Outcomes of Deep Brain Stimulation on Adolescent and Adult Women with Refractory Anorexia Nervosa

Abstract

Background: Anorexia nervosa is a psychosomatic disease that affects many women worldwide. It is commonly associated with comorbidities and has the highest mortality rate of any mental illness. Current treatments are often insufficient in treating this disease and frequently fail to improve the health and quality of life of these women. Deep brain stimulation (DBS) is an established treatment for neurological movement disorders and is emerging as a treatment for psychological disorders similar to anorexia. Due to this similarity, DBS may be an option for treating these women who fail other treatments. This review looks at the outcomes of DBS as a treatment for anorexia nervosa. Methods: An exhaustive search of available medical literature was conducted using Medline-OVID, CINAHL, and Web of Science using the keywords: deep brain stimulation, anorexia nervosa, and female. Relevant articles were assessed for quality using GRADE. Results: Through screening, three studies were found that fit the criteria for this review. This included three observational studies. All three showed improved outcomes in the majority of subjects and demonstrated the relative safety of the procedure. Outcomes included body mass index (BMI), vital signs, anxiety, depression, obsessive-compulsion, quality of life, intelligence, memory, social functioning, brain glucose metabolism, and adverse events associated with the surgery. Though the results of the three studies were promising, the overall quality of the studies was very low. More research is needed to demonstrate the efficacy and safety of this treatment and better understand its mechanism for treating this disorder. Conclusion: DBS may play an important role in treating anorexia nervosa that has proven refractory to standard treatments. DBS may be associated with improvement in physical symptoms, psychological outcomes, and changes in brain glucose metabolism, but more research is needed to further examine this association. Keywords: deep brain stimulation, anorexia nervosa, femal