• Julia Steinhardt, Henrike Hanssen, Marcus Heldmann, Alexander Neumann, Alexander Münchau, Peter Schramm, Dirk Rasche, Assel Saryyeva, Lars Büntjen, Jürgen Voges, Volker Tronnier, Joachim K Krauss, Thomas F Münte, and Norbert Brüggemann.
• Department of Neurology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany.
• J. Neurol. Neurosurg. Psychiatr. 2022 Mar 1; 93 (3): 324-331.

BackgroundAn increase in body weight is observed in the majority of patients with Parkinson's disease (PD) who undergo deep brain stimulation (DBS) of the subthalamic nucleus (STN) although the mechanisms are unclear.ObjectivesTo identify the stimulation-dependent effects on reward-associated and attention-associated neural networks and to determine whether these alterations in functional connectivity are associated with the local impact of DBS on different STN parcellations.MethodsWe acquired functional task-related MRI data from 21 patients with PD during active and inactive STN DBS and 19 controls while performing a food viewing paradigm. Electrode placement in the STN was localised using a state-of-the-art approach. Based on the 3D model, the local impact of STN DBS was estimated.ResultsSTN DBS resulted in a mean improvement of motor function of 22.6%±15.5% (on medication) and an increase of body weight of ~4 kg within 2 years of stimulation. DBS of the limbic proportion of the STN was associated with body weight gain and an increased functional connectivity within the salience network and at the same time with a decreased activity within the reward-related network in the context of sweet food images.ConclusionsOur findings indicate increased selective attention for high-caloric foods and a sweet food seeking-like behaviour after DBS particularly when the limbic proportion of the STN was stimulated.© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

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