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PLoS One. 2016 Apr 12;11(4):e0153438. doi: 10.1371/journal.pone.0153438. eCollection 2016.

Weight Gain following Pallidal Deep Brain Stimulation: A PET Study.

Author information

1
"Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue Léon Bernard, Rennes, France.
2
Department of Neurophysiology, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.
3
Department of Neurology, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.
4
Department of Neurosurgery, Rennes University Hospital, rue Henri Le Guilloux, Rennes, France.
5
"MediCIS" laboratory (UMR 1099 LTSI), INSERM, University of Rennes 1, Avenue Léon Bernard, Rennes, France.
6
Department of Psychiatry, Rennes University Hospital, avenue du Général Leclerc, Rennes, France.
7
Department of Oncology, Eugene Marquis Center, Avenue de la Bataille Flandres-Dunkerque, Rennes, France.

Abstract

The mechanisms behind weight gain following deep brain stimulation (DBS) surgery seem to be multifactorial and suspected depending on the target, either the subthalamic nucleus (STN) or the globus pallidus internus (GPi). Decreased energy expenditure following motor improvement and behavioral and/or metabolic changes are possible explanations. Focusing on GPi target, our objective was to analyze correlations between changes in brain metabolism (measured with PET) and weight gain following GPi-DBS in patients with Parkinson's disease (PD). Body mass index was calculated and brain activity prospectively measured using 2-deoxy-2[18F]fluoro-D-glucose PET four months before and four months after the start of GPi-DBS in 19 PD patients. Dopaminergic medication was included in the analysis to control for its possible influence on brain metabolism. Body mass index increased significantly by 0.66 ± 1.3 kg/m2 (p = 0.040). There were correlations between weight gain and changes in brain metabolism in premotor areas, including the left and right superior gyri (Brodmann area, BA 6), left superior gyrus (BA 8), the dorsolateral prefrontal cortex (right middle gyrus, BAs 9 and 46), and the left and right somatosensory association cortices (BA 7). However, we found no correlation between weight gain and metabolic changes in limbic and associative areas. Additionally, there was a trend toward a correlation between reduced dyskinesia and weight gain (r = 0.428, p = 0.067). These findings suggest that, unlike STN-DBS, motor improvement is the major contributing factor for weight gain following GPi-DBS PD, confirming the motor selectivity of this target.

PMID:
27070317
PMCID:
PMC4829218
DOI:
10.1371/journal.pone.0153438
[Indexed for MEDLINE]
Free PMC Article

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