# Weight gain mechanisms after deep brain stimulation of the subthalamic nucleus in Parkinson's disease patients

Philippe Derost, S. Bannier, Christophe Montaurier, Béatrice Morio, Franck Durif

► To cite this version:

Philippe Derost, S. Bannier, Christophe Montaurier, Béatrice Morio, Franck Durif. Weight gain mechanisms after deep brain stimulation of the subthalamic nucleus in Parkinson's disease patients. 10. International Congress of Parkinson's Disease and Movement Disorders, Oct 2006, Kyoto, Japan. Movement Disorders, 21, 2006, Movement Disorders. hal-01601062

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Submitted on 3 Jun 2020

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<figure><img src="image_1.png" /></figure>
# WEIGHT GAIN MECHANISMS AFTER DEEP BRAIN STIMULATION OF THE SUBTHALAMIC NUCLEUS IN PARKINSON'S DISEASE PATIENTS

Derost P (1), Bannier S (1), Montorier C (2), Morio B (2), Durif F (1) (1) Department of Neurology, Clermont-Ferrand, France. (2) Human nutrition Laboratory, Clermont-Ferrand, France

**INTRODUCTION** : Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves parkinsonian symptoms and attenuate motor fluctuations, it allows antiparkinsonian medication reduction but one of the frequent adverse effect is an important weight gain.

**OBJECTIVES** : to study the mechanisms of this body weight gain in Parkinson's disease (PD) patients 3 months after surgery.

## PATIENTS

Number : 17.

Gender (M/F) : 14/3.

Age (year) : 59,9 ± 6,3.

Disease duration (year) : 9,3 ± 3,4.

LEDD (mg/day) : 1156 ± 374,5.

Levodopa challenge before surgery: 79,9% improvement.

Hoehn & Yahr on medication :1,86 ± 0,61.

## METHODS

<figure><img src="image_2.png" /></figure>

* weight and BMI

* Hormonal dosages

* Energy expenditure in calorimetric room

* Resting EE by indirect calorimetry (Datex)

* > off and on medication

* Body composition : DEXA.

* Dietary interview (covering 7 days).

* weight and BMI

* Hormonal dosages

* Energy expenditure in calorimetric room

* Resting EE by indirect calorimetry (Datex)

* > off and on stimulation

* Body composition : DEXA.

* Dietary interview (covering 7 days).

<figure><img src="image_3.png" /><figcaption>ENERGY EXPENDITURE DURING 24 HOURS IN A CALORIMETRIC ROOM IN DIFFERENT SITUATIONS</figcaption></figure>

## RESULTS

<figure><img src="image_4.png" /><figcaption>Significant improvement of the motor fluctuations after DBS-STN</figcaption></figure>

<figure><img src="image_5.png" /></figure>

<figure><img src="image_6.png" /><figcaption>Mean Body weight gain : 3,5 kg</figcaption></figure>

<figure><img src="image_7.png" /><figcaption>energy expenditure during different situations before surgery</figcaption></figure>

<figure><img src="image_8.png" /><figcaption>Comparison of food intakes and EE (24h) before and after surgery</figcaption></figure>

<figure><img src="image_9.png" /><figcaption>energy expenditure during 24h before surgery in different conditions (off or on medication): Importance of the motor status on the EE.</figcaption></figure>

<figure><img src="image_10.png" /><figcaption>Before surgery :</figcaption></figure>

Resting EE (DATEX) is significantly decreased during a levodopa challenge

<caption>After surgery :</caption>

Resting EE (DATEX) is decreased during an acute DBS challenge.

**Discussion** : Before surgery, EE is increased during the off condition, especially during a physical activity. After chronic DBS-STN, there is a significant reduction of the motor fluctuations and a decrease of EE whereas the food intakes are not changed.

**Conclusion** : The gain weight after chronic DBS-STN in PD patients EE after surgery is explained by a normalization of EE without changes of the food intakes.