Some women with severe anorexia have returned to a healthy weight and feel less anxious and depressed after having electrical devices implanted into their brains, according to a small study. But more research is needed before the treatment can be recommended for wider use.
About one in five people with anorexia nervosa, who are mostly women, die of the illness and there is a lack of effective treatments. Imaging studies suggest that certain brain circuits may underlie the fear of gaining weight and compulsion to self-starve.
Bomin Sun at Shanghai Jiao Tong University School of Medicine in China and his colleagues wondered whether they could disrupt these circuits by electrically stimulating a part聽of聽the brain known as the nucleus accumbens. This brain region helps us to learn from experience, but in people with anorexia it seems to form abnormal connections with other聽brain regions.
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The team recruited 28 women with at least a three-year history of anorexia who hadn鈥檛 improved following standard treatment. The women had an average body mass index (BMI) of 13; a BMI of less than 18.5 is considered underweight. The researchers surgically implanted electrodes into the nucleus accumbens on both sides of the women鈥檚 brains. They connected the electrodes by wires to a battery inserted beneath the collarbone, to continuously stimulate the nucleus accumbens.
Over the next two years, the average BMI of the participants increased to 18 and almost half regained a BMI of 18.5 or above. They also reported feeling fewer anxiety and depression symptoms and experiencing less of an effect on their social lives.
Placebo effect?
鈥淭his is a very promising result,鈥澛爏ays Philip Mosley at QIMR聽Berghofer Medical Research Institute in Australia. But the study didn鈥檛 include a placebo group for comparison, meaning it isn鈥檛 possible to rule out that the participants鈥� improvement was simply because they expected the treatment to work, says Mosley.
He and his colleagues are about聽to launch a trial of the same聽treatment in which they will聽control for the placebo effect. They will implant electrodes into聽the nucleus accumbens of 10聽people with severe anorexia, but聽for the first four months, only聽half will have the electrodes switched on. Participants won鈥檛 know if their electrodes are on or聽off. If the improvement is greater when the electrodes are on, it will make it easier to tell if the treatment is working.
Brain surgery may seem like an extreme treatment, but for people with severe anorexia, it may be better than the alternative, which is often death, says Mosley.
鈥淎norexia has the highest mortality rate of any psychiatric illness 鈥� it鈥檚 an astonishingly sinister disease,鈥� he says. 鈥淲e hope this treatment will help some people who are at the sickest end聽of the scale and had years of聽suffering and tried all other evidence-based treatments.鈥� 鉂�
Brain Stimulation
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