A systematic review of body mass gain after deep brain stimulation of the subthalamic nucleus in patients with Parkinson's disease

Abstract

This systematic review investigated the effects of deep brain stimulation of the subthalamic nucleus on extent and time course of body mass changes in patients with Parkinson's disease. A computerized search identified relevant articles using a priori defined inclusion and exclusion criteria. A descriptive analysis was calculated for the main outcome parameters body mass and BMI. Thirty-eight out of 206 studies fulfilled the inclusion criteria (979 patients aged 59.0±7.5 years). Considering the longest follow-up time for each study, body mass and BMI showed a mean increase across studies of +5.71kg (p < .0001; d = 0.64) and +1.8kg/m 2 (p < .0001; d = 1.61). The time course of body mass gain revealed a continuous increase ranging from +3.25kg (d = 0.69) at 3 months, +3.88kg (d = 0.21) at 6 months, +6.35kg (d = 0.72) at12 months, and +6.11kg (d = 1.02) greater than 12 months. Changes in BMI were associated with changes in disease severity (r = 0.502, p = .010) and pharmacological treatment (r = 0.440, p = .0231). Data suggest that body mass gain is one of the most common side effects of deep brain stimulation going beyond normalization of preoperative weight loss. Considering the negative health implications of overweight, we recommend the development of tailored therapies to prevent overweight and associated metabolic disorders following this treatment.

Weight Change After Subthalamic Nucleus Deep Brain Stimulation in Patients With Isolated Dystonia

“…Interestingly, many researchers have reported that weight gain (WG) is common in patients with PD after DBS of the subthalamic nucleus (STN-DBS) (9). This is concerning because WG may lead to additional health complications such as obesity and diabetes (6).…”

“…This is concerning because WG may lead to additional health complications such as obesity and diabetes (6). Some potential mechanisms underlying WG in patients with PD after STN-DBS treatment have been suggested, including the improvement of resting tremor and dyskinesias, reduction in energy expenditure (EE), changes in eating behavior and food intake, perturbations of homeostatic control, changes in hormone and neurotransmitter systems, and improvement in motor function; however, the exact mechanism underlying WG remains unknown (9).…”

Lower Energy Intake among Advanced vs. Early Parkinson’s Disease Patients and Healthy Controls in a Clinical Lunch Setting: A Cross-Sectional Study

“…Different treatment strategies in PD have diverse impacts on body weight. For example, deep brain stimulation (DBS), an effective treatment option for motor complications, has been associated with weight gain among treated PD patients [ 17 ]. Similar results have also been observed during the initiation of dopamine replacement therapy [ 18 ].…”

Does Apomorphine Have an Effect on Body Weight? An Observational Study

“…In a systematic review (n = 979), it was noted that body weight increased across the studies to a mean value of 5.71 kg and was higher with longer duration of follow-ups. 12 The literature is sparse in relation to pharmacological interventions including LCIG and apomorphine pumps. Fabbri et al (2019), in their analysis, noted 30/44 patients of PD who were on LCIG, noted an average weight loss of 9.9% ± 10.5% (7.6 ± 7.1 kg) over a period of 51.6 ± 28.5 months of therapy.…”