Elsevier

Biological Psychiatry

Volume 73, Issue 9, 1 May 2013, Pages e29-e31
Biological Psychiatry

Correspondence
Improvements in Anorexia Symptoms After Deep Brain Stimulation for Intractable Obsessive-Compulsive Disorder

https://doi.org/10.1016/j.biopsych.2012.09.015Get rights and content

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

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      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.

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