Weight and survival after deep brain stimulation for Parkinson's disease.

Humans Parkinson Disease / therapy Retrospective Studies Deep Brain Stimulation / methods Globus Pallidus / physiology Weight Loss Treatment Outcome
Deep brain stimulation Globus pallidus internus Parkinson's disease Subthalamic nucleus Survival Weight

Journal

Parkinsonism & related disorders
ISSN: 1873-5126
Titre abrégé: Parkinsonism Relat Disord
Pays: England
ID NLM: 9513583

Informations de publication

Date de publication:
10 2023
Historique:
received: 31 05 2023
revised: 05 08 2023
accepted: 13 08 2023
medline: 9 10 2023
pubmed: 4 9 2023
entrez: 3 9 2023
Statut: ppublish

Résumé

Weight loss in Parkinson's disease (PD) is common and associated with increased mortality. The clinical significance of weight changes following deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus internus (GPi) is unclear. To address (1) whether PD patients exhibit progressive weight loss, (2) whether staged DBS surgery is associated with weight changes, and (3) whether survival after DBS correlates with post-DBS weight. This is a single-center, longitudinal, retrospective cohort study of 1625 PD patients. We examined trends in weight over time and the relationship between weight and years survival after DBS using regression and mixed model analyses. There was a decline in body weight predating motor symptom onset (n = 756, 0.70 ± 0.03% decrease per year, p < 0.001). Weight decline accelerated in the decade preceding death (n = 456, 2.18 ± 0.31% decrease per year, p < 0.001). DBS patients showed a weight increase of 2.0 ± 0.33% at 1 year following the first DBS lead implant (n = 455) and 2.68 ± 1.1% at 3 years if a contralateral DBS lead was placed (n = 249). The bilateral STN DBS group gained the most weight after surgery during 6 years of follow up (vs bilateral GPi, 3.03 ± 0.45% vs 1.89 ± 0.31%, p < 0.01). An analysis of the DBS cohort with date of death available (n = 72) revealed that post-DBS weight (0-12 months after the first or 0-36 months after the second surgery) was positively associated with survival (R Though PD is associated with significant weight loss, DBS patients gained weight following surgery. Higher post-operative weight was associated with increased survival. These results should be replicated in other cohorts.

Sections du résumé

BACKGROUND
Weight loss in Parkinson's disease (PD) is common and associated with increased mortality. The clinical significance of weight changes following deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus internus (GPi) is unclear.
OBJECTIVES
To address (1) whether PD patients exhibit progressive weight loss, (2) whether staged DBS surgery is associated with weight changes, and (3) whether survival after DBS correlates with post-DBS weight.
METHODS
This is a single-center, longitudinal, retrospective cohort study of 1625 PD patients. We examined trends in weight over time and the relationship between weight and years survival after DBS using regression and mixed model analyses.
RESULTS
There was a decline in body weight predating motor symptom onset (n = 756, 0.70 ± 0.03% decrease per year, p < 0.001). Weight decline accelerated in the decade preceding death (n = 456, 2.18 ± 0.31% decrease per year, p < 0.001). DBS patients showed a weight increase of 2.0 ± 0.33% at 1 year following the first DBS lead implant (n = 455) and 2.68 ± 1.1% at 3 years if a contralateral DBS lead was placed (n = 249). The bilateral STN DBS group gained the most weight after surgery during 6 years of follow up (vs bilateral GPi, 3.03 ± 0.45% vs 1.89 ± 0.31%, p < 0.01). An analysis of the DBS cohort with date of death available (n = 72) revealed that post-DBS weight (0-12 months after the first or 0-36 months after the second surgery) was positively associated with survival (R
DISCUSSION
Though PD is associated with significant weight loss, DBS patients gained weight following surgery. Higher post-operative weight was associated with increased survival. These results should be replicated in other cohorts.

Identifiants

DOI: 10.1016/j.parkreldis.2023.105810 PMID: 37660542 PMC: PMC10664863
pubmed: 37660542
pii: S1353-8020(23)00889-1
doi: 10.1016/j.parkreldis.2023.105810
pmc: PMC10664863
mid: NIHMS1945300
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

105810

Subventions

Organisme : NINDS NIH HHS
ID : F30 NS111841
Pays : United States
Organisme : NINDS NIH HHS
ID : T32 NS082168
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000064
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001427
Pays : United States

Informations de copyright

Copyright © 2023. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest No conflict of interest

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Auteurs

Robert S Eisinger (RS)

Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, USA; Department of Neurology, Hospital of the University of Pennsylvania, USA. Electronic address: eisi@upenn.edu.

Michael S Okun (MS)

Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, USA; Department of Neurosurgery, Norman Fixel Institute for Neurological Diseases, University of Florida, USA.

Stephanie Cernera (S)

Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, USA; Department of Neurosurgery, University of California, San Francisco, USA.

Jackson Cagle (J)

Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, USA.

Matthew Beke (M)

Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, USA; Food Science and Human Nutrition Department, University of Florida, USA.

Adolfo Ramirez-Zamora (A)

Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, USA.

B Hope Kim (BH)

Department of Neurology, Hospital of the University of Pennsylvania, USA.

Daniel A N Barbosa (DAN)

Department of Neurosurgery, Hospital of the University of Pennsylvania, USA.

Liming Qiu (L)

Department of Neurosurgery, Hospital of the University of Pennsylvania, USA.

Pavan Vaswani (P)

Department of Neurology, Hospital of the University of Pennsylvania, USA.

Whitley W Aamodt (WW)

Department of Neurology, Hospital of the University of Pennsylvania, USA.

Casey H Halpern (CH)

Department of Neurosurgery, Hospital of the University of Pennsylvania, USA; Department of Surgery, Corporal Michael J. Crescenz Veterans Affairs Medical Center, PA, Philadelphia, USA.

Kelly D Foote (KD)

Department of Neurosurgery, Norman Fixel Institute for Neurological Diseases, University of Florida, USA.

Aysegul Gunduz (A)

Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, USA; Department of Biomedical Engineering, University of Florida, USA.

Leonardo Almeida (L)

Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, USA; Department of Neurology, University of Minnesota, Minneapolis, MN, USA.

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questionsmedicales.fr › Maladies du système nerveux › Maladies neurodégénératives › Maladie de Parkinson › Weight and survival after deep brain...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Weight and survival after deep brain...
questionsmedicales.fr › Procédures de chirurgie opératoire › Stimulation cérébrale profonde › Weight and survival after deep brain...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Prosencéphale › Télencéphale › Cerveau › Noyaux gris centraux › Corps strié › Globus pallidus › Weight and survival after deep brain...
questionsmedicales.fr › Phénomènes physiologiques › Croissance et développement › Croissance › Mensurations corporelles › Poids › Modifications du poids corporel › Perte de poids › Weight and survival after deep brain...
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