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
| Autor: | Rocío Guardiola, Gustavo Faus, José María Ginés, Maria Polo, Santiago Medrano, Antoni Grau, Carlos Cedrón, Purificación Salgado, Gloria Villalba Martínez, Rosa María Manero, Azucena Justicia, Gerardo Conesa, Ignacio Delgado-Martínez, Matilde Elices, Víctor Pérez |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Deep brain stimulation nucleus accumbens medicine.medical_treatment lcsh:Medicine anorexia nervosa deep brain stimulation psychosurgery clinical trial subcallosal cingulate body mass index Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Quality of life law Internal medicine medicine business.industry lcsh:R nutritional and metabolic diseases General Medicine 030227 psychiatry Clinical trial Anorexia nervosa (differential diagnoses) Anxiety medicine.symptom business Body mass index 030217 neurology & neurosurgery Psychosurgery |
| Zdroj: | Journal of Clinical Medicine Journal of Clinical Medicine, Vol 9, Iss 1946, p 1946 (2020) Journal of Clinical Medicine; Volume 9; Issue 6; Pages: 1946 |
| ISSN: | 2077-0383 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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