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Effects of subthalamic nucleus deep brain stimulation and levodopa on energy production rate and substrate oxidation in Parkinson's disease

Published online by Cambridge University Press:  08 March 2007

Caroline Perlemoine ,
Frédéric Macia ,
François Tison ,
Isabelle Coman ,
Dominique Guehl ,
Pierre Burbaud ,
Emmanuel Cuny ,
Laurence Baillet ,
Henri Gin  and
Vincent Rigalleau
Caroline Perlemoine*
Affiliation:
Service de Nutrition-Diabétologie, Hôpital Haut-Lévêque, Avenue Magellan, 33600 Pessac, France
Frédéric Macia
Affiliation:
Service de Neurologie, Hôpital Haut-Lévêque, Pessac, France
François Tison
Affiliation:
Service de Neurologie, Hôpital Haut-Lévêque, Pessac, France
Isabelle Coman
Affiliation:
Service de Neurologie, Hôpital Haut-Lévêque, Pessac, France
Dominique Guehl
Affiliation:
Service de Neurologie, Hôpital Haut-Lévêque, Pessac, France
Pierre Burbaud
Affiliation:
Service de Neurologie, Hôpital Haut-Lévêque, Pessac, France
Emmanuel Cuny
Affiliation:
Service de Neurochirurgie, Hôpital du Tripode, Bordeaux, France
Laurence Baillet
Affiliation:
Service de Nutrition-Diabétologie, Hôpital Haut-Lévêque, Avenue Magellan, 33600 Pessac, France
Henri Gin
Affiliation:
Service de Nutrition-Diabétologie, Hôpital Haut-Lévêque, Avenue Magellan, 33600 Pessac, France
Vincent Rigalleau
Affiliation:
Service de Nutrition-Diabétologie, Hôpital Haut-Lévêque, Avenue Magellan, 33600 Pessac, France
*
*Corresponding author: Dr Caroline Perlemoine, fax +33 0557656484, email caroline.perlemoine@chu-bordeaux.fr
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Abstract

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Patients with Parkinson's disease (PD) often lose weight, but after subthalamic nucleus deep brain stimulation (STN-DBS), they gain weight. We compared daily energy intake (DEI), resting energy expenditure (REE) and substrate oxidation rates (measured by indirect calorimetry) in nineteen STN-DBS-treated patients (Group S), thirteen others on pharmacologic treatment by levodopa (Group L) and eight control subjects. We also determined the acute effects of STN-DBS and levodopa on REE and substrate oxidation rates. STN-DBS treated patients gained 9·7 (sem 7·1) kg after surgery, whereas patients on pharmacologic treatment lost 3·8 (sem 10·0) kg since diagnosis. In STN-DBS-treated patients, REE (−16·5 %; P<0·001), lipid oxidation (−27 %; P<0·05) and protein oxidation (−46 %; P<0·05) were decreased, whereas glucose oxidation was elevated (+81 %; P<0·05) as compared to patients on pharmacologic treatment. Levodopa acutely reduced REE (−8·3 %; P<0·05) and glucose oxidation (−37 %; P<0·01) with a slight hyperglycaemic effect (after levodopa challenge: 5·6 (sem 0·8) v. before levodopa challenge: 5·3 (sem 0·6) mmol/l; P<0·01). Switching ‘on’ STN-DBS acutely reduced REE (−17·5 %; P<0·01) and lipid oxidation (−24 %; P<0·001) 30 min after starting stimulation. Fasting glycaemia was slightly but significantly reduced (5·4 (sem 1·4) v. 5·5 (sem 1·3) mmol/l; P<0·01). After STN-DBS, the normalization of REE and the reduction in lipid and protein oxidation contribute to the restoration of weight. As levodopa decreases glucose oxidation, the reduction in daily dose of levodopa in STN-DBS-treated patients helps prevent the effect of weight gain on glycaemia.

Keywords

Parkinson's diseaseResting energy expenditureWeight changeSubstrate oxidationDiet-induced thermogenesis
Type
Research Article
Information
British Journal of Nutrition , Volume 93 , Issue 2 , February 2005 , pp. 191 - 198
Copyright
Copyright © The Nutrition Society 2005

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