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
Villalba Martínez, Gloria (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Justicia, Azucena (Hospital del Mar (Barcelona, Catalunya))
Salgado, Purificación (Hospital del Mar (Barcelona, Catalunya))
Ginés, José María (Hospital del Mar (Barcelona, Catalunya))
Guardiola, Rocío (Hospital del Mar (Barcelona, Catalunya))
Cedrón, Carlos (Hospital del Mar (Barcelona, Catalunya))
Polo, María (Hospital del Mar (Barcelona, Catalunya))
Delgado Martínez, Ignacio (Hospital del Mar (Barcelona, Catalunya))
Medrano, Santiago (Institut Hospital del Mar d'Investigacions Mèdiques)
Manero, Rosa María (Hospital del Mar (Barcelona, Catalunya))
Conesa, Gerardo (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Faus, Gustavo (Instituto de Trastornos Alimentarios (ITA))
Grau Touriño, Antoni (Instituto de Trastornos Alimentarios (ITA))
Elices, M (Centro de Investigación Biomédica en Red de Salud Mental)
Pérez Solà, Víctor (Hospital del Mar (Barcelona, Catalunya))

Fecha:	2020
Resumen:	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.
Ayudas:	Ministerio de Economía y Competitividad PI16/00382
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Anorexia nervosa ; Deep brain stimulation ; Psychosurgery ; Clinical trial ; Subcallosal cingulate ; Nucleus accumbens ; Body mass index
Publicado en:	Journal of clinical medicine, Vol. 9 (june 2020) , ISSN 2077-0383

DOI: 10.3390/jcm9061946
PMID: 32580399

17 p, 1.4 MB

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