Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease
OBJECTIVE: To assess the occurrence of weight gain in patients with Parkinson's disease, with an average 16 months of follow-up after subthalamic nucleus deep brain stimulation.
METHODS: We used dual x ray absorptiometry to evaluate changes in body weight and body composition in 22 patients with Parkinson's disease (15 men and seven women) before surgery, 3 months after surgery and on average 16 months after surgery. RESULTS: No patient was underweight before surgery and 50% were overweight. By contrast, 68% were overweight or obese 3 months after surgery and 82% after 16 months (p<0.001). For men, the mean increase in body mass index (BMI) was 1.14 (0.23) kg/m(2) 3 months after surgery and 2.02 (0.36) kg/m(2) 16 months after surgery. For women, the mean increases in BMI at the same evaluation times were 1.04 (0.30) kg/m(2) and 2.11 (0.49) kg/m(2). This weight gain was mainly secondary to an increase in fat mass in both men and women. Three months after surgery, acute subthalamic deep brain stimulation induced an improvement in parkinsonian symptoms (evaluated by the Unified Parkinson Disease Rating Scale (UPDRS) part III) by 60.7 (2.9)% in the "off" dopa condition and a dramatic improvement of motor complications (dyskinesia duration: 82.8 (12.8)%, p<0.0001; off period duration: 92.7 (18.8)%, p<0.0001).
CONCLUSION: Although subthalamic nucleus deep brain stimulation significantly improved parkinsonian symptoms and motor complications, many patients became overweight or obese. This finding highlights the necessity to understand the underlying mechanisms and to provide a diet management with a physical training schedule appropriate for patients with Parkinson's disease.
source:
Predictors of cognitive and psychosocial outcome after STN DBS in Parkinson Disease.
OBJECTIVE: To find predictors of cognitive decline and quality of life one year after bilateral subthalamic nucleus stimulation (STN DBS) in Parkinson's disease (PD).
METHODS: A total of 105 patients were evaluated with a comprehensive neuropsychological assessment before and 12 months after surgery. A control group of 40 PD patients was included to control for effects of repeated testing and disease progression. We determined individual changes in cognition, mood and quality of life using a statistical method that controls for multiple comparisons. We performed logistic regression analyses to assess predictors of cognitive changes and quality of life.
RESULTS: Twelve months after surgery, the improvement in motor function was 41% (UPDRS3 score in off). The STN group showed a large improvement in quality of life compared to the control group (Cohen's d=0.9). At the individual level, 32 percent (95% CI: 22 - 40) of the STN group showed a substantial improvement in quality of life. Thirty six percent (95% CI: 27 - 46) of the STN patients showed a profile of cognitive decline compared to the control group. Mood improved in 16 STN patients and declined in 16 subjects. Impaired attention, advanced age and a low levodopa response at baseline predicted cognitive decline, whereas a high levodopa response at baseline predicted improvement in quality of life. Postoperative decrease in dopaminergic medication was not related to cognitive decline.
CONCLUSIONS: STN DBS improves quality of life. However, a profile of cognitive decline can be found in a significant number of patients. Levodopa response, age and attention at baseline are predictors of cognitive and psychosocial outcome.
source:
Both published articles tackle on the use of Deep Brain Stimulation (DBS) in the treatment of Parkinson's disease. Both discussed the possibility of an improved quality of life and alleviation of some symptoms of Parkinson's disease. However, the first article went a step further in noting the occurrence of obesity in some patients so a diet and exercise regimen is also recommended vis-a-vis STN DBS.
ReplyDeleteMy father was diagnosed with Parkinson's disease.his symptoms were shuffling of feet,slurred speech,degradation of hand writing, horrible driving skills, right arm held at 46 degree angle, things were tough for me, but now he finally free from the disease with the help of total cure from ULTIMATE LIFE CLINIC, he now walks properly and all symptoms has reversed, he was having trouble with balance especially at night, getting into the shower and exiting it is difficult,getting into bed is also another thing he finds impossible.we had to find a better solution for his condition which really helped him a lot,the biggest helped we had was ultimate life clinic they walked us through the proper steps,i recommended this www.ultimatelifeclinic.com to anyone who also needs help.
ReplyDelete