Long-term follow-up of deep brain stimulation for anorexia nervosa

Introduction

Anorexia nervosa (AN) is an eating disorder characterised by pervasive preoccupations with body weight, shape and size. This translates into caloric restriction and/or excessive physical exercise to obtain and maintain a low body mass index (BMI). Pharmacotherapy has no sustained impact on weight or AN psychometrics. Conventional psychiatric treatment fails in about half, and 30%–50% of weight-restored patients relapse within a year.1 2

Since 2011, we have investigated deep brain stimulation (DBS) targeting the subcallosal cingulate (SCC) in patients with chronic, severe and highly refractory AN.3 4 We previously published 9-month outcomes in six patients3 and 1-year outcomes in 16 patients.4 We demonstrated short-term safety and acceptability of SCC–DBS and observed affective symptom improvements and cerebral glucose metabolism changes in key AN-related structures. Moreover, average BMI increased by 3.5 kg/m2 from baseline after 1-year of SCC–DBS.3 4<cross-ref…

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