Objective: To determine if weight changes occur after Deep Brain Stimulation (DBS) Surgery for Parkinson’s disease (PD).

Background: PD patients lose weight with disease progression due to hyperkinetic movements and reduced energy intake, however, weight gain after DBS surgery for PD has been reported, particularly when the subthalamic nucleus (STN) is targeted. RAD–PD is a longitudinal cohort of PD participants who have undergone DBS surgery. The cause of weight gain after DBS surgery is due to 1.) post-operative changes in energy intake and reduction in energy expenditure [1-3], 2.) increased impulsivity after STN-DBS surgery, 3.) changes in brain connectivity and 4.) reduction in hyperkinetic movements [4-7]. The goal of this cross-sectional study is to determine if DBS targeting affects weight change.

Method: Linear regression models were performed assessing the relationships between weight gain and STN versus GPi targets. Analyses were adjusted for age, sex, and pre-operative BMI. Baseline, and 6- and 12-month post-operative data were used. Post-operative weight of patients undergoing STN and GPi was assessed at both 6 and 12 months. Linear regression was performed to assess the relationship between QUIP-RS and BDI Apathy scores and post-operative weight gain.

Results: A total of 104 participants (26.9% female and 73.1% male, mean age 63.9 years) were included in the analyses. 67 participants underwent STN DBS surgery and 37 underwent GPi DBS surgery. There was no statistically significant difference in weight gain at both 6 and 12 months when comparing STN vs GPi groups (p = 0.38). When pre-operative BMI was added to the model, individuals with BMI > 25 kg/m2 undergoing GPi DBS surgery experienced weight loss at 12 months post-operatively (p = 0.01). Individuals undergoing STN DBS surgery experienced modest, but non-significant weight gain. Post-operative weight change was not affected by QUIP-RS score or BDI scores.

Conclusion: The association of pre-operative BMI on post-operative weight change is affected by DBS surgical target, specifically the GPi. This change is significant only when comparing weight at baseline to one year after surgery, but not at 6 months, suggesting gradual post-operative weight changes occur. Weight change was not significantly associated with changes in measures of apathy and impulsivity.

References: 1. Rusch C, Beke M, Tucciarone L, et al. Mediterranean Diet Adherence in People With Parkinson’s Disease Reduces Constipation Symptoms and Changes Fecal Microbiota After a 5-Week Single-Arm Pilot Study. Front Neurol. 2021;12:794640. Published 2021 Dec 23. doi:10.3389/fneur.2021.794640
2. Baert, F., Matthys, C., Maselyne, J. et al. Parkinson’s disease patients’ short chain fatty acids production capacity after in vitro fecal fiber fermentation. npj Parkinsons Dis. 7, 72 (2021). https://doi.org/10.1038/s41531-021-00215-5
3. Black AE (1996) Under-reporting of energy intake at all levels of energy expenditure: evidence from doubly labelled water studies. Proc Nutr Soc 56, 121A.
4. Eguchi K, Shirai S, Matsushima M, et al. Correlation of active contact location with weight gain after subthalamic nucleus deep brain stimulation: a case series. BMC Neurol. 2021;21(1):351. Published 2021 Sep 13. doi:10.1186/s12883-021-02383-6
5. Chastan N, Achamrah N, Derrey S, et al. Role of gastric motility in weight gain after subthalamic nucleus stimulation in Parkinson’s disease. Brain Stimul. 2021;14(4):801-803. doi:10.1016/j.brs.2021.04.027
6. Ahmad OF, Huang L, Vanegas-Arroyave N, Zaghloul K, Horovitz SG, Lungu C. DTI tractographic correlates of weight gain in Parkinson’s disease patients after STN DBS [abstract]. Mov Disord. 2016; 31 (suppl 2).
7. Romito LM, Contarino MF, Vanacore N, Bentivoglio AR, Scerrati M, Albanese A. Replacement of dopaminergic medication with subthalamic nucleus stimulation in Parkinson’s disease: long-term observation. Mov Disord. 2009;24(4):557-563. doi:10.1002/mds.22390

« Back to 2024 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/weight-changes-after-deep-brain-stimulation-for-parkinsons-disease-in-the-registry-for-the-advancement-of-dbs-in-parkinsons-disease-rad-pd/