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Case report
Impressive weight gain after deep brain stimulation of nucleus accumbens in treatment-resistant bulimic anorexia nervosa
  1. Isabel Fernandes Arroteia1,
  2. Andreas Husch2,
  3. Mehri Baniasadi2 and
  4. Frank Hertel1,2
  1. 1Department of Neurosurgery, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
  2. 2Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
  1. Correspondence to Dr Isabel Fernandes Arroteia; isfernan{at}outlook.com

Abstract

Anorexia nervosa (AN) severely impacts individual’s mental and physical health as well as quality of life. In 21% of cases no durable response to conservative treatment can be obtained. The serious course of the disease in the most severely affected patients justifies invasive treatment options. One of the treatment methods increasingly used in recent years is deep brain stimulation (DBS). A 42-year-old woman suffering from chronic AN of the bulimic subtype shows a 46.9% weight gain and a subjective increase in quality of life, 12 months after bilateral nucleus accumbens (NAcc) DBS implantation. No improvement in comorbid depression could be achieved. DBS of the NAcc is a treatment option to be considered in severe AN when conventional treatment modalities recommended by evidence-based guidelines have not been able to bring lasting relief to the patient’s suffering.

  • neurosurgery
  • eating disorders
  • psychiatry

https://doi.org/10.1136/bcr-2020-239316

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    Footnotes

    • Twitter @IArroteia

    • Contributors IFA contributed to review of literature, reconstruction of electrode position and VTA using lead DBS v2 software (Figure 1), close follow-up of the patient, adaptation of stimulation parameters. AH involved in article revision, IT support for the use of lead DBS v2 software and Simbio/Fieldtrip Model for the reconstruction of electrode positioning and VTA. MB contributed to IT support in use of FastField software and article revision. FH is the Chair of the Neurosurgical Department of the Centre Hospitalier de Luxembourg and guarantor of the case report. FH monitored data collection, review of literature and writing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.