Department of Neurology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20123, Milan, MI, Italy.
Department of Neuroscience "Rita Levi Montalcini", University of Turin, Torino, Italy.
Neurol Sci. 2017 Dec;38(12):2123-2129. doi: 10.1007/s10072-017-3102-7. Epub 2017 Sep 14.
Parkinson's disease is a common neurodegenerative disease that can be treated with pharmacological or surgical therapy. Subthalamic nucleus (STN) deep brain stimulation is a commonly used surgical option. A reported side effect of STN-DBS is weight gain: the aim of our study was to find those factors that determine weight gain, through one year-long observation of 32 patients that underwent surgery in our centre. During the follow-up, we considered: anthropometric features, hormonal levels, motor outcome, neuropsychological and quality of life outcomes, therapeutic parameters and electrodes position. The majority (84%) of our patients gained weight (6.7 kg in 12 months); more than a half of the cohort became overweight. At 12th month, weight gain showed a correlation with dyskinesias reduction, electrodes voltage and distance on the lateral axis. In the multivariate regression analysis, the determinants of weight gain were dyskinesias reduction and electrodes position. In this study, we identified dyskinesias reduction and distance between the active electrodes and the third ventricle as determining factors of weight gain after STN-DBS implantation in PD patients. The first finding could be linked to a decrease in energy consumption, while the second one could be due to a lower stimulation of the lateral hypothalamic area, known for its important role in metabolism and body weight control. Weight gain is a common finding after STN-DBS implantation, and it should be carefully monitored given the potential harmful consequences of overweight.
帕金森病是一种常见的神经退行性疾病，可以通过药物或手术治疗。丘脑底核（STN）深部脑刺激是一种常用的手术选择。有报道称 STN-DBS 的副作用之一是体重增加：我们的研究目的是通过对在我们中心接受手术的 32 名患者进行为期一年的观察，找到导致体重增加的因素。在随访期间，我们考虑了：人体测量特征、激素水平、运动结果、神经心理学和生活质量结果、治疗参数和电极位置。我们的大多数患者（84%）体重增加（12 个月增加 6.7 公斤）；超过一半的患者超重。在第 12 个月时，体重增加与运动障碍减少、电极电压和侧轴上的距离相关。在多变量回归分析中，体重增加的决定因素是运动障碍减少和电极位置。在这项研究中，我们确定运动障碍减少和活性电极与第三脑室之间的距离是 STN-DBS 植入后 PD 患者体重增加的决定因素。第一个发现可能与能量消耗减少有关，而第二个发现可能与外侧下丘脑区域的刺激降低有关，该区域已知在代谢和体重控制中起着重要作用。体重增加是 STN-DBS 植入后的常见现象，鉴于超重可能带来的潜在有害后果，应密切监测体重。
