Subthalamic Nucleus Deep Brain Stimulation in Early Stage Parkinson's Disease Is Not Associated with Increased Body Mass Index
Sarah H Millan, Mallory L Hacker, Maxim Turchan, Anna L Molinari, Amanda D Currie, David Charles, Sarah H Millan, Mallory L Hacker, Maxim Turchan, Anna L Molinari, Amanda D Currie, David Charles
Abstract
Previous studies suggest that deep brain stimulation of the subthalamic nucleus (STN-DBS) for Parkinson's disease (PD) leads to weight gain. This study analyzes changes in body mass index (BMI) in 29 subjects from a prospective, single-blind trial of DBS in early stage PD (age 50-75, Hoehn & Yahr stage II off medication, treated with antiparkinsonian medications for ≥6 months but <4 years, and without a history of motor fluctuations, dyskinesias, or dementia). Subjects were randomized to DBS plus optimal drug therapy (DBS+ODT; n = 15) or ODT (n = 14) and followed for 24 months. Weight and height were recorded at baseline and each follow-up visit and used to calculate BMI. BMIs were compared within and between groups using nonparametric t-tests. Mean BMI at baseline was 29.7 in the ODT group and 32.3 in the DBS+ODT group (p > 0.05). BMI change over two years was not different between the groups (p = 0.62, ODT = -0.89; DBS+ODT = -0.17). This study suggests that STN-DBS is not associated with weight gain in subjects with early stage PD. This finding will be tested in an upcoming FDA-approved phase III multicenter, randomized, double-blind, placebo-controlled, pivotal clinical trial evaluating DBS in early stage PD (ClinicalTrials.gov identifier NCT00282152).
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References
- Barichella M., Marczewska A. M., Mariani C., Landi A., Vairo A., Pezzoli G. Body weight gain rate in patients with Parkinson's disease and deep brain stimulation. Movement Disorders. 2003;18(11):1337–1340. doi: 10.1002/mds.10543.
- Moro E., Scerrati M., Romito L. M. A., Roselli R., Tonali P., Albanese A. Chronic subthalamic nucleus stimulation reduces medication requirements in Parkinson's disease. Neurology. 1999;53(1):85–90. doi: 10.1212/WNL.53.1.85.
- Sauleau P., Leray E., Rouaud T., et al. Comparison of weight gain and energy intake after subthalamic versus pallidal stimulation in Parkinson's disease. Movement Disorders. 2009;24(14):2149–2155. doi: 10.1002/mds.22765.
- Rieu I., Derost P., Ulla M., et al. Body weight gain and deep brain stimulation. Journal of the Neurological Sciences. 2011;310(1-2):267–270. doi: 10.1016/j.jns.2011.06.055.
- Bachmann C. G., Trenkwalde C. Body weight in patients with Parkinson's disease. Movement Disorders. 2006;21(11):1824–1830. doi: 10.1002/mds.21068.
- Weaver F. M., Follett K. Bilateral deep brain stimulation vs best medical therapy for patients with advanced parkinson disease: a randomized controlled trial. Journal of the American Medical Association. 2009;301(1):63–73. doi: 10.1001/jama.2008.929.
- Kashihara K. Weight loss in Parkinson's disease. Journal of Neurology. 2006;253(7):VII/38–VII/41. doi: 10.1007/s00415-006-7009-0.
- Charles D., Konrad P. E., Neimat J. S., et al. Subthalamic nucleus deep brain stimulation in early stage Parkinson's disease. Parkinsonism and Related Disorders. 2014;20(7):731–737. doi: 10.1016/j.parkreldis.2014.03.019.
- Charles D., Tolleson C., Davis T. L., et al. Pilot study assessing the feasibility of applying bilateral subthalamic nucleus deep brain stimulation in very early stage Parkinson's disease: study design and rationale. Journal of Parkinson's Disease. 2012;2(3):215–223. doi: 10.3233/JPD-2012-012095.
- Charles P. D., Dolhun R. M., Gill C. E., et al. Deep brain stimulation in early Parkinson's disease: enrollment experience from a pilot trial. Parkinsonism and Related Disorders. 2012;18(3):268–273. doi: 10.1016/j.parkreldis.2011.11.001.
- Finder S. G., Bliton M. J., Gill C. E., Davis T. L., Konrad P. E., Charles P. D. Potential subjects' responses to an ethics questionnaire in a Phase I study of deep brain stimulation in early Parkinson's disease. Journal of Clinical Ethics. 2012;23(3):207–216.
- Van der Marck M. A., Dicke H. C., Uc E. Y., et al. Body mass index in Parkinson's disease: a meta-analysis. Parkinsonism and Related Disorders. 2012;18(3):263–267. doi: 10.1016/j.parkreldis.2011.10.016.
Source: PubMed