Objective: To analyze longitudinal changes in nutritional status in Parkinson’s disease (PD) patients treated with deep brain stimulation (DBS), compared with pharmacological therapy (L-dopa) and to evaluate the influence of nutritional and metabolic markers on motor and non-motor outcomes.

Background: Nutritional and metabolic alterations are increasingly recognized as contributors to clinical heterogeneity in PD. However, their relationship with different therapeutic strategies, including  DBS remains insufficiently characterized.

Method: A prospective longitudinal study included 63 PD patients [L-dopa (n=33), DBS (n=30)] followed for 12 months. Clinical outcomes included Hoehn & Yahr (H&Y), UPDRS I–IV, Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), and PDQ-39 quality of life. Nutritional status was assessed using anthropometric measures and Mini Nutritional Assessment (MNA), while metabolic markers included albumin, vitamin B6, vitamin B12, and homocysteine. Group comparisons were performed using non-parametric tests and longitudinal associations using linear mixed-effects models.

Results: At baseline, DBS patients showed longer disease duration (p<.001) and greater motor severity, with differences in H&Y (p=.011), UPDRS II (p=.028), and UPDRS IV (p=.010). Nutritional parameters were similar between groups, but DBS patients had lower vitamin B12 (p=.044) and higher homocysteine levels (p=.017).

At 12 months, motor and non-motor outcomes remained stable, with persistent differences only in H&Y (p=.010). Metabolic differences also persisted (vitamin B12 p=.024; homocysteine p=.013).

Mixed-effects models showed that DBS was associated with lower UPDRS II scores (β≈−6.68, p<.001), while years of treatment also predicted UPDRS II (β≈−0.54, p=.002). UPDRS III showed significant improvement at 12 months, and nutritional markers including MNA, body weight, albumin, vitamin B12, and homocysteine were associated with motor and peripheral outcomes.

Conclusion: Nutritional and metabolic factors appear to influence clinical expression in PD independently of treatment modality, supporting the relevance of systematic nutritional assessment in PD management.

PARKINSON DISEASE AND NUTRITION

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MDS Abstracts - https://www.mdsabstracts.org/abstract/nutritional-status-as-a-modifiable-determinant-of-clinical-outcomes-in-parkinsons-disease-a-12-month-longitudinal-study-in-patients-treated-with-dbs-and-l-dopa/