Body weight and food intake in Parkinson's disease. A review of the association to non-motor symptoms

Weight gain after STN-DBS: The role of reward sensitivity and impulsivity

“…Consistently with the literature (Kistner et al, 2014;Aiello et al, 2015), the majority of the patients in this study gained weight postoperatively. Moreover, patients at surgery were normal weight, overweight and obese, confirming the observation that Parkinson's disease is not necessarily associated with malnutrition or underweight (Kistner et al, 2014;Aiello et al, 2015).…”

“…Moreover, patients at surgery were normal weight, overweight and obese, confirming the observation that Parkinson's disease is not necessarily associated with malnutrition or underweight (Kistner et al, 2014;Aiello et al, 2015).…”

“…Interestingly, weight gain, food craving and binge eating have been reported in patients with Parkinson's disease after subthalamic nucleus-deep brain stimulation (STN-DBS), a therapeutic option in the treatment of the disease widely used nowadays (Witjas et al, 2005;Ardouin et al, 2006;Lim et al, 2009;Zahodne et al, 2011;Kistner et al, 2014;Aiello et al, 2015). Several hypotheses have been put forward to explain this outcome, including changes in energy metabolism (due to motor improvement) or in medication, dysphagia and hypoosmia.…”

Enteral feeding in neurological disorders

“…Dysphagia, together with increased physical, cognitive and psychological impairment as the disease progresses, contributes greatly to a reduced oral nutritional intake. This, combined with gastrointestinal dysfunction and increased energy expenditure (eg, due to involuntary movements and rigidity), can lead to malnutrition and weight loss,75 with the latter being associated with poor clinical outcomes, increased morbidity and mortality 76. Moreover, dysphagia can affect the pharmacological management of Parkinson's disease as it causes problems in the oral administration of medication, which in turn may exacerbate the disease 3…”

Dopamine and eating behavior disorders in Parkinson's disease: A complex recipe

“…Moreover, the variable association of other nonmotor symptoms, such as anosmia, constipation, dysphagia, sialorrhea, cognitive deficits, as well as altered energy expenditure, may also influence eating habits and feeding behavior in PD. 6 The contribution of dopamine replacement therapy to feeding behavior is also far from being a straightforward issue. If drugs elevating extracellular dopamine levels, such a psychostimulants, can exert anorexigenic effects, reduced food intake can also be observed, both with dopamine agonists and antagonists, depending on the doses used or the sites of intracerebral injections, consistent with the involvement of dopamine in many aspects of feeding behavior.Accordingly, investigating the pathophysiological basis of binge-like eating in preclinical models of PD is not a simple task, given that it requires disentangling the contribution of the lesion and subsequent dopamine replacement therapy to the multiple dopamine-dependent aspects of feeding behavior mentioned above.In this issue of Movement Disorders, Mineo and colleagues endeavored to investigate how dopaminergic loss and dopamine replacement therapy could impact the development of binge-like eating behavior and its associated synaptic plasticity in the nucleus accumbens in a rat model of PD with unilateral 6-OHDA-induced lesion of mesencephalic dopaminergic neurons and subsequent chronic treatment with levodopa.…”