Carbohydrate metabolism and lipid profile in patients with Parkinson’s disease with subthalamic deep brain stimulation

Introduction.Corticobasal syndrome (CBS) is a specific clinical manifestation shared by multiple pathologies. The exact mechanism of this phenomenon remains unclear. Differential diagnosis of CBS in everyday clinical practice is challenging, as this syndrome can overlap with other entities, especially progressive supranuclear palsy Richardson-Steele phenotype (PSP-RS). Several papers have suggested a possible role of vascular pathology as a linking factor in the pathogenesis of CBS based on different neuropathologies. This paper analyses differences in the occurrence of the most common vascular risk factors such as hypertension and lipid profile with respect to dietary habits among patients who fulfill the diagnostic criteria for probable/possible CBS and PSP-RS.Material and methods. Seventy (70) patients in total were included in the study. Exclusion criteria comprised hydrocephalus, stroke in the past, the presence of marked vascular changes in white matter defined as the presence of vascular change ≥ 1 mm in 3T MRI, medical history of hyperlipidemia or the use of drugs that could impact upon lipid metabolism before the initiation of the neurodegenerative disease, and neoplastic focuses in the central nervous system. Patients with diabetes, or with BMI exceeding 18-25, or who were smokers, or who were affected by chronic stress were also excluded. Data was analysed statistically using the Shapiro-Wilk test, the U Mann-Whitney test for group comparison, and a Bonferroni correction to control the false discovery rate (FDR).Results. Our obtained results indicated a statistically significantly higher level of total cholesterol in the CBS group (p = 0.0039) without a correlation with dietary habits. Conclusions and clinical implications.The results obtained in our study may suggest a possible role of vascular pathology in CBS development. This issue requires further research.

Section: Discussionmentioning

confidence: 98%

Could hyperlipidemia be a risk factor for corticobasal syndrome? — a pilot study

Madetko

Alster

Bartošová

et al. 2023

“…Thus, we speculate that autonomic dysfunction and STN-DBS may have a pivotal role in decreased tears production in such patients. Moreover, a "burning sensation in the eye" may be considered, among others, an ocular adverse effect after STN-DBS in PD patients [14,15]. Reduced contrast sensitivity, which is a common symptom in PD, is not yet fully understood [6].…”

Section: Discussionmentioning

confidence: 99%

Visual disturbances in patients with Parkinson’s Disease treated with oral medications or deep brain stimulation

Rusinek

Porębska

Sawczyńska

et al. 2023

Aim of the study. Ophthalmological symptoms are common in patients with Parkinson's disease (PD) and can be evaluated by the Visual Impairment in Parkinson's Disease Questionnaire (VIPD-Q). This study aimed to assess the prevalence of ophthalmological symptoms in PD depending on the type of treatment used i.e. pharmacological or subthalamic nucleus deep brain stimulation (STN-DBS).Material and methods. We performed a cross-sectional study. The data was gathered from a VIPD-Q and from medical records. Patients with PD were divided into two groups based on the type of treatment -pharmacological (control group, CG) (39 patients) or STN-DBS (40 patients).Results. The great majority of patients -72 (91.1%) -experienced an ophthalmological symptom. The prevalence of three symptoms differed significantly between the groups. A burning sensation or a gritty feeling in the eyes occurred more often in patients in the STN-DBS group (40.0% vs. 15.4%; p = 0.015). On the other hand, the inability to read plain text on a coloured or grey background and problems with rapid changes of light intensity were more common in the CG group (38.5% vs. 15.0%, p = 0.018 and 28.2% vs. 10.0%, p = 0.039, respectively).Conclusions and clinical implications. The prevalence of ophthalmological symptoms in PD is high. Despite significant differences in the three symptoms, the overall prevalence of ophthalmological clinical features was similar in the evaluated groups.

“…Choosing between these targets is based on institutional preference and/or, more importantly, patient characteristics. Elsewhere in this issue, Samborska-Ćwik et al have reported weight gain and several negative metabolic consequences in PD patients who underwent STN DBS [9]. These may represent direct stimulation-related effects and/or indirect consequences of DBS clinical effects, e.g.…”

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confidence: 99%

“…The recent work by Samborska-Ćwik et al [9] has begun to untangle the complex cascade of glycaemic control in PD and how it is altered with DBS. While most work in this field has focused on weight changes and glucose effects, these authors have begun to uncover changes in the metabolism of other macromolecules, e.g.…”

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confidence: 99%

Does deep brain stimulation stimulate metabolism?

Tipton

Middlebrooks

2022