A new study suggests deep brain stimulation might help improve the mental and physical health of anorexia nervosa patients by altering the brain circuits associated with their symptoms.
Deep brain stimulation or neurostimulation is referred to the purposeful modulation of the nervous system through both invasive and non-invasive procedures. Most studies consider the system to be safe. It entails placing electrodes inside areas of the brain that control dysfunctional behaviors to stimulate them later.
Andres Lozano, a professor at the University of Toronto and head researcher for the study, stated that the procedure could help minimize and eventually neutralize the psychiatric disorder.
Lozano believed implanted stimulation electrodes may just be the solution to ease certain psychological issues related to the disorder, like anxiety concerning the body and depression. At the same time, it could help them gain weight and improve their overall quality of life, as reported by News Medical.
Anorexia nervosa currently affects 0.5% of the total world population, most of which is made up of teenage girls.
The eating disorder is known for persistent anxiety about body weight, shape, and size then causing abnormal drops in weight. Many anorexia patients experience mood and anxiety disorders as well, often denying their condition and refusing medical help.
Over time, people suffering from anorexia can develop severe health complications resulting from malnutrition. Chronic side effects include weak bones and muscles, sexual disturbances, infertility, heart problems, and seizures. Patients who become critically ill are admitted to specialized hospital units to undergo nutritional support, medical stabilization, and behavioral therapy.
In other cases, the condition is lethal, which has made anorexia the psychiatric disorder with the highest mortality rate. The medical community points out the urgent need to develop safe, effective and evidence-driven treatment methods by better understanding the circuitry of the brain, said Lozano.
The findings
The study published in The Lancet Psychiatry journal was conducted on 16 subjects with severe anorexia. The candidates were all woman with 21 and 57 years of age who had had the eating disorder for an average of 18 years and were extremely underweight, averaging around the 13.8 of BMI. An additional selection criteria was that other available treatments had not worked for them and they were at risk of an early death.
Electrodes were implanted in the subcallosal cingulate, an area located in the center of the brain, which has been linked to anorexia because of alterations in serotonin bindings. The researchers measured mood, anxiety, BMI, and wellbeing.
A few months after performing the deep brain stimulation, researchers carried out follow-up checkings and found that the body mass of the anorexic individuals increased by 3.5 points.
Mood and anxiety symptoms were reduced in 5 patients, and ten patients reported decreased symptoms of depression as well as a better perception of wellbeing. Two of the participants of the study asked to have the electrodes removed and could not be taken into account for the follow-up observation.
While psychological symptoms showed improvement soon after the stimulation, changes in weight started to take place after three months. This might serve as proof that mental health has to get better to enable changes in weight.
Lozano and his team also employed PET scans to look at how brain activity changed after one year of stimulation. The results confirmed variations in the region believed to be associated with the disorder. More specifically, less activity in the putamen, thalamus, cerebellum and more activation of the peripheral cortical areas related to social perception and behavior.
Lozano concluded that deep brain stimulation seems promising for anorexia therapy, but research is not complete for patients to have access to it. Some other limitations with their recent investigation involved the size of the group, the absence of a control group and the potential impact of the placebo effect.
Although the technique might be seen as delicate, it has also been used to solve other nervous system illnesses like Parkinson’s disease, dystonia, and tremors and has proved to be useful in controlling symptoms.
Source: News Medical