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首页> 外文期刊>The Lancet >Subcallosal cingulate deep brain stimulation for treatment-refractory anorexia nervosa: a phase 1 pilot trial
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Subcallosal cingulate deep brain stimulation for treatment-refractory anorexia nervosa: a phase 1 pilot trial

机译：call肌扣带回深脑刺激治疗难治性神经性厌食症：1期试验

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Background Anorexia nervosa is characterised by a chronic course that is refractory to treatment in many patients and has one of the highest mortality rates of any psychiatric disorder. Deep brain stimulation (DBS) has been applied to circuit-based neuropsychiatric diseases, such as Parkinson's disease and major depression, with promising results. We aimed to assess the safety of DBS to modulate the activity of limbic circuits and to examine how this might affect the clinical features of anorexia nervosa.Methods We did a phase 1, prospective trial of subcallosal cingulate DBS in six patients with chronic, severe, and treatment-refractory anorexia nervosa. Eligible patients were aged 20-60 years, had been diagnosed with restricting or binge-purging anorexia nervosa, and showed evidence of chronicity or treatment resistance. Patients underwent medical optimisation preoperatively and had baseline body-mass index (BMI), psychometric, and neuroimaging investigations, followed by implantation of electrodes and pulse generators for continuous delivery of electrical stimulation. Patients were followed up for 9 months after DBS activation, and the primary outcome of adverse events associated with surgery or stimulation was monitored at every follow-up visit. Repeat psychometric assessments, BMI measurements, and neuroimaging investigations were also done at various intervals. This trial is registered with ClinicalTrials.gov, number NCT01476540.
机译：背景神经性厌食症的特征是许多患者难以接受治疗的慢性病，​​是所有精神病患者中死亡率最高的疾病之一。深脑刺激（DBS）已应用于基于回路的神经精神疾病，例如帕金森氏病和重度抑郁症，并取得了可喜的结果。我们旨在评估DBS调节边缘回路活动的安全性，并研究其可能对神经性厌食症的临床特征的影响。方法我们对6例慢性，重症，和治疗难治性神经性厌食症。符合条件的患者年龄在20至60岁之间，已被诊断出患有限制性或狂泻性神经性厌食症，并显示出慢性或治疗耐药性的证据。术前对患者进行了医学优化，并进行了基线身体质量指数（BMI），心理测量和神经影像检查，然后植入电极和脉冲发生器以连续输送电刺激。在DBS激活后对患者进行了9个月的随访，并在每次随访中监测了与手术或刺激相关的不良事件的主要结果。还以不同的间隔进行了重复的心理测评，BMI测量和神经影像检查。该试验已在ClinicalTrials.gov上注册，编号为NCT01476540。

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