Journal of Neurology

, 256:2072

Modulation of nutritional state in Parkinsonian patients with bilateral subthalamic nucleus stimulation

  • Joana Guimarães
  • Eduarda Matos
  • Maria José Rosas
  • Augusta Vieira-Coelho
  • Nuno Borges
  • Flora Correia
  • Rui Vaz
  • Carolina Garrett
Original Communication

DOI: 10.1007/s00415-009-5252-x

Cite this article as:
Guimarães, J., Matos, E., Rosas, M.J. et al. J Neurol (2009) 256: 2072. doi:10.1007/s00415-009-5252-x

Abstract

Chronic bilateral subthalamic stimulation (DBS-STN) provides considerable clinical benefits in Parkinson disease patients, with improvement in primary symptoms and resolution of side effects of chronic pharmacological treatment. Apart from its therapeutic effects on PD symptoms, DBS-STN also appears to induce weight gain, which may itself induce critical metabolic disorders and limit the benefits of surgery. No data are available in literature showing the efficacy of a nutritional intervention to prevent rapid and/or excessive weight gain after DBS-STN. Fifty-seven PD patients were included in this study and were divided into two groups: Group 1 comprised 16 patients with a nutritional intervention immediately after surgery (1 week after); Group 2 comprised 41 patients with a nutritional intervention in a later period after surgery (mean time of 2.5 ± 1.6 years). Weight, body mass index (BMI), percentage of fat mass, levodopa daily dose (LDD) and part III of the Unified Parkinson’s disease rating scale (UPDRS) were studied before and after an individualized and structured nutritional intervention. Three months after nutritional intervention, Group 1 had a mean BMI (24.1 ± 2.99), that was not significantly different (p = 0.114) from BMI before intervention, with stability of the weight and in percentage of fat mass. In Group 2 all the patients gained weight, reaching to 13.17 ± 10%; a total of 63% of patients became overweight (BMI 25 kg/m2). Three months after nutritional intervention, Group 2 had a mean BMI (24.80 ± 2.45) that was significantly (p = 0.03) different from BMI before intervention (26.75 ± 2.99), although percentage of fat mass was higher in women. With this study, we have conclude that nutritional intervention adequate to patient-age, disease characteristics, medical therapy with l-dopa and physical activity, is effective incontrolling weight after DBS-STN surgery.

Keywords

Nutritional interventionBilateral subthalamicNucleus stimulationEnergy metabolism

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Joana Guimarães
    • 1
  • Eduarda Matos
    • 2
  • Maria José Rosas
    • 3
  • Augusta Vieira-Coelho
    • 4
  • Nuno Borges
    • 4
  • Flora Correia
    • 5
  • Rui Vaz
    • 6
  • Carolina Garrett
    • 1
  1. 1.Department of Neurology, Faculty of Medicine, University of Porto, Hospital de São JoãoSão João HospitalPortoPortugal
  2. 2.Faculty of Nutrition SciencesSão João HospitalPortoPortugal
  3. 3.Department of NeurologySão João HospitalPortoPortugal
  4. 4.Institute of Pharmacology and Therapeutics, Faculty of MedicineSão João HospitalPortoPortugal
  5. 5.Faculty of Nutrition Sciences, University of PortoSão João HospitalPortoPortugal
  6. 6.Neurosurgery Department, Faculty of Medicine, University of Porto, Hospital de São JoãoSão João HospitalPortoPortugal