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Chronic Anorexia Nervosa Might Be Treated with a Brain Pacemaker

Update Date: Mar 07, 2013 01:32 PM EST

People with anorexia nervosa have a difficult time accepting their body weight, and are constantly trying to perfect their bodies by losing weight and abstaining from food. Certain people suffer from a severe case of the disease and do not respond to any treatment options currently available. According to a new study, researchers found that deep brain stimulation (DBS) might be effective in treating patients with severe and chronic anorexia. This study, the first in the world, implanted a device that works similarly to a pacemaker in the brain to control and stimulate the areas known to cause anorexia.

The lead researcher, Dr. Nir Lipsman worked with two other doctors in this study titled "Deep Brain Stimulation of the Subcallosal Cingulate Area for Treatment-Refractory Anorexia Nervosa: A Phase I Pilot Trial," published in The Lancet. Dr. Lipsman, Dr. Andres Lozano and Dr. Blake Woodside recruited six patients that were considered high risk for premature death due to the disease. These patients suffered from anorexia chronically, never maintained a constant weight for a long period of time, and did not respond to other treatments. The average age of the patients were 38 and the mean duration of the illness was 18 years. Only one of the patients did not have other psychiatric illnesses, such as obsessive compulsive disorder and manic depressive disorder, but all patients had medical complications from anorexia that resulted in the total of 50 hospitalizations.

The research team used DBS, which is a surgical procedure aimed to control dysfunctional brain circuits' activity, and implanted electrodes specifically on areas of the brain responsible for emotions. The electrodes were connected to a pulse generator implanted onto the right clavicle. The researchers did three follow ups that occurred in one, three, and six-month intervals. After the nine months, they found that a half of the patients had weight gain measured by body mass index (BMI) and were able to keep the weight on. Four of the patients stated that changes in their mood made it easier for them to control their emotional urges to binge or purge.

Although the results showed that DBS could reverse abnormal brain activities, the researchers stressed that this is still phase one of the experiment. The sample size is considered to be very small in the research field. However, if future research continues to show positive results from this procedure, people with severe anorexia might have another treatment option.

Dr. Lipsman is a neurosurgery resident at the University of Toronto and a PhD student at the Krembil Neuroscience Center. Dr. Lozano is a neurosurgeon at the Krembil Neuroscience Center in the Toronto Western Hospital. He is also a professor and chairman of neurosurgery at the University of Toronto. Dr. Woodside is the medical director of the eating disorders program at Toronto General Hospital, as well as a professor of psychiatry at the University of Toronto.

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