Implanting a “brain” pacemaker in anorexic patients has been found to help those with severe cases of the eating disorder who have not responded to other treatments.
In a new study reported in the Lancet, researchers based at the Krembil Neuroscience Centre and University Health Network in Canada said they were able to safely treat six anorexia patients with a neurosurgical implant. At least half of the patients who took part in the study showed improvements in mood and weight gain, which researchers said should prompt larger trials to confirm the effectiveness of the technique in treating patients with severe anorexia.
The technique — known as deep brain stimulation (DBS) — involves a device similar to a pacemaker that is implanted into a patient's brain. Although the treatment requires some surgery, it is minimally invasive, and completely reversible. DBS is currently used to treat several neurological disorders, including Parkinson's disease and chronic pain, and being tested for possible use for depression and epilepsy.
But the Canada study is the first to try it with anorexia patients.
The researchers used Magnetic Resonance Imaging (MRI) to identify a specific area of the brain previously targeted for DBS in patients with depression. Electrodes were then implanted into the area and connected to a pulse generator, implanted under the skin. The device was activated 10 days after it was implanted, with the researchers measuring changes in the patients' mood and anxiety levels to determine the correct level of stimulation.
The results showed that three months after the treatment, five of the six patients either gained or stabilized their weight. After nine months, three patients were maintaining a higher weight than before the treatment started — the longest period of sustained increase in weight that any of them had ever achieved, researchers said. Half of the patients also experienced improvements in their mood or reduced obsessive-compulsive behavior.
According to lead researcher Andres Lozano, M.D., a leading neurosurgeon in the field of DBS, the results are particularly encouraging because they indicate a genuine therapeutic effect, rather than a placebo or hunger-increasing effect.
"The finding of improvements in mood and anxiety in patients who were still underweight is especially striking, in view of the well-known poor response of underweight patients to conventional pharmacotherapies or psychotherapies," Dr. Lozano said.
Anorexia is among the most common psychiatric disorders in young women. Treatment usually focuses on behavioral change, but up to 20 percent of patients don’t benefit from the available treatment and are at risk of dying prematurely from the disease.
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