Deep-Brain Stimulation for Anorexia Nervosa
ABSTRACT OBJECTIVE: Anorexia nervosa (AN) is a complex and severe, sometimes life-threatening, psychiatric disorder with high relapse rates under standard treatment. After decades of brain-lesioning procedures offered as a last resort, deep-brain stimulation (DBS) has come under investigation in the last few years as a treatment option for severe and refractory AN. METHODS AND RESULTS: In this jointly written article, Sun et al. (the Shanghai group) report an average of 65% increase in body weight in four severe and refractory patients with AN after they underwent the DBS procedure in (average follow-up, 38 months). All patients weighed greater than 85% of expected body weight and thus no longer met the diagnostic criteria of AN at last follow-up. Nuttin et al. (the Leuven group) describe other clinical studies that provide evidence for the use of DBS for AN and further discuss patient selection criteria, target selection, and adverse event of this evolving therapy. CONCLUSION: Preliminary results from the Shanghai group and other clinical centers showed that the use of DBS to treat AN may be a valuable option for weight restoration in otherwise-refractory and life-threatening cases. The nature of this procedure, however, remains investigational and should not be viewed as a standard clinical treatment option. Further scientific investigation is essential to warrant the long-term efficacy and safety of DBS for AN.
- SourceAvailable from: Valentina Cardi
[Show abstract] [Hide abstract]
- "It has been suggested that this approach may be a viable treatment option for patients in the severe and enduring stage of illness as a method to target the neurobiological mechanisms that underlie symptoms  . A preliminary study from China with DBS of the nucleus accumbens in the early stage of AN reported benefits . DBS in the subcallosal cingulate (an area implicated in treatment resistant depression) has also been used. "
ABSTRACT: The aim of this paper is to map the possibility of new treatment approaches for eating disorders. Eating disorders have a protracted trajectory with over 50% of cases developing a severe and enduring stage of illness. Although a good response to family-based interventions occurs in the early phase, once the illness has become severe and enduring there is less of a response to any form of treatment. Neuroprogressive changes brought about by poor nutrition and abnormal eating patterns contribute to this loss of treatment responsivity. We have summarised the profile of symptoms at the various stages of illness and considered new treatments that might be applied. In the enduring stage of illness in addition to problems with body image, food and eating, there are additional problems of low mood, high anxiety and compulsivity and problems in social functioning. This suggests that there are dysfunctions in circuits subsuming reward, punishment, decision-making and social processes. New approaches have been developed targeting these areas. New interventions targeting both the primary and secondary symptoms seen in the enduring stage of eating disorders may improve the response to treatment. Copyright © 2015. Published by Elsevier Inc.Physiology & Behavior 06/2015; DOI:10.1016/j.physbeh.2015.06.007 · 3.03 Impact Factor
[Show abstract] [Hide abstract]
- "), and DBS is currently being explored as a treatment for depression (Anderson et al. 2012; Mayberg et al. 2005), Tourette's syndrome (Kuhn et al. 2009), Alzheimer's disease (AD) (Laxton et al. 2010), anorexia (Wu et al. 2012), and alcoholism (Heldmann et al. 2012). TMS (specifically repetitive TMS, or rTMS) was given FDA approval in 2008 as a treatment for medication refractory depression. 1 There is also ongoing research into its potential therapeutic benefits for a variety of other neurologic and psychiatric conditions, including but not limited to motor dysfunction (Groppa et al. 2012), obsessive compulsive disorder (OCD) (Wu et al. 2010), Alzheimer's disease (Haffen et al. 2012), hallucinations in schizophrenia (Guller et al. 2012), and pain disorders (Sampson et al. 2011). "
ABSTRACT: In recent years, non-pharmacologic approaches to modifying human neural activity have gained increasing attention. One of these approaches is brain stimulation, which involves either the direct application of electrical current to structures in the nervous system or the indirect application of current by means of electromagnetic induction. Interventions that manipulate the brain have generally been regarded as having both the potential to alleviate devastating brain-related conditions and the capacity to create unforeseen and unwanted consequences. Hence, although brain stimulation techniques offer considerable benefits to society, they also raise a number of ethical concerns. In this paper we will address various dilemmas related to brain stimulation in the context of clinical practice and biomedical research. We will survey current work involving deep brain stimulation, transcranial magnetic stimulation and transcranial direct current stimulation. We will reflect upon relevant similarities and differences between them, and consider some potentially problematic issues that may arise within the framework of established principles of medical ethics: nonmaleficence and beneficence, autonomy, and justice.Brain Topography 06/2013; 27(1). DOI:10.1007/s10548-013-0296-8 · 2.52 Impact Factor
Article: Emotion in Eating DisordersEuropean Eating Disorders Review 11/2012; 20(6). DOI:10.1002/erv.2211 · 1.38 Impact Factor