before surgery significantly gained more weight. Our study provides further evidence that the WG is a problem after STN-DBS and concerns a majority of patients at the long term. It may expose them to complications that should be considered for prevention and the patient's information before surgery.
丘脑底核脑深部电刺激（STN-DBS）是治疗晚期帕金森病（PD）伴运动波动的主要方法。尽管该疗法对运动症状和生活质量有疗效，但最近也有报道出现紧急不良事件。其中，体重增加（WG）是帕金森病（PD）患者接受丘脑底核脑深部电刺激（STN-DBS）后的一种公认不良事件。此外，长期的 WG 情况尚不清楚，且尚未确定其诱发因素。
我们对 1999-2006 年间进行 STN-DBS 的 47 例 PD 患者进行了 WG 的横断面研究。在手术时和手术后 1 年，回顾性地收集了疾病史、运动状态和多巴胺能药物治疗的数据。通过自动问卷收集了疾病诊断时、手术时、当前体重和身高。此外，90%以上的患者通过医疗记录获取并验证了手术前的体重。
纳入了 1999-2006 年间接受手术的 66 例患者，但其中 6 例死亡，4 例拒绝参与，9 例失访。因此，我们的分析保留了 47 例（71%）患者。结果显示，78.7%的患者体重增加。手术后平均随访 4.7 年，与术前评估相比，平均体重增加 7.2±8.1kg（p<0.001），平均 BMI 增加 2.7±3.0kg/m(2)（p<0.001）。与术前相比，患者手术后的体重增加超过了术前疾病演变期间的体重减轻量。术前 UPDRS-III“关期”药物评分更严重的女性和患者体重增加更多。
本研究进一步证实，WG 是 STN-DBS 后的一个问题，长期来看，大多数患者都会出现这种情况。这可能会使他们面临并发症的风险，应在手术前对患者的情况进行充分评估和预防。
