Therapies — 09 March 2013

Surgeons have found yet another use for deep brain stimulation — helping patients with anorexia to gain weight.

Three out of six women with chronic anorexia nervosa gained and achieved a stable weight within nine months of having electrodes permanently inserted into the subcallosal cingulate, which regulates mood.

The women in the pilot study, published Thursday in the Lancet (online), had had severe anorexia for an average of 18 years, all with a history of ICU admissions.

Four had been “surgically fed” in the past.

Over nine months, three women experienced significant increases in BMI, from an average of 13.5 to 16, 20 and 21 in each case.

“For all three of these patients, this was the longest period of sustained increase in BMI since the onset of their illness,” the study authors wrote.

“Deep brain stimulation might be able to change the natural history of the illness, with the potential to improve clinical outcomes in some patients.”

Five of the six patients were found to have improved on clinical scales of mood, obsession and compulsion following the surgery.

However, while the surgeries had been “generally” safe, the authors highlighted some safety concerns.

One woman had a one-off but serious seizure when the subcutaneous device that sends signals to the electrodes was switched on.

Another had a panic attack as a surgeon drilled through her skull prior to inserting the electrodes (patients are conscious during the procedure so that optimum electrode placement can be gauged).

Anorexia nervosa has a mortality rate of 6-11% and is among the most challenging psychiatric disorders to treat, with up to 20% of patients deriving no benefit from available treatment programs, the authors wrote.

Deep brain stimulation is typically used to treat Parkinson’s disease, but has also been used in major depression, Tourette syndrome, Alzheimer’s disease and obsessive-compulsive disorder.


This story first appeared in Australian Doctor, 8 March 2013. Source: The Lancet 2013; online.

The study was funded by the Canadian Institutes of Health and the Klarman Family Foundation Grants Program in Eating Disorders Research.

Three of the authors consult for companies that produce deep brain stimulation devices.



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