Nucleus accumbens stimulation in pathological obesity

Abstract

One of the potential treatment methods of obesity is deep brain stimulation (DBS) of nucleus accumbens. We describe the case of 19 years old woman with hypothalamic obesity. She weighted 151.4 kg before DBS and the non-surgical methods proved to be inefficient. She was treated with implantation of DBS electrode to nucleus accumbens bilaterally. Results were measured with body mass index and neuropsychological tests. Follow-up was 14 months. Fourteen months after surgery weight was 138 kg, BMI was 48.3. Neuropsychological test results were intact. The presented case supports the thesis of treatment of obesity with nucleus accumbens stimulation.

Cognitive and neuromodulation strategies for unhealthy eating and obesity: Systematic review and discussion of neurocognitive mechanisms

“…This scale assesses methodological rigor in alignment with the criteria of the Preferred Reporting Items for Systematic Reviews and Meta Analyses-P 2015 recommendations, the Cochrane collaboration criteria and the PEDro guidelines (Bahar-Fuchs et al, 1996;de Morton, 2009;Shamseer et al, 2015). We did not include case reports in this quality assessment (Harat et al, 2016;Whiting et al, 2013).…”

Current and future directions of deep brain stimulation for neurological and psychiatric disorders

“…The NAc has also been studied as a potential DBS target to reduce the reward of eating, with some success. 40,61 Other theoretical targets include the medial and lateral orbitofrontal cortex, medial prefrontal cortex, ventral pallidum, caudate, insula, anterior cingulate cortex (ACC), amygdala, putamen, and hippocampus. 55 Similar to other DBS indications, early evidence for DBS treatment originated from the benefits of lesioning procedures, such as leukotomy, 65,69 thalamotomy, 91 and capsulotomy for anorexia nervosa.…”

Innovative solutions in bariatric surgery

“…At the same time, neuropsychological tests results were intact. The technical problems with stimulating device in this patient were uncontrolled periods of switching the stimulator off, which needed correction during follow-up visits (27). Other experiences with deep brain stimulation for obesity are very limited (26).…”