He Weibin, Li Hongxia, Lai Yijie, Wu Yunhao, Wu Yiwen, Ramirez-Zamora Adolfo, Yi Wei, Zhang Chencheng
Department of Neurosurgery, Renmin Hospital, Wuhan University, Wuhan, China.
Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Neurol. 2021 Feb 24;12:632913. doi: 10.3389/fneur.2021.632913. eCollection 2021.
Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment method for advanced Parkinson's disease (PD) and isolated dystonia and provides marked improvement of major motor symptoms. In addition, non-motor effects have been reported including weight gain (WG) in patients with PD after STN-DBS. However, it is still unclear whether patients with isolated dystonia also experience WG. Data from 47 patients with isolated dystonia who underwent bilateral STN-DBS surgery between October 2012 and June 2019 were retrospectively collected. The severity of dystonia was assessed via the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). Changes in the body mass index (BMI) and BFMDRS score were analyzed using paired Student's -tests. Regression analysis was performed to identify factors that affected the BMI after surgery. Postoperative WG was observed in 78.7% of patients. The percentage of overweight and obese patients increased from 25.5% (before STN-DBS) to 48.9% (at the last follow-up). The mean BMI and mean percentage change in BMI increased by 1.32 ± 1.83 kg/m ( < 0.001) and 6.28 ± 8.34%, respectively. BMI increased more in female than in male patients. At the last follow-up, BFMDRS movement and disability scores improved by 69.76 ± 33.23% and 65.66 ± 31.41%, respectively (both < 0.001). The final regression model analysis revealed that sex and preoperative BMI alone were independently associated with BMI change ( < 0.05). STN-DBS is associated with postoperative WG with patients with isolated dystonia. WG is more prominent in female patients and is associated with preoperative weight but not with the efficacy of STN-DBS on motor symptoms.
丘脑底核深部脑刺激术（STN-DBS）是治疗晚期帕金森病（PD）和孤立性肌张力障碍的有效方法，能显著改善主要运动症状。此外，有报道称STN-DBS术后帕金森病患者存在非运动效应，包括体重增加（WG）。然而，孤立性肌张力障碍患者是否也会出现体重增加仍不清楚。回顾性收集了2012年10月至2019年6月期间接受双侧STN-DBS手术的47例孤立性肌张力障碍患者的数据。通过伯克-法恩-马斯登肌张力障碍评定量表（BFMDRS）评估肌张力障碍的严重程度。采用配对t检验分析体重指数（BMI）和BFMDRS评分的变化。进行回归分析以确定影响术后BMI的因素。78.7%的患者术后出现体重增加。超重和肥胖患者的比例从25.5%（STN-DBS术前）增至48.9%（末次随访时）。BMI均值和BMI平均变化百分比分别增加了1.32±1.83kg/m²（P<0.001）和6.28±8.34%。女性患者的BMI增加幅度大于男性患者。在末次随访时，BFMDRS运动和残疾评分分别改善了69.76±33.23%和65.66±31.41%（均P<0.001）。最终回归模型分析显示，仅性别和术前BMI与BMI变化独立相关（P<0.05）。STN-DBS与孤立性肌张力障碍患者术后体重增加有关。体重增加在女性患者中更显著，且与术前体重有关，但与STN-DBS对运动症状的疗效无关。
