A Randomized Trial of Deep Brain Stimulation to the Subcallosal Cingulate and Nucleus Accumbens in Patients with Treatment-Refractory, Chronic, and Severe Anorexia Nervosa: Initial Results at 6 Months of Follow Up.

Abstract

BACKGROUND:

The main objective of this study was to assess the safety and efficacy of deep brain stimulation (DBS) in patients with severe anorexia nervosa (AN).

METHODS:

Eight participants received active DBS to the subcallosal cingulate (SCC) or nucleus accumbens (NAcc) depending on comorbidities (affective or anxiety disorders, respectively) and type of AN. The primary outcome measure was body mass index (BMI).

RESULTS:

Overall, we found no significant difference (p = 0.84) between mean preoperative and postoperative (month 6) BMI. A BMI reference value (BMI-RV) was calculated. In patients that received preoperative inpatient care to raise the BMI, the BMI-RV was defined as the mean BMI value in the 12 months prior to surgery. In patients that did not require inpatient care, the BMI-RV was defined as the mean BMI in the 3-month period before surgery. This value was compared to the postoperative BMI (month 6), revealing a significant increase (p = 0.02). After 6 months of DBS, five participants showed an increase of ≥10% in the BMI-RV. Quality of life was improved (p = 0.03). Three cases presented cutaneous complications.

CONCLUSION:

DBS may be effective for some patients with severe AN. Cutaneous complications were observed. Longer term data are needed.

• Authors: Gloria Villalba Martínez, Azucena Justicia, Purificación Salgado, José María Ginés, Rocío Guardiola, Carlos Cedrón, María Polo, Ignacio Delgado-Martínez, Santiago Medrano, Rosa María Manero, Gerardo Conesa, Gustavo Faus, Antoni Grau, Matilde Elices, Víctor Pérez
• Journal: Journal of clinical medicine (J Clin Med) Vol. 9 Issue 6 (Jun 22 2020) ISSN: 2077-0383 [Print] Switzerland
• PMID: 32580399 (Publication Type: Journal Article)