Abstract
Although patients with advanced neurodegenerative diseases finally fall into the bed-ridden state, their degree of mental activity and brain atrophy differs in each case. The brain consumes ten times more energy and oxygen than other body organs per unit weight, so we estimated the resting energy expenditure (REE) in order to identify the proper nutrition supply for patients with neurodegenerative diseases. REE was investigated for 29 patients (14 men, 61.6±9.5 years old; 15 women 58.1±15.3 years old) and 22 healthy controls (11 men, 58.1±2.4 years old; 11 women, 58.9±1.1 years old). Seven of the patients were suffering from multiple system atrophy (MSA), 6 from spin-ocerebellar degeneration (SCD), 8 from Parkinsonism (P-ism), 4 from motor neuron disease (MND), 2 from Huntington's chorea (HC), one from Leigh's-encephalomyelopathy, and one from subacute myelo-optico-neuropathy (SMON). Four of the cases showed continuous or phasic involuntary movement in bed (the two HC patients, one of the SCD patients, and the one patient with Leigh's-encephalomyelopathy).
The REE value of those patients with neurodegenerative diseases without involuntary movement was significantly lower (21.5±3.3kcal/kg) than that of the control group (24.0±3.6, p<0.02). Those patients with involuntary movement demonstrated an elevated REE value ranging from 25.1 to 37.8kcal/kg (31.8±5.7). REE was significantly lower in those patients with low mental activity (p<0.001) and those with marked brain atrophy (p<0.002). The influence of volitional physical activity on REE was slight.
The neurodegenerative disease patients with well-preserved mental activity and brain tissue, as well as those with involuntary movement, showed relatively higher REE values, so the results of this study should be taken into consideration when planning the nutritional supply for bed-ridden patients.
