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帕金森病和肌张力障碍患者接受内侧苍白球或丘脑底核深部脑刺激后的体重变化

Weight change after globus pallidus internus or subthalamic nucleus deep brain stimulation in Parkinson's disease and dystonia.

作者信息

Mills Kelly A, Scherzer Rebecca, Starr Philip A, Ostrem Jill L

机构信息

Department of Neurology, Surgical Movement Disorders Center, University of California San Francisco, San Francisco, CA 94115, USA.

出版信息

Stereotact Funct Neurosurg. 2012;90(6):386-93. doi: 10.1159/000340071. Epub 2012 Aug 23.

Abstract

BACKGROUND

Weight gain has been described in Parkinson's disease (PD) patients after subthalamic nucleus (STN) deep brain stimulation (DBS).

OBJECTIVES

We examined change in weight following DBS in both PD and dystonia patients to further investigate the role of disease and brain target (STN or globus pallidus internus, GPi) specificity.

METHODS

Data was retrospectively collected on 61 PD DBS patients (STN n = 31 or GPi n = 30) and on 36 dystonia DBS patients (STN n = 9 and GPi n = 27) before and after surgery. Annual change in body mass index (BMI) was evaluated with nonparametric tests between groups and multiple quantile regression.

RESULTS

PD patients treated with STN DBS had a small increase in median BMI while those with GPi had a small decrease in BMI. Dystonia patients treated with STN DBS had a greater increase in BMI per year compared to those treated with GPi DBS. Multivariable regression analyses for each disease showed little difference between targets in weight gain in those with PD, but STN target was strongly associated with weight gain in dystonia patients (STN vs. GPi, +7.99 kg, p = 0.012).

CONCLUSIONS

Our results support previous reports of weight gain after DBS in PD. This is the first report to suggest a target-specific increase in weight following STN DBS in dystonia patients.

摘要

背景

已有报道称帕金森病(PD)患者在接受丘脑底核(STN)深部脑刺激(DBS)后体重增加。

目的

我们研究了PD和肌张力障碍患者在DBS术后的体重变化,以进一步探究疾病及脑靶点(STN或苍白球内侧部,GPi)特异性的作用。

方法

回顾性收集了61例接受DBS治疗的PD患者(STN组n = 31,GPi组n = 30)以及36例接受DBS治疗的肌张力障碍患者(STN组n = 9,GPi组n = 27)手术前后的数据。采用非参数检验和多变量分位数回归评估体重指数(BMI)的年度变化。

结果

接受STN - DBS治疗的PD患者BMI中位数略有增加,而接受GPi - DBS治疗的患者BMI略有下降。与接受GPi - DBS治疗的肌张力障碍患者相比,接受STN - DBS治疗的患者每年BMI增加幅度更大。对每种疾病进行的多变量回归分析显示,PD患者中不同靶点在体重增加方面差异不大,但STN靶点与肌张力障碍患者的体重增加密切相关(STN与GPi相比,增加7.99 kg,p = 0.012)。

结论

我们的结果支持先前关于PD患者DBS术后体重增加的报道。这是首次表明肌张力障碍患者接受STN - DBS后体重有靶点特异性增加的报告。

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