{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:18:01Z","timestamp":1787800681926,"version":"build-2784847793"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative weight gain is a recognized complication of deep brain stimulation, but whether ablative surgery produces target\u2010dependent weight effects remains unknown. We investigated whether pallidothalamic tractotomy (PTT) causes greater weight gain than pallidotomy and explored spatial associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 79 patients with focal, segmental, or generalized dystonia who underwent unilateral PTT (n\u2009=\u200941) or globus pallidus internus (GPi) lesioning (n\u2009=\u200938). Multivariable linear regression quantified the effect of target on weight and body mass index (BMI) changes, adjusting for age, sex, side, preoperative BMI, follow\u2010up duration, and Burke\u2013Fahn\u2013Marsden dystonia rating scale (BFMDRS) improvement. In a subset with postoperative magnetic resonance imaging (MRI), lesion overlap (N) maps and voxel\u2010wise mean BMI\u2010change maps were generated to explore anatomical associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PTT resulted in greater postoperative weight gain than GPi lesioning (+6.7\u2009\u00b1\u20097.5\u2009kg vs. +1.1\u2009\u00b1\u20094.7\u2009kg), with \u226510\u2009kg gain in 29.3% versus 5.3% of patients. After covariate adjustment, PTT remained independently associated with greater weight gain (adjusted difference\u2009+\u20095.18\u2009kg; 95% confidence interval [CI] +13 to +8.23) and BMI increase (+1.92\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; 95% CI +0.85 to +2.99). Lesion mapping localized PTT lesions to Forel's field H1. Weight\u2010gain hotspots mapped medial to the inferior border of the subthalamic nucleus, whereas GPi maps showed no consistent intranuclear hotspot.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PTT was associated with greater postoperative weight gain than pallidotomy, independent of covariates. These findings suggest that lesion target influences postoperative body\u2010weight regulation, highlighting the potential risk of lesions extending into the caudal subthalamic region. \u00a9 2026 International Parkinson and Movement Disorder Society.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.70323","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T03:51:04Z","timestamp":1777002664000},"page":"2062-2070","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Target\u2010Dependent Postoperative Weight Gain after Pallidothalamic Tractotomy versus Pallidotomy for Dystonia"],"prefix":"10.1002","volume":"41","author":[{"given":"Ryosuke","family":"Jozuka","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Tokyo Women's Medical University  Tokyo 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