Long-term follow-up of deep brain stimulation for anorexia nervosa
| Autor: | Eileen Lam, Philippe De Vloo, D. Blake Woodside, Andres M. Lozano, Nir Lipsman, Kalam Sutandar, Gavin J B Elias, Peter Giacobbe, Alexandre Boutet |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Anorexia Nervosa Psychometrics Beck Anxiety Inventory Deep Brain Stimulation Anorexia nervosa Gyrus Cinguli 03 medical and health sciences 0302 clinical medicine Rating scale Hamd Medicine Humans Prospective Studies Depression (differential diagnoses) business.industry Beck Depression Inventory medicine.disease Psychiatry and Mental health Treatment Outcome Inclusion and exclusion criteria Physical therapy Surgery Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of neurology, neurosurgery, and psychiatry. 92(10) |
| ISSN: | 1468-330X |
| Popis: | 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 Given the invasive and experimental nature of SCC–DBS and the characteristic waxing and waning course of AN, we wished to report our long-term observations. This was a prospective long-term extension of a previously published open-label trial (ClinicalTrials.gov NCT01476540) conducted at the University of Toronto.3 4 Research Ethics Board approval (#10-0991-A) and informed consent were obtained. Inclusion and exclusion criteria, surgical details, adverse event classification and DBS programming algorithms have been described previously.3 4 In the current study, we exclusively analysed patients who had been stimulated for ≥3 years as of 1 October 2018. The primary outcome was procedure safety and acceptability. Secondary outcomes were long-term changes in BMI, eating behaviour, psychometrics (Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Yale-Brown Obsessive Compulsive Scale (YBOCS), Yale-Brown-Cornell Eating Disorder Scale rituals … |
| Databáze: | OpenAIRE |
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