Abstract
Background: Subthalamic nucleus deep brain stimulation (STN-DBS) is a valuable alternative to pharmacotherapy alone in an advanced Parkinson's disease (PD). Given the growing number of patients with STN-DBS, its impact on the comorbidities should be considered.Aim: The aim of this study was to evaluate the influence of bilateral STN-DBS on the lipid profile in patients with PD.Methods: Three groups of parkinsonian patients were included: 20 treated pharmacologically–PHT group, 20 newly qualified for STN-DBS–DBS group, and 14 postoperative patients (median 30 months after surgery)–POP group. Plasma concentrations of the total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and body weight were measured thrice in 9 ± 2 month intervals.Results: A significant increase in the LDL-C concentration is observed early after surgery in the DBS group (11.4 mg/dl, P < 0.01) followed by adverse changes in the HDL-C (−7.7 mg/dl, P = 0.01) and TG (14.1 mg/dl, P = 0.05) plasma levels. In the POP group, the average level of TC at the first visit was significantly higher (P < 0.01) than in the other groups and the TG level was higher than in the PHT group during the follow-up (P < 0.01). A strong positive correlation with body weight alteration after surgery was observed only for long-term changes in the TG levels.Conclusions: Our data indicate that STN-DBS may negatively affect the cardiometabolic profile of patients. Similarly to body weight gain, an increase in the LDL-C concentration occurred early after surgery while adverse changes in the HDL-C and TG plasma levels were more gradual.
Highlights
Deep brain stimulation (DBS) represents a well-known treatment of Parkinson’s disease, being a favorable option for patients whose symptoms cannot be adequately controlled with medications [1]
Data was collected from 54 patients (29 males, 25 females) aged from 31 to 79 years old with a clinical diagnosis of idiopathic Parkinson’s disease
The distribution of body mass was similar in all groups of patients during each visit (V1, V2, V3), the rates of weight change between visits were significantly different between PHT and DBS patients in the first assessed period (−1.0 ± 6.4% vs 5.8 ± 9.7%, P = 0.01 for V1–V2 interval)
Summary
Deep brain stimulation (DBS) represents a well-known treatment of Parkinson’s disease, being a favorable option for patients whose symptoms cannot be adequately controlled with medications [1]. The positive impact of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on motor symptoms and reduction of the dose-related side effects of levodopa is unquestionable [2, 3], its influence on non-motor symptoms and comorbidity requires further investigation. A frequently observed side effect of DBS is weight gain after the implantation of electrodes [4, 5]. It is a reversal of the tendency observed among patients not treated surgically as numerous studies reported the unintentional continuous weight loss in the natural course of the disease, as summarized by van der Marck et al [6]. Given the growing number of patients with STN-DBS, its impact on the comorbidities should be considered
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