Objective: Define the role and integration of a dietitian into the multidisciplinary screening process for deep brain stimulation (DBS) in movement disorders.
Background: Most DBS centers utilize a multidisciplinary assessment to determine DBS patient candidacy. Although the role of nutrition has been reported to be critical for patients with various neurological disorders, its role in DBS evaluations remains unknown. [1,2] Dietary assessments and interventions have been shown to improve functional recovery, reduce operative complications and decrease adverse outcomes.[3]
Method: A retrospective chart review was conducted of 100 consecutive patients referred for multidisciplinary DBS evaluation. The clinical characteristics, comorbid conditions, indications for DBS, pre-operative height, pre-operative weight, preoperative body mass index (BMI) and a patient generated subjective global assessment (PG-SGA) score were all collected. Pre-operative and post-operative evaluations compared the change in BMI and weight. Also reviewed and summarized were the dietitian evaluations and recommendations.
Results: There were 100 charts reviewed (77 males), and 98 patients had a least a single visit from the dietician. The indications for multidisciplinary DBS evaluation included Parkinson’s disease (n=73), essential tremor (n=17), dystonic tremor (n=6), and rubral tremor(n=1). The most common comorbidity was hypertension (39%). Other comorbidities included diabetes (16%), constipation (14%), ulcerative colitis (2%) and Crohn’s disease (2%). In the cohort, 59% were malnourished (29% obese, 26% overweight, and 4% underweight). The mean change in weight within a month of DBS surgery in 57 patients with complete data was 0.21 lbs and the mean change in BMI was 0.13 kg/m2. The mean PG-SGA score was 2.55. Personalized recommendations based on a nutritional profile were made by the dietitian.
Conclusion: The nearly 60% rate of malnourishment in the DBS cohort suggested the need for a dietitian. The dietitian played a critical role in producing personalized pre-operative dietary recommendations.
References: 1.Hankey GJ. Nutrition and the risk of stroke. Lancet Neurol. 2012 Jan;11(1):66-81. doi: 10.1016/S1474-4422(11)70265-4. Erratum in: Lancet Neurol. 2012 Feb;11(2):125. PMID: 22172622.
2.Flanagan R, Rusch C, Lithander FE, Subramanian I. The missing piece of the puzzle – The key role of the dietitian in the management of Parkinson’s disease. Parkinsonism Relat Disord. 2024 Apr;121:106021. doi: 10.1016/j.parkreldis.2024.106021. Epub 2024 Feb 1. PMID: 38326170. https://pubmed.ncbi.nlm.nih.gov/38326170/
3.Emara AK, Hadad MJ, Dube M, Klika AK, Burguera B, Piuzzi NS. Team Approach: Nutritional Assessment and Interventions in Elective Hip and Knee Arthroplasty. JBJS Rev. 2022 Mar 1;10(3). doi: 10.2106/JBJS.RVW.21.00138. PMID: 35230998.
To cite this abstract in AMA style:
T. Mehta, P. Graese, A. Barnes, E. Truscott, C. Hess, M. Okun. Role and Integration of a Dietitian into the Deep Brain Stimulation Multidisciplinary Screening Process [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/role-and-integration-of-a-dietitian-into-the-deep-brain-stimulation-multidisciplinary-screening-process/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/role-and-integration-of-a-dietitian-into-the-deep-brain-stimulation-multidisciplinary-screening-process/