Deep Brain Stimulation May Be Option in Chronic Anorexia
(HealthDay News) – For patients with chronic, severe, treatment-refractory anorexia nervosa, deep brain stimulation (DBS) seems to be a safe treatment option, according to a phase 1 pilot trial published online March 7 in The Lancet.
Nir Lipsman, MD, from the University of Toronto, and colleagues conducted a prospective trial of subcallosal cingulate DBS in six patients (age 20–60 years) with chronic, severe, treatment-refractory anorexia nervosa. Participants underwent preoperative medical optimization and were followed for nine months after DBS.
The researchers found that several adverse events were associated with DBS, including panic attacks during surgery, nausea, air embolus, and pain, but only one seemed serious (seizure during programing, about two weeks after surgery). Three of the participants had achieved and maintained a body mass index above their historical baseline after nine months. After six months of stimulation, four of the participants experienced DBS-linked improvements in mood, anxiety, affective regulation, and anorexia nervosa-related obsessions and compulsions, and three experienced improvements in quality of life. These improvements correlated with changes in cerebral glucose metabolism consistent with a reversal of the anorexia nervosa-linked abnormalities observed in the anterior cingulate, insula, and parietal lobe.
"Subcallosal cingulate DBS seems to be generally safe in this sample of patients with chronic and treatment-refractory anorexia nervosa," the authors write.
Several authors disclosed financial ties to the medical technology industry. One author holds intellectual property related to brain stimulation for depression.