Weight and survival after deep brain stimulation for Parkinson's disease.
Weight and survival after deep brain stimulation for Parkinson's disease.
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DOI：
10.1016/j.parkreldis.2023.105810
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发表时间：
2023-10
影响因子：
4.1
通讯作者：
Almeida, Leonardo
中科院分区：
文献类型：
--
作者：
Eisinger, Robert S.;Okun, Michael S.;Cernera, Stephanie;Cagle, Jackson;Beke, Matthew;Ramirez-Zamora, Adolfo;Kim, B. Hope;Barbosa, Daniel A. N.;Qiu, Liming;Vaswani, Pavan;Aamodt, Whitley W.;Halpern, Casey H.;Foote, Kelly D.;Gunduz, Aysegul;Almeida, Leonardo
关键词：
帕金森病（PD）的体重减轻是常见的，并与死亡率增加有关。颅底核（STN）和内苍白球（GPi）脑深部刺激（DBS）后体重变化的临床意义尚不清楚。为了解决(1)PD患者是否表现出进行性体重减轻，(2)分阶段DBS手术是否与体重变化有关，以及(3)DBS后的生存是否与DBS后的体重相关。这是一项单中心、纵向、回顾性队列研究，纳入了1625名PD患者。我们使用回归和混合模型分析检查了体重随时间的变化趋势，以及DBS后体重与生存年数之间的关系。运动症状出现前体重下降（n=756，每年下降0.70±0.03%,p<0.001）。死亡前10年体重下降加速（n=456，每年下降2.18±0.31%,p<0.001）。首次植入DBS导联后1年，DBS患者体重增加2.0±0.33% (n=455)，对侧植入DBS导联后3年体重增加2.68±1.1% （n=249）。6年随访中，双侧STN DBS组术后体重增加最多（vs双侧GPi， 3.03±0.45% vs 1.89±0.31%,p<0.01）。一项有死亡日期的DBS队列分析（n=72）显示，DBS术后体重（第一次手术后0-12个月或第二次手术后0-36个月）与生存率呈正相关（R2=0.14, p<0.001）。虽然PD与显著的体重减轻有关，但DBS患者在手术后体重增加。术后体重增加与生存率增加有关。这些结果应该在其他队列中得到重复。
Weight loss in Parkinson’s disease (PD) is common and associated with increased mortality. The clinical significance of weight changes following deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus internus (GPi) is unclear. To address (1) whether PD patients exhibit progressive weight loss, (2) whether staged DBS surgery is associated with weight changes, and (3) whether survival after DBS correlates with post-DBS weight. This is a single-center, longitudinal, retrospective cohort study of 1,625 PD patients. We examined trends in weight over time and the relationship between weight and years survival after DBS using regression and mixed model analyses. There was a decline in body weight predating motor symptom onset (n=756, 0.70±0.03% decrease per year, p<0.001). Weight decline accelerated in the decade preceding death (n=456, 2.18±0.31% decrease per year, p<0.001). DBS patients showed a weight increase of 2.0±0.33% at 1 year following the first DBS lead implant (n=455) and 2.68±1.1% at 3 years if a contralateral DBS lead was placed (n=249). The bilateral STN DBS group gained the most weight after surgery during 6 years of follow up (vs bilateral GPi, 3.03±0.45% vs 1.89±0.31%, p<0.01). An analysis of the DBS cohort with date of death available (n=72) revealed that post-DBS weight (0–12 months after the first or 0–36 months after the second surgery) was positively associated with survival (R2=0.14, p<0.001). Though PD is associated with significant weight loss, DBS patients gained weight following surgery. Higher post-operative weight was associated with increased survival. These results should be replicated in other cohorts.
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影响因子：
8.6
作者：
Guttman, M;Slaughter, PM;Naylor, CD
通讯作者：
Naylor, CD
DOI：
10.1007/bf01818955
发表时间：
1992-06-01
期刊：
Clinical autonomic research : official journal of the Clinical Autonomic Research Society
影响因子：
--
作者：
Durrieu, G;LLau, M E;Montastruc, J L
通讯作者：
Montastruc, J L
影响因子：
3.3
作者：
Arabia, G;Zappia, M;Quattrone, A
通讯作者：
Quattrone, A
影响因子：
5.1
作者：
Bachmann, C. G.;Zapf, A.;Trenkwalder, C.
通讯作者：
Trenkwalder, C.
影响因子：
3.4
作者：
Kistner A;Lhommée E;Krack P
通讯作者：
Krack P