Impressive weight gain after deep brain stimulation of nucleus accumbens in treatment-resistant bulimic anorexia nervosa

BMJ Case Rep. 2020 Nov 30;13(11):e239316. doi: 10.1136/bcr-2020-239316.

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.

Keywords: eating disorders; neurosurgery; psychiatry.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anorexia Nervosa / physiopathology
  • Anorexia Nervosa / psychology
  • Anorexia Nervosa / therapy*
  • Bulimia Nervosa / psychology
  • Bulimia Nervosa / therapy*
  • Deep Brain Stimulation*
  • Electrodes, Implanted / adverse effects
  • Female
  • Humans
  • Quality of Life
  • Weight Gain*