Deep brain stimulation (DBS) is a surgical treatment where electrodes are inserted into specific parts of the brain in order to treat neuropsychiatric diseases, such as Parkinson’s and major depression. Comprised of an implanted pulse generator, a battery powered neurostimulator encased in a titanium shell, this “brain pacemaker” creates electrical pulses to interfere with neural activity at a specific site of interest.
Researchers in the Lozano Laboratory at the Toronto Western Research Institute have been using this method in the first part of a clinical trial with the aim of improving mood and health in patients suffering from anorexia nervosa.
People with eating disorders, such as anorexia nervosa, are concerned with food and/or their weight and body shape, usually feeling incredibly unhappy with their appearance. The majority of eating disorders also involve low self-esteem, shame, and denial and so many believe that improving mood could be a major step towards treatment of this disease.
In the Phase I trial published this month, six patients with chronic, severe, and treatment-refractory anorexia nervosa were treated with DBS to test the safety of this procedure for future study. Following the implantation of these electrode appliances, patients were exposed to a continuous delivery of electrical stimulation into a region of the brain called the subcallosal cingulate.
Functional imaging has highlighted that the subcallosal cingulate is an area linked to mood regulation. Through direction of electrical impulses into discreet sites, DBS offers clinicians the ability to adjustably and reversibly modulate the activity of dysfunctioning circuits without the need for removing parts of the brain, and has already been shown to be effective in patients with depression. Despite some adverse affects of the treatment: one patient suffered a serious seizure during programming, and another experienced a panic attack during surgery, four of the six patients reported improvements in mood, anxiety, and anorexia nervosa-related obsessions and compulsions, while three associated the treatment with an enhanced quality of life.
This method of electrically stimulating specific parts of the brain has been in effect for more than 25 years, and although a larger population would be required to validate these results in patients with anorexia nervosa, this pilot study offers a promising outcome for sufferers.