Anorexia Nervosa Benefits from Deep Brain Stimulation
Significant improvements in affective symptoms and body mass index for treatment-refractory anorexia.
HealthDay News — Deep brain stimulation (DBS) is associated with significant improvements in affective symptoms and body mass index (BMI) in treatment-refractory anorexia nervosa, according to a study published in The Lancet.
Nir Lipsman, MD, from the University of Toronto in Canada, and colleagues conducted an open-label trial involving participants aged 20 to 60 years with a diagnosis of anorexia nervosa and a demonstrated history of chronicity or treatment resistance. Sixteen patients underwent surgery for DBS and received open-label continuous stimulation for the one-year study duration.
Two participants requested that their devices be removed or deactivated during the study. The researchers found that pain related to surgical incision or positioning was the most common adverse event, which required oral analgesics for longer than three to four days after surgery (31 percent); 44 percent of patients had serious adverse events. After 12 months of stimulation, the mean BMI was 17.34 kg/m², compared with 13.83 kg/m² at baseline (P = 0.0009). DBS correlated with significant improvements in measures of depression, anxiety, and affective regulation. At 6 and 12 months of ongoing brain stimulation there were significant changes in cerebral glucose metabolism in key anorexia nervosa-related structures.
"In patients with chronic treatment-refractory anorexia nervosa, DBS is well tolerated and is associated with significant and sustained improvements in affective symptoms, BMI, and changes in neural circuitry at 12 months after surgery," the authors write.
Two authors disclosed financial ties to the medical device industry; one author holds intellectual property related to brain stimulation for depression.
Lipsman N, Lam E, Volpini m, et al. Deep brain stimulation of the subcallosal cingulate for treatment-refractory anorexia nervosa: 1 year follow-up of an open-label trial. The Lancet. 2017; http://dx.doi.org/10.1016/S2215-0366(17)30076-7