Fatima Jinnah Medical University, Lahore, Punjab, 54000, Pakistan.
Neurosurg Rev. 2024 Oct 21;47(1):808. doi: 10.1007/s10143-024-03041-4.
Deep brain stimulation (DBS) has revolutionized the treatment of movement disorders, including Parkinson's disease (PD), essential tremors, dystonia, and treatment-refractory obsessive-compulsive disorder (OCD). This systematic review and meta-analysis aimed to assess the impact of DBS on Body Mass Index (BMI). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, data from 49 studies were reviewed, with 46 studies specifically focusing on BMI and DBS. These studies involved 1,478 participants, predominantly PD patients, with an average age of 58.82 years. The primary DBS implantation site was the subthalamic nucleus (STN). Over six months, the mean BMI increased from 25.69 to 27.41, despite a reduction in daily energy intake from 1992 to 1873 kJ. While the findings suggest a correlation between DBS and weight gain, the study has limitations. The sample largely comprised PD patients (91%), preventing analysis of other subtypes. Additionally, most studies focused on the STN, limiting comparisons with other targets like the globus pallidus internus (GPi). Inconsistencies in assessing daily energy intake and food consumption further complicate the results. Integrating artificial intelligence (AI) in future research could address these gaps. For example, machine learning algorithms, such as those used by Oliveira et al., can predict post-DBS weight changes based on pre-surgical BMI and demographic factors. Similarly, AI-driven models like CLOVER-DBS can optimize DBS settings for improved motor control in PD patients. In conclusion, DBS affects BMI, and AI has the potential to enhance the precision of future studies.
深部脑刺激(DBS)已经彻底改变了运动障碍的治疗方法,包括帕金森病(PD)、原发性震颤、肌张力障碍和难治性强迫症(OCD)。本系统评价和荟萃分析旨在评估 DBS 对体重指数(BMI)的影响。根据 2020 年系统评价和荟萃分析的首选报告项目(PRISMA)指南,共回顾了 49 项研究的数据,其中 46 项研究专门关注 BMI 和 DBS。这些研究涉及 1478 名参与者,主要是 PD 患者,平均年龄为 58.82 岁。主要的 DBS 植入部位是丘脑底核(STN)。尽管每日能量摄入量从 1992 减少到 1873kJ,但在六个月内,BMI 平均值从 25.69 增加到 27.41。尽管研究结果表明 DBS 与体重增加之间存在相关性,但该研究存在局限性。样本主要由 PD 患者组成(91%),这使得无法分析其他亚型。此外,大多数研究都集中在 STN 上,限制了与其他靶点(如内苍白球)的比较。评估每日能量摄入和食物消耗的不一致进一步使结果复杂化。未来的研究中整合人工智能(AI)可以解决这些差距。例如,机器学习算法,如 Oliveira 等人使用的算法,可以根据术前 BMI 和人口统计学因素预测 DBS 后的体重变化。类似地,像 CLOVER-DBS 这样的 AI 驱动模型可以优化 DBS 设置,以改善 PD 患者的运动控制。总之,DBS 会影响 BMI,AI 有可能提高未来研究的精确性。