Change of the melanocortin system caused by bilateral subthalamic nucleus stimulation in Parkinson’s disease
- 4 January 2011
- journal article
- research article
- Published by Hindawi Limited in Acta Neurologica Scandinavica
- Vol. 124 (4), 275-281
- https://doi.org/10.1111/j.1600-0404.2010.01469.x
Abstract
Escamilla‐Sevilla F, Pérez‐Navarro MJ, Muñoz‐Pasadas M, Sáez‐Zea C, Jouma‐Katati M, Piédrola‐Maroto G, Ramírez‐Navarro A, Mínguez‐Castellanos A. Change of the melanocortin system caused by bilateral subthalamic nucleus stimulation in Parkinson’s disease.Acta Neurol Scand: 2011: 124: 275–281.© 2011 John Wiley & Sons A/S. Objectives – Determine whether bilateral subthalamic nucleus stimulation (STN–DBS) in Parkinson’s disease (PD) is associated with an increase in neuropeptide Y (NPY) and/or resistance to inhibition by leptin in relation to post‐surgery weight gain. Materials and Methods – This prospective study included 20 patients who underwent bilateral STN–DBS and 17 who refused surgery. Data were obtained at baseline, 3 and 6 months on neurological and nutritional status, including determination of body mass index (BMI) and serum NPY and leptin levels. Results – NPY and leptin levels changed over time, with a distinct pattern. The BMI increase at 6 months was greater in the surgical group (5.5 ± 6.3% vs 0.5 ± 3.5%; P = 0.035). Medical group exhibited a reduction in leptin level (−2.0 ± 4.3 ng/ml) and a consequent increase in NPY level (72.4 ± 58.7 pmol/ml). However, STN–DBS patients showed an increase in leptin (3.1 ± 5.0 ng/ml; P = 0.001 vs medical group) and also in NPY (12.1 ± 53.6 pmol/ml; P = 0.022 vs medical group) levels, which suggests resistance to inhibition by leptin. Rise in NPY level correlated with higher stimulation voltages. Conclusions – Bilateral STN–DBS causes disruption of the melanocortin system, probably related to diffusion of the electric current to the hypothalamus. This mechanism may in part explain the weight gain of patients with PD after surgery.Keywords
This publication has 27 references indexed in Scilit:
- Comparison of weight gain and energy intake after subthalamic versus pallidal stimulation in Parkinson's diseaseMovement Disorders, 2009
- Leptin regulated calcium channels of neuropeptide Y and proopiomelanocortin neurons by activation of different signal pathwaysNeuroscience, 2008
- The central melanocortin system directly controls peripheral lipid metabolismJCI Insight, 2007
- Mechanisms of body weight gain in patients with Parkinson's disease after subthalamic stimulationBrain, 2007
- A Randomized Trial of Deep-Brain Stimulation for Parkinson's DiseaseThe New England Journal of Medicine, 2006
- Weight and body mass index in Parkinson's disease patients after deep brain stimulation surgeryParkinsonism & Related Disorders, 2005
- Anatomy and regulation of the central melanocortin systemNature Neuroscience, 2005
- Parkinson's disease patients with bilateral subthalamic deep brain stimulation gain weightMovement Disorders, 2003
- Body weight gain rate in patients with Parkinson's disease and deep brain stimulationMovement Disorders, 2003
- Serum Immunoreactive-Leptin Concentrations in Normal-Weight and Obese HumansThe New England Journal of Medicine, 1996