Deep Brain Stimulation as a Treatment Approach for Anorexia Nervosa: a Systematic Literature Review

Abstract

Anorexia nervosa is a psychiatric disorder characterized by distortions of body size, weight, and shape perception, as well as by food restriction and/or binge and purging behaviors. It mostly affects young women and causes severe negative impacts on their physical, psychological, and social health. Recent studies have analyzed deep brain stimulation (DBS), a neurosurgical procedure that involves electrode implantation in strategical brain areas, to obtain remission of the symptoms of anorexia nervosa. The results showed that the stimulation of areas associated to the neurocircuitry of anorexia nervosa, such as nucleus accumbens, anterior cingulate cortex, ventral striatum, and bed nucleus of the stria terminalis, provokes beneficial responses in terms of body mass index, quality of life, social functioning, and psychiatric comorbidities. Nevertheless, broader investigations are needed to endorse the clinical usage of DBS in the management of anorexia nervosa.

Resumo

A anorexia nervosa é uma desordem psiquiátrica caracterizada pela distorção da percepção de tamanho, peso e formas corporais, bem como por restrição alimentar e/ou comportamentos excessivos e purgativos. Afeta principalmente mulheres jovens e causa grande impacto negativo sobre a sua saúde física, psicológica e social. Estudos recentes analisaram a estimulação cerebral profunda (ECP), um procedimento neurocirúrgico que envolve a implantação de eletrodos em áreas cerebrais estratégicas, como forma de obter remissão dos sintomas da anorexia nervosa. Os resultados demonstraram que a estimulação de regiões que participam da neurocircuitaria da anorexia nervosa, como núcleo accumbens, córtex do cíngulo anterior, estriato e núcleo da estria terminal, provocou respostas benéficas em termos de índice de massa corporal, qualidade de vida, funcionamento social e comorbidades psiquiátricas. No entanto, investigações mais amplas são necessárias para se recomendar a aplicação clínica da ECP no manejo da anorexia nervosa.

Keywords

anorexia nervosa - eating disorder - deep brain stimulation - neuromodulation

Palavras-chave

anorexia nervosa - desordem alimentar - estimulação cerebral profunda - neuromodulação

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