CorrespondenceImprovements in Anorexia Symptoms After Deep Brain Stimulation for Intractable Obsessive-Compulsive Disorder
Section snippets
Case Report
The patient, a 52-year-old woman, had childhood-onset OCD. Symptoms included contamination obsessions and perfectionism. Compulsions included washing herself and inanimate objects, checking, and ordering/arranging. She completed high school with great difficulty. She had a few jobs but was unable to be employed long-term due to her severe OCD. Before surgery, OCD symptoms occupied most of her waking hours (Yale–Brown Obsessive Compulsive Scale severity score presurgery was 32). Extensive prior
Discussion
Reduction in residual AN symptoms occurred after DBS targeting the ventral portion of the left anterior limb of the internal capsule (part of the ventral capsule/ventral striatum target). This patient showed long-term reductions in her concerns about eating food and decreased concerns about weight gain. The only similar prior report found lasting remission of chronic AN after DBS to subgenual white matter, a target developed for major depression (12). Postimplantation electrode mapping
References (23)
- et al.
What is the association between obsessive-compulsive disorder and eating disorders?
Clin Psychol Rev
(2009) - et al.
Neurosurgery for intractable obsessive-compulsive disorder and depression: Critical issues
Neurosurg Clin N Am
(2003) - et al.
Towards a neurocircuitry in anorexia nervosa: Evidence from functional neuroimaging studies
J Psychiatr Res
(2009) - et al.
Functional topography of the ventral striatum and anterior limb of the internal capsule determined by electrical stimulation of awake patients
Clin Neurophysiol
(2009) - et al.
Increased neural processing of rewarding and aversive food stimuli in recovered anorexia nervosa
Biol Psychiatry
(2011) - et al.
Compulsivity predicts fronto striatal activation in severely anorectic individuals
Neuroscience
(2011) - et al.
Spatiotemporal dynamics of the hedonic processing of chocolate images in individuals with and without trait chocolate craving
Appetite
(2012) - et al.
Review of the prevalence and incidence of eating disorders
Int J Eating Disord
(2003) Anorexia nervosa: Current status and future directions
Annu Rev Med
(2010)- et al.
Update on course and outcome in eating disorders
Int J Eating Disord
(2010)
A case of anorexia nervosa treated successfully by leucotomy
Am J Psychiatry 1952;109
Cited by (61)
Deep brain stimulation for psychiatric disorders and behavioral/cognitive-related indications: Review of the literature and implications for treatment
2022, Journal of the Neurological SciencesCerebral—deep
2022, Essential NeuromodulationModern neurosurgical techniques for psychiatric disorders
2022, Progress in Brain ResearchCitation Excerpt :Many patients with severe anorexia nervosa suffer from comorbid mental conditions, such as MDD, OCD, and anxiety (Herpertz-Dahlmann, 2015; Treasure et al., 2010). Some reports on DBS for MDD or OCD in patients with concurrent anorexia nervosa demonstrated improvement of its manifestations (Blomstedt et al., 2017; Israël et al., 2010; McLaughlin et al., 2013). In particular, Israël et al. (2010) described such clinical scenario in a patient with MDD, and noted that after DBS of subgenual cingulate the symptoms of depression and anorexia nervosa decreased and over 3-year follow-up the body mass index (BMI) normalized.
Deep brain stimulation in the management of paediatric neuropsychiatric conditions: Current evidence and future directions
2021, European Journal of Paediatric NeurologyNeuromodulation in Anorexia Nervosa
2018, Neuromodulation: Comprehensive Textbook of Principles, Technologies, and Therapies, Second Edition: Volume 1-3DeltaFosB and Preclinical Binge Eating: Implications for Clinical Contextual Applications
2023, Eating Disorders: Volume 1,2