Free‐living energy expenditure reduced after deep brain stimulation surgery for Parkinson’s disease

Abstract

The STN-DBS operated patients have a significant postoperative weight gain, as a result of a decrease in free-living energy expenditure concomitant with an insufficient decrease in energy intake.

Body weight and food intake in Parkinson's disease. A review of the association to non-motor symptoms

“…Recently, it has been proposed to name eating abnormalities after DBS "hypo-dopaminergic snacking" rather than Binge Eating, thus emphasizing the role of dopaminergic reduction in the occurrence of these abnormalities (Kistner et al, 2014). As a final remark, the majority of the studies do not report an increase in food intake among PD patients with DBS or an improvement in appetite or change in eating habits (Bannier et al, 2009;Macia et al, 2004;Montaurier et al, 2007;Perlemoine et al, 2005;Rieu et al, 2011;Sauleau et al, 2009) but few studies report such findings (Jorgensen, Werdelin, Lokkegaard, Westerterp, & Simonsen, 2012;Nirenberg & Waters, 2006). However, as we have already argued in this review, the evaluation of food intake, via self-reported measures, may be imprecise and inaccurate.…”

Weight Change after Globus Pallidus Internus or Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s Disease and Dystonia

“…The drop in EE following DBS was not found to be predictive of post-operative weight gain.There was no correlation between weight gain and reduction of Parkinson’s disease medications or with improvement in UPDRS IV score (measures severity of dyskinesias and motor fluctuations). While it has been proposed that an improvement in motor symptoms corrects EE[28] allows for weight gain[15], this has not necessarily been shown in the Montaurier study or other studies assessing a correlation between motoric improvement and weight change[9,10]. This led the authors to conclude that post-DBS weight gain may be due to improvement in spontaneous motor fluctuations, but that they could not rule out the possibility of an effect on central regulation of energy expenditure, possibly through stimulation of the nearby thalamus.…”

Mechanisms of Body Weight Fluctuations in Parkinson’s Disease

“…After STN-DBS, a significant decrease (7–13%) of daily EE was reported (86, 145). A decrease of EE of 13% without adaptation of intake would lead to a weight gain of 20 kg after 1 year (145).…”

“…A decrease of EE of 13% without adaptation of intake would lead to a weight gain of 20 kg after 1 year (145). This decrease of EE after successful STN-DBS may be explained by:

a reduced resting EE (87) following improvement of rigidity and tremor,

a reduction of levodopa-induced dyskinesia (146),

reduction of OFF-period dystonia (147),

a reduction of levodopa-induced behavioral hyperactivity (121),

an improvement of sleep pattern and nocturnal hyperactivity (121, 148).

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