Objective: To investigate if preoperative body mass index (BMI) can predict functional and quality of life (QOL) outcomes following deep brain stimulation surgery (DBS) in Parkinson’s disease (PD).

Background: The relation between BMI and PD is complex. Low BMI has been linked to increased disease severity, while high BMI is thought to be a risk factor for neurodegenerative disorders, including PD. In addition, obese patients are generally considered high surgical risk. Increased BMI has also been observed after DBS surgery. We aim to study the effect of preoperative BMI on outcome following DBS in PD patients.

Methods: We chose a cohort of PD patients who underwent DBS at our Center from 2007 to 2011 who had complete charting including pre- and post-op assessments using the MDS-UPDRS Part II and European QOL Questionnaire (EQ-5D). We correlated their pre-op BMI to the improvement in their scores from baseline to 6-months and 1-year post-DBS. We created multiple regression models where post-op scores at 6 months and 1-year were the response variable and BMI was the predictor, adjusted for pre-op scores.

Results: We identified 43 patients [72.1% male, mean age 60+/-9.2 years, mean PD duration 11+/-4.5 years, mean BMI 28.2 +/-4.7] with complete charting. Based on BMI, 0 patients were underweight, 12 had normal weight, 16 were overweight, and 15 were obese. There was no significant correlation between BMI and EQ-5D index at 6 months (P=0.9630) or 1-year (P=0.7983). There was no significant association between BMI and pre-op UPDRS II (P=0.72). After excluding 2 outliers in the 6-month analysis and after adjusting for the effect of pre-op UPDRSII, a 1-unit increase in BMI resulted in a significant 0.49 point increase (worsening) in the 6-month post-op UPDRSII (P=0.0332), and a 0.68 point increase in the 1-year post-op score (P=0.0507). A separate analysis of 130 patients implanted in the same period (including our cohort) revealed that 35% of the patients had an increment in their BMI of 1 Kg/M2 1 year after surgery and 41% had the same increment at the latest available follow up (average 4 years).

Conclusions: Higher pre-operative BMI predicted worse functional outcome 6-months after DBS with a similar but weaker effect at 1-year. However, our initial retrospective observations will need to be replicated in a carefully executed prospective study, taking into consideration significant confounders associated with higher BMI.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/does-body-mass-index-influence-outcome-of-deep-brain-stimulation-in-parkinsons-patients/