Matteo Manuelli1, Andrea Franzini2,3, Roberta Galentino2, Roberta Bidone2, Bernardo Dell'Osso4,5,6, Mauro Porta2, Domenico Servello2, Hellas Cena7,8. 1. Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy. m.manuelli88@gmail.com. 2. IRCCS Orthopedic Institute Galeazzi, Tourette's Syndrome and Movement Disorders Centre, Milan, Italy. 3. Department of Neurological Surgery, University of Virginia Health Science Center, Charlottesville, VA, USA. 4. Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. 5. Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA, USA. 6. CRC "Aldo Ravelli" for Neuro-technology and Experimental Brain Therapeutics, University of Milan, Milan, Italy. 7. Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy. 8. Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy.
Abstract
PURPOSE: The purpose of this study was to evaluate changes in the nutritional status, body image concerns, and eating behaviors occurring in a patient who underwent deep brain stimulation (DBS) of the bed nucleus of the stria terminalis for treatment-refractory anorexia nervosa (AN). METHODS: Bilateral DBS of the bed nucleus of the stria terminalis was performed in a 37-year-old woman affected by refractory AN. Pre- and post-surgical evaluations were conducted via an array of validated testing instruments, which took into account the weight variations, body image concerns, eating behavior, quality of life, and nutritional status. RESULTS: Overall, eating behavior-, body image concern-, and nutritional status-related testing instruments demonstrated improvements starting from the first post-operative month. Normal body weight was restored after 4 months of stimulation. DISCUSSION: Only a few cases of DBS for AN have been conducted to determine the efficacy of surgery based upon weight variation and psychometric scales for anxiety and affective disorders. In contrast, we have designed a comprehensive approach taking into account the most important aspects of this disease. This approach should be considered in future studies dealing with the neurosurgical treatment of AN.
PURPOSE: The purpose of this study was to evaluate changes in the nutritional status, body image concerns, and eating behaviors occurring in a patient who underwent deep brain stimulation (DBS) of the bed nucleus of the stria terminalis for treatment-refractory anorexia nervosa (AN). METHODS: Bilateral DBS of the bed nucleus of the stria terminalis was performed in a 37-year-old woman affected by refractory AN. Pre- and post-surgical evaluations were conducted via an array of validated testing instruments, which took into account the weight variations, body image concerns, eating behavior, quality of life, and nutritional status. RESULTS: Overall, eating behavior-, body image concern-, and nutritional status-related testing instruments demonstrated improvements starting from the first post-operative month. Normal body weight was restored after 4 months of stimulation. DISCUSSION: Only a few cases of DBS for AN have been conducted to determine the efficacy of surgery based upon weight variation and psychometric scales for anxiety and affective disorders. In contrast, we have designed a comprehensive approach taking into account the most important aspects of this disease. This approach should be considered in future studies dealing with the neurosurgical treatment of AN.
Entities:
Keywords:
Anorexia nervosa; Body image; Deep brain stimulation; Nutritional assessment; Surgical approach
Authors: Lora Kahn; Brianne Sutton; Helena R Winston; Aviva Abosch; John A Thompson; Rachel A Davis Journal: Front Psychiatry Date: 2021-03-24 Impact factor: 4.157