Deep Brain Stimulation shows promise for patients with chronic, treatment resistant anorexia nervosa

March 6, 2013

In a world first, a team of researchers at the Krembil Neuroscience Centre and the University Health Network have shown that Deep Brain Stimulation (DBS) in patients with chronic, severe and treatment-resistant Anorexia Nervosa (anorexia) helps some patients achieve and maintain improvements in body weight, mood, and anxiety.

The results of this trial, entitled of the Subcallosal Cingulate Area for Treatment-Refractory Anorexia Nervosa: A Phase I Pilot Trial, are published today in the medical journal The Lancet. The study is a collaboration between lead author Dr. Nir Lipsman a neurosurgery resident at the University of Toronto and PhD student at the Krembil Neuroscience Centre; Dr. Andres Lozano, a , at the Krembil Neuroscience Centre of Toronto Western Hospital and a professor and chairman of neurosurgery at the University of Toronto, whose research lab was instrumental in conducting the DBS research; and Dr. Blake Woodside, medical director of Canada's largest eating disorders program at Toronto General Hospital and a professor of psychiatry at the University of Toronto.

The phase one safety trial investigated the procedure in six patients who would likely continue with a chronic illness and/or die a because of the severity of their condition. The study's participants had an average age of 38, and a mean duration of illness of 18 years. In addition to the anorexia, all patients, except one, also suffered from such as and obsessive-compulsive disorder. At the time of the study, all patients currently, or had previously, suffered multiple related to their anorexia – altogether, the six patients had a history of close to 50 hospitalizations during their illnesses.

were treated with Deep (DBS), a that moderates the activity of dysfunctional brain circuits. has shown that there are both structural and functional differences between anorexia patients and healthy controls in which regulate mood, anxiety, reward and body-perception.

This video is not supported by your browser at this time.
Dr. Andres Lozano of the Krembil Neuroscience Centre describes how Deep Brain Stimulation works to help patients with severe Anorexia Nervosa. Credit: Aaron Szimanski

Patients were awake when they underwent the procedure which implanted electrodes into a specific part of the brain involved with emotion, and found to be highly important in disorders such as depression. During the procedure, each electrode contact was stimulated to look for patient response of changes in mood, anxiety or adverse effects. Once implanted, the electrodes were connected to an implanted pulse generator below the right clavicle, much like a heart pacemaker.

Testing of patients was repeated at one, three, and six-month intervals after activation of the pulse generator device. After a nine-month period following surgery, the team observed that three of the six patients had achieved weight gain which was defined as a body-mass index (BMI) significantly greater than ever experienced by the patients. For these patients, this was the longest period of sustained weight gain since the onset of their illness.

Furthermore, four of the six patients also experienced simultaneous changes in mood, anxiety, control over emotional responses, urges to binge and purge and other symptoms related to anorexia, such as obsessions and compulsions. As a result of these changes, two of these patients completed an inpatient eating disorders program for the first time in the course of their illness.

"We are truly ushering in a new of era of understanding of the brain and the role it can play in certain neurological disorders," says Dr. Lozano. "By pinpointing and correcting the precise circuits in the brain associated with the symptoms of some of these conditions, we are finding additional options to treat these illnesses."

While the treatment is still considered experimental, it is believed to work by stimulating a specific area of the brain to reverse abnormalities linked to mood, anxiety, emotional control, obsessions and compulsions all of which are common in anorexia. In some cases after surgery, patients are then able to complete previously unsuccessful treatments for the disease. The research may not only provide an additional therapy option for these patients in the future, but also furthers practitioners' understanding of anorexia and the factors that cause it to be persistent.

"There is an urgent need for additional therapies to help those suffering from severe anorexia," says Dr. Woodside. "Eating disorders have the highest death rate of any mental illness and more and more women are dying from anorexia. Any treatment that could potentially change the natural course of this illness is not just offering hope but saving the lives for those that suffer from the extreme form of this condition."

A leading international expert in the field of DBS research, Dr. Lozano has been exploring the potential of DBS to treat a variety of conditions. Most recently, his team began the first ever DBS trial of with early Alzheimer's disease, and showed that stimulation may help improve memory. This trial has now entered its second phase and expanded to medical centres in the United States.

is an eating disorder and psychiatric condition characterized by food restriction, body distortion and an overwhelming fear of gaining weight. Death rates from anorexia can be as high as 15%, and a further 15% to 20% of those with anorexia develop a chronic course of the condition that is unresponsive to traditional treatments. Research has shown that addressing the emotional symptoms, psychological issues and other mental illnesses associated with – rather than solely treating low body weight – is linked to lower rates of relapse and improved treatment outcomes.

Explore further: Spring babies face anorexia risk

More information:

Related Stories

Spring babies face anorexia risk

April 28, 2011

(Medical Xpress) -- Anorexia nervosa is more common among people born in the spring, a new study led by Oxford University scientists has found.

Does eating give you pleasure or make you anxious?

May 20, 2011

(Medical Xpress) -- Perhaps the most puzzling symptom of anorexia nervosa -- a disorder that tends to occur in young women -- is the refusal to eat, resulting in extreme weight loss. While most people have a great deal of ...

World's first trial of new anorexia treatment

June 20, 2011

(Medical Xpress) -- Researchers from the University of Western Sydney are trialling a new method of treatment for anorexia nervosa, which addresses the role of extreme exercise in perpetuating the dangerous and debilitating ...

New approach to diagnosing anorexia nervosa

January 9, 2012

(Medical Xpress) -- A new approach for diagnosing patients with anorexia nervosa has been developed at the University of Sydney. The approach could have a significant impact on the treatment and recovery of sufferers, as ...

Study shows brain function differences in women with anorexia

September 17, 2012

A new study published in Social Cognitive and Affective Neuroscience by researchers at the Center for BrainHealth at UT Dallas and UT Southwestern found brain-based differences in how women with and without anorexia perceive ...

Recommended for you

Serious research into what makes us laugh

November 24, 2015

More complex jokes tend to be funnier but only up to a point, Oxford researchers have found. Jokes that are too complicated tend to lose the audience.

Psychologists dispute continuum theory of sexual orientation

November 19, 2015

Washington State University researchers have established a categorical distinction between people who are heterosexual and those who are not. By analyzing the reported sexual behavior, identity and attraction of more than ...

Babies have logical reasoning before age one, study finds

November 18, 2015

Human infants are capable of deductive problem solving as early as 10 months of age, a new study by psychologists at Emory University and Bucknell finds. The journal Developmental Science is publishing the research, showing ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.