Cargando…
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
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...
Autores principales: | , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357090/ https://www.ncbi.nlm.nih.gov/pubmed/32580399 http://dx.doi.org/10.3390/jcm9061946 |
_version_ | 1783558633173286912 |
---|---|
author | Villalba Martínez, Gloria Justicia, Azucena Salgado, Purificación Ginés, José María Guardiola, Rocío Cedrón, Carlos Polo, María Delgado-Martínez, Ignacio Medrano, Santiago Manero, Rosa María Conesa, Gerardo Faus, Gustavo Grau, Antoni Elices, Matilde Pérez, Víctor |
author_facet | Villalba Martínez, Gloria Justicia, Azucena Salgado, Purificación Ginés, José María Guardiola, Rocío Cedrón, Carlos Polo, María Delgado-Martínez, Ignacio Medrano, Santiago Manero, Rosa María Conesa, Gerardo Faus, Gustavo Grau, Antoni Elices, Matilde Pérez, Víctor |
author_sort | Villalba Martínez, Gloria |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7357090 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-73570902020-07-23 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 Villalba Martínez, Gloria Justicia, Azucena Salgado, Purificación Ginés, José María Guardiola, Rocío Cedrón, Carlos Polo, María Delgado-Martínez, Ignacio Medrano, Santiago Manero, Rosa María Conesa, Gerardo Faus, Gustavo Grau, Antoni Elices, Matilde Pérez, Víctor J Clin Med Article 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. MDPI 2020-06-22 /pmc/articles/PMC7357090/ /pubmed/32580399 http://dx.doi.org/10.3390/jcm9061946 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Villalba Martínez, Gloria Justicia, Azucena Salgado, Purificación Ginés, José María Guardiola, Rocío Cedrón, Carlos Polo, María Delgado-Martínez, Ignacio Medrano, Santiago Manero, Rosa María Conesa, Gerardo Faus, Gustavo Grau, Antoni Elices, Matilde Pérez, Víctor 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357090/ https://www.ncbi.nlm.nih.gov/pubmed/32580399 http://dx.doi.org/10.3390/jcm9061946 |
work_keys_str_mv | AT villalbamartinezgloria arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT justiciaazucena arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT salgadopurificacion arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT ginesjosemaria arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT guardiolarocio arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT cedroncarlos arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT polomaria arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT delgadomartinezignacio arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT medranosantiago arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT manerorosamaria arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT conesagerardo arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT fausgustavo arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT grauantoni arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT elicesmatilde arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT perezvictor arandomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT villalbamartinezgloria randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT justiciaazucena randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT salgadopurificacion randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT ginesjosemaria randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT guardiolarocio randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT cedroncarlos randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT polomaria randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT delgadomartinezignacio randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT medranosantiago randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT manerorosamaria randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT conesagerardo randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT fausgustavo randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT grauantoni randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT elicesmatilde randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup AT perezvictor randomizedtrialofdeepbrainstimulationtothesubcallosalcingulateandnucleusaccumbensinpatientswithtreatmentrefractorychronicandsevereanorexianervosainitialresultsat6monthsoffollowup |