Cargando…
Efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis
BACKGROUND: Several pioneering studies investigated deep brain stimulation (DBS) in treatment-refractory anorexia nervosa (AN) patients, but overall effects remain yet unclear. Aim of this study was to obtain estimates of efficacy of DBS in AN-patients using meta-analysis. METHODS: We searched three...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9378729/ https://www.ncbi.nlm.nih.gov/pubmed/35970847 http://dx.doi.org/10.1038/s41398-022-02102-w |
_version_ | 1784768576623738880 |
---|---|
author | Karaszewska, Dominika Cleintuar, Patrick Oudijn, Marloes Lok, Anja van Elburg, Annemarie Denys, Damiaan Mocking, Roel |
author_facet | Karaszewska, Dominika Cleintuar, Patrick Oudijn, Marloes Lok, Anja van Elburg, Annemarie Denys, Damiaan Mocking, Roel |
author_sort | Karaszewska, Dominika |
collection | PubMed |
description | BACKGROUND: Several pioneering studies investigated deep brain stimulation (DBS) in treatment-refractory anorexia nervosa (AN) patients, but overall effects remain yet unclear. Aim of this study was to obtain estimates of efficacy of DBS in AN-patients using meta-analysis. METHODS: We searched three electronic databases until 1st of November 2021, using terms related to DBS and AN. We included trials that investigated the clinical effects of DBS in AN-patients. We obtained data including psychiatric comorbidities, medication use, DBS target, and study duration. Primary outcome was Body Mass Index (BMI), secondary outcome was quality of life, and the severity of psychiatric symptoms, including eating disorder, obsessive-compulsive, depressive, and anxiety symptoms. We assessed the risk of bias using the ROBINS-I tool. RESULTS: Four studies were included for meta-analysis, with a total of 56 patients with treatment-refractory AN. Follow-up ranged from 6–24 months. Random effects meta-analysis showed a significant increase in BMI following DBS, with a large effect size (Hedges’s g = 1 ∙ 13; 95% CI = 0 ∙ 80 to 1 ∙ 46; Z-value = 6 ∙ 75; P < 0 ∙ 001), without heterogeneity (I(2 )= 0 ∙ 00, P = 0 ∙ 901). Random effects meta-analysis also showed a significant increase in quality of life (Hedges’s g = 0 ∙ 86; 95% CI = 0 ∙ 44 to 1 ∙ 28; Z-value = 4 ∙ 01, P < 0 ∙ 001). Furthermore, DBS decreased the severity of psychiatric symptoms (Hedges’s g = 0 ∙ 89; 95% CI = 0 ∙ 57 to 1 ∙ 21; Z-value = 5 ∙ 47; P < 0 ∙ 001, I(2 )= 4 ∙ 29, P = 0 ∙ 371). DISCUSSION: In this first meta-analysis, DBS showed statistically large beneficial effects on weight restoration, quality of life, and reduction of psychiatric symptoms in patients with treatment-refractory AN. These outcomes call for more extensive naturalistic studies to determine the clinical relevance for functional recovery. This study is preregistered in PROSPERO,CRD42022295712. |
format | Online Article Text |
id | pubmed-9378729 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-93787292022-08-17 Efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis Karaszewska, Dominika Cleintuar, Patrick Oudijn, Marloes Lok, Anja van Elburg, Annemarie Denys, Damiaan Mocking, Roel Transl Psychiatry Systematic Review BACKGROUND: Several pioneering studies investigated deep brain stimulation (DBS) in treatment-refractory anorexia nervosa (AN) patients, but overall effects remain yet unclear. Aim of this study was to obtain estimates of efficacy of DBS in AN-patients using meta-analysis. METHODS: We searched three electronic databases until 1st of November 2021, using terms related to DBS and AN. We included trials that investigated the clinical effects of DBS in AN-patients. We obtained data including psychiatric comorbidities, medication use, DBS target, and study duration. Primary outcome was Body Mass Index (BMI), secondary outcome was quality of life, and the severity of psychiatric symptoms, including eating disorder, obsessive-compulsive, depressive, and anxiety symptoms. We assessed the risk of bias using the ROBINS-I tool. RESULTS: Four studies were included for meta-analysis, with a total of 56 patients with treatment-refractory AN. Follow-up ranged from 6–24 months. Random effects meta-analysis showed a significant increase in BMI following DBS, with a large effect size (Hedges’s g = 1 ∙ 13; 95% CI = 0 ∙ 80 to 1 ∙ 46; Z-value = 6 ∙ 75; P < 0 ∙ 001), without heterogeneity (I(2 )= 0 ∙ 00, P = 0 ∙ 901). Random effects meta-analysis also showed a significant increase in quality of life (Hedges’s g = 0 ∙ 86; 95% CI = 0 ∙ 44 to 1 ∙ 28; Z-value = 4 ∙ 01, P < 0 ∙ 001). Furthermore, DBS decreased the severity of psychiatric symptoms (Hedges’s g = 0 ∙ 89; 95% CI = 0 ∙ 57 to 1 ∙ 21; Z-value = 5 ∙ 47; P < 0 ∙ 001, I(2 )= 4 ∙ 29, P = 0 ∙ 371). DISCUSSION: In this first meta-analysis, DBS showed statistically large beneficial effects on weight restoration, quality of life, and reduction of psychiatric symptoms in patients with treatment-refractory AN. These outcomes call for more extensive naturalistic studies to determine the clinical relevance for functional recovery. This study is preregistered in PROSPERO,CRD42022295712. Nature Publishing Group UK 2022-08-15 /pmc/articles/PMC9378729/ /pubmed/35970847 http://dx.doi.org/10.1038/s41398-022-02102-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Systematic Review Karaszewska, Dominika Cleintuar, Patrick Oudijn, Marloes Lok, Anja van Elburg, Annemarie Denys, Damiaan Mocking, Roel Efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis |
title | Efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis |
title_full | Efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis |
title_fullStr | Efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis |
title_full_unstemmed | Efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis |
title_short | Efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis |
title_sort | efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9378729/ https://www.ncbi.nlm.nih.gov/pubmed/35970847 http://dx.doi.org/10.1038/s41398-022-02102-w |
work_keys_str_mv | AT karaszewskadominika efficacyandsafetyofdeepbrainstimulationfortreatmentrefractoryanorexianervosaasystematicreviewandmetaanalysis AT cleintuarpatrick efficacyandsafetyofdeepbrainstimulationfortreatmentrefractoryanorexianervosaasystematicreviewandmetaanalysis AT oudijnmarloes efficacyandsafetyofdeepbrainstimulationfortreatmentrefractoryanorexianervosaasystematicreviewandmetaanalysis AT lokanja efficacyandsafetyofdeepbrainstimulationfortreatmentrefractoryanorexianervosaasystematicreviewandmetaanalysis AT vanelburgannemarie efficacyandsafetyofdeepbrainstimulationfortreatmentrefractoryanorexianervosaasystematicreviewandmetaanalysis AT denysdamiaan efficacyandsafetyofdeepbrainstimulationfortreatmentrefractoryanorexianervosaasystematicreviewandmetaanalysis AT mockingroel efficacyandsafetyofdeepbrainstimulationfortreatmentrefractoryanorexianervosaasystematicreviewandmetaanalysis |