Six women pilot deep brain stimulation for intractable anorexia nervosaBMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1566 (Published 12 March 2013) Cite this as: BMJ 2013;346:f1566
Six women with intractable and life threatening anorexia nervosa have been treated with deep brain stimulation in a preliminary study from Toronto, Canada. Doctors selected the women for deep brain stimulation after many years of unsuccessful conventional management. They had average body mass indices (BMIs) of 11 to 15 in the years leading up to the study, accompanied by multiple medical complications of chronic starvation. Five had psychiatric comorbidities, most often major depression and obsessive compulsive disorder.
Surgeons drilled bilateral burr holes and placed electrodes just beneath the corpus callosum. One patient had a self limiting panic attack during the local anaesthetic phase of the procedure and one developed a cardiac air embolus that resolved within five minutes after the operating table was repositioned. A third patient had a seizure during device programming two weeks after the procedure. It was switched off then restarted one week later with no further problems.
Three of the six women gained weight during nine months of stimulation, relative to their average weight in the five to seven years before treatment (BMIs increased from 11.1 to 21, 14.2 to 16, and 15.1 to 20). They also reported improved quality of life. Symptom scores measuring mood, anxiety, and anorexia nervosa related obsessions and compulsions improved in four patients.
The pilot was designed to assess safety, not effectiveness. The authors judge deep brain stimulation to be safe enough for further evaluation.
Cite this as: BMJ 2013;346:f1566