WEIGHT GAIN AFTER FUNCTIONAL SURGERY FOR PARKINSON'S DISEASE

Abstract
Background: The origin of weight gain after functional surgery for Parkinson's disease (PD) is incompletely known. We have done a prospective study to determine the possible causes of weight gain after pallidal and subthalamic surgery. Methods: Twenty-seven patients were studied with a follow-up of 12 months. The relationship between weight gain and changes in motor situation, levodopa dosage, dyskinesias, dysphagia and mood state were analized. The patients filled a questionaire about the severity and etiology of weight gain. Results: Weight gain was noted in 26 patients (mean of 4.7 kg). It was found a significant correlation between weight gain and improvement of dyskinesias (AIMS) (r = 0.461, p = 0.023), the scores of the UPDRS part III, (r = 0.479; p = 0.028), and a significant inverse correlation with the pre-operative weight of the patient (r = -0.399, p = 0.050). Weight gain was most pronounced with bilateral than unilateral pallidal surgery (p = 0.021). The majority of patients referred weight gain as an slight adverse event and secondary to the improvement of dyskinesias. Conclusion: Functional surgery for PD, independently of the surgical target, provokes weight gain which is benign in the majority of cases. Reduction of energy expenditure with respect to the pre-operative situation would be the responsible of that phenomenon.

Key words
Parkinson's disease, weight, pallidotomy, deep brain stimulation, subthalamus

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