ArticleMovement disorders : official journal of the Movement Disorder Society2026
Target-Dependent Postoperative Weight Gain after Pallidothalamic Tractotomy versus Pallidotomy for Dystonia.
Article in Movement disorders : official journal of the Movement Disorder Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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11 authors.
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Abstract
backgroundPostoperative weight gain is a recognized complication of deep brain stimulation, but whether ablative surgery produces target-dependent weight effects remains unknown. We investigated whether pallidothalamic tractotomy (PTT) causes greater weight gain than pallidotomy and explored spatial associations.
methodsWe retrospectively analyzed 79 patients with focal, segmental, or generalized dystonia who underwent unilateral PTT (n = 41) or globus pallidus internus (GPi) lesioning (n = 38). Multivariable linear regression quantified the effect of target on weight and body mass index (BMI) changes, adjusting for age, sex, side, preoperative BMI, follow-up duration, and Burke-Fahn-Marsden dystonia rating scale (BFMDRS) improvement. In a subset with postoperative magnetic resonance imaging (MRI), lesion overlap (N) maps and voxel-wise mean BMI-change maps were generated to explore anatomical associations.
resultsPTT resulted in greater postoperative weight gain than GPi lesioning (+6.7 ± 7.5 kg vs. +1.1 ± 4.7 kg), with ≥10 kg gain in 29.3% versus 5.3% of patients. After covariate adjustment, PTT remained independently associated with greater weight gain (adjusted difference + 5.18 kg; 95% confidence interval [CI] +13 to +8.23) and BMI increase (+1.92 kg/m
conclusionsPTT was associated with greater postoperative weight gain than pallidotomy, independent of covariates. These findings suggest that lesion target influences postoperative body-weight regulation, highlighting the potential risk of lesions extending into the caudal subthalamic region. © 2026 International Parkinson and Movement Disorder Society.
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