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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*
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.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2005

References

Abbott, RA, Cox, M, Markus, H & Tomkins, A (1992) Diet, body size and micronutrient status in Parkinson's disease. Eur J Clin Nutr 46, 879884.Google ScholarPubMed
Acheson, KJ, Ravussin, E, Wahren, J, Jéquier, E (1984) Thermic effect of glucose in man: obligatory and facultative thermogenesis. J Clin Invest 74, 15721580.CrossRefGoogle ScholarPubMed
Atrens, DM, Siviy, SM, Holmes, LJ, Solowij, N & Jirasek, M (1987) Hypothalamic modulation of thermogenesis and energy substrate utilization. Brain Res Bull 18, 303308.CrossRefGoogle ScholarPubMed
Beyer, PL, Palarino, MY, Michalek, D, Busenbark, K & Koller, WC (1995) Weight change and body composition in patients with Parkinson's disease. J Am Diet Assoc 95, 979983.CrossRefGoogle ScholarPubMed
Bloesch, D, Schutz, Y, Breitenstein, E, Jéquier, E & Felber, JP (1988) Thermogenic response to an oral glucose load in man: comparison between young and elderly subjects. J Am Coll Nutr 7, 471483.CrossRefGoogle Scholar
Broussolle, E, Borson, F, Gonzalez, de, Suso, JM, Chayvialle, JA, Beylot, M & Chazot, G (1991) Increase of energy expenditure in Parkinson's disease. Rev Neurol 147, 4651.Google ScholarPubMed
Campbell, AJ, Spears, GFS, Brown, JS, Busby, WJ & Borrie, MJ (1990) Anthropometric measurements as predictors of mortality in a community population aged 70 years and over. Age Ageing 19, 131135.CrossRefGoogle Scholar
Chen, H, Zhang, SM, Hernán, MA, Willet, WC & Ascherio, A (2003) Weight loss in Parkinson's disease. Ann Neurol 53, 676679.CrossRefGoogle ScholarPubMed
Cuny, E, Guehl, D, Burbaud, P, Gross, C, Dousset, V & Rougier, A (2002) Lack of agreement between direct magnetic resonance imaging and statistical determination of a subthalamic target: the role of electrophysiological guidance. J Neurosurg 97, 591597.CrossRefGoogle ScholarPubMed
Durnin, JVGA & Womersley, J (1974) Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 32, 7797.CrossRefGoogle ScholarPubMed
Fahn, S, Elton, RL members of the UPDRS Development Committee (1987) The unified Parkinson's disease rating scale.In Recent Developments in Parkinson's Disease, vol. 2, pp.153163293304 [Fahn, SMarsden, CDCalne, DBGoldstein, M, editors]. New Jersey: Macmillan Healthcare Information.Google Scholar
Ferrannini, E (1988) The theoretical bases of indirect calorimetry: a review. Metabolism 37, 287301.CrossRefGoogle ScholarPubMed
Jéquier, E & Schutz, Y (1988) Energy expenditure in obesity and diabetes. Diabetes/Metab Rev 4, 583593.CrossRefGoogle ScholarPubMed
Jéquier, E & Tappy, L (1999) Regulation of body weight in humans. Physiol Rev 79, 451480.CrossRefGoogle ScholarPubMed
Just, H & Ostergaard, K (2002) Health-related quality of life in patients with advanced Parkinson's disease treated with deep brain stimulation of the subthalamic nuclei. Mov Disord 17, 539545.CrossRefGoogle ScholarPubMed
Langston, JW & Forno, LS (1978) The hypothalamus in Parkinson disease. Ann Neurol 3, 129133.CrossRefGoogle ScholarPubMed
Levi, S, Cox, M, Lugon, M, Hodkinson, M & Tomkins, A (1990) Increased energy expenditure in Parkinson's disease. Br Med J 301, 12561257.CrossRefGoogle ScholarPubMed
Limousin, P, Krack, P, Pollak, P, Benazzowz, A, Ardorin, C, Hoffmann, D & Benabid, AL (1998) Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease. N Engl J Med 339, 11051111.CrossRefGoogle ScholarPubMed
Lopiano, L, Rizzone, M, Bergamasco, B, Tavella, A, Torre, E, Perozzo, P, Valentini, MC & Lanotte, M (2001) Deep brain stimulation of the subthalamic nucleus: clinical effectiveness and safety. Neurology 56, 552554.CrossRefGoogle ScholarPubMed
Markus, HS, Cox, M & Tomkins, AM (1992) Raised resting energy expenditure in Parkinson's disease and its relationship to muscle rigidity. Clin Sci (Lond) 83, 199204.CrossRefGoogle ScholarPubMed
Moro, E, Scerrati, M, Romito, LM, Roselli, R, Tonali, P & Albanese, A (1999) Chronic subthalamic nucleus stimulation reduces medication requirements in Parkinson's disease. Neurology 53, 8590.CrossRefGoogle ScholarPubMed
Mueller, PS & Horwitz, D (1962) Plasma free fatty acid and blood glucose responses to analogues of norepinephrine in man. J Lipid Res 3, 251255.CrossRefGoogle Scholar
Parkinson, J (1817) An Essay on the Shaking Palsy, London: Whittingham and Bowland.Google Scholar
Rigalleau, V, Combe, C, Blanchetier, V, Aubertin, J, Aparicio, M & Gin, H (1997) Low protein diet in uremia: effects on glucose metabolism and energy production rate. Kidney Int 51, 12221227.CrossRefGoogle ScholarPubMed
Romito, LM, Scerrati, M, Contarino, MF, Bentivoglio, AR, Tonali, P & Albanese, A (2002) Long-term follow up of subthalamic nucleus stimulation in Parkinson's disease. Neurology 58, 15461550.CrossRefGoogle ScholarPubMed
Sandyk, R (1993) The relationship between diabetes mellitus and Parkinson's disease. Int J Neurosci 69, 125130.CrossRefGoogle ScholarPubMed
Toth, MJ, Fishman, PS & Poehlman, ET (1997) Free-living daily energy expenditure in patients with Parkinson's disease. Neurology 48, 8891.CrossRefGoogle ScholarPubMed
Vardi, J, Oberman, Z, Rabey, I, Streifler, M, Ayalon, D & Herzberg, M (1976) Weight loss in patients treated long-term with levodopa. J Neurol Sci 30, 3340.CrossRefGoogle ScholarPubMed
Volkmann, A, Allert, N, Voges, J, Weiss, PH, Freund, HJ & Sturm, V (2001) Safety and efficacy of pallidal or subthalamic nucleus stimulation in advanced PD. Neurology 56, 548551.CrossRefGoogle ScholarPubMed
Wermuth, L, Stenager, EN, Stenager, E & Boldsen, J (1995) Mortality in patients with Parkinson's disease. Acta Neurol Scand 92, 5558.CrossRefGoogle ScholarPubMed
Yapa, RS, Playfer, JR & Lye, M (1989) Anthropometric and nutritional assessment of elderly patients with Parkinson's disease. J Clin Exp Gerontol 11, 155164.Google Scholar