Neurosurgical treatment of anorexia nervosa: review of the literature from leucotomy to deep brain stimulation.
Eur Eat Disord Rev
; 21(6): 428-35, 2013 Nov.
Article
em En
| MEDLINE
| ID: mdl-23873668
ABSTRACT
This paper reviews the literature on the surgical treatment of refractory anorexia nervosa (AN) and examines how this literature can inform current circuit models of the disease. The literature contains reports of 35 patients undergoing a neurosurgical procedure for the specific treatment of refractory AN, with the first reported operation, a lobotomy, in 1950. All patients were deemed treatment resistant according to contemporary standards, with the nature of the procedure changing with evolving surgical techniques and methods. All procedures targeted the limbic system and, in a majority of cases, were associated with reported symptomatic improvement. Neurosurgery in AN has been, and continues to be, reserved for patients with chronic and life-threatening illness, for whom conventional treatment has failed. Early procedures, which were viewed as life-saving measures, were crude by today's standards but targeted anatomic structures and pathways implicated in modern models of AN. The last decade has seen a concerted effort in elucidating the neurocircuitry underlying prominent etiologic and maintaining factors in AN, including mood, anxiety and dysfunctional reward processing. This has translated into the development of novel, focused therapeutic options for patients with treatment-refractory AN.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Anorexia Nervosa
/
Procedimentos Neurocirúrgicos
/
Estimulação Encefálica Profunda
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Eur Eat Disord Rev
Assunto da revista:
CIENCIAS DA NUTRICAO
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Canadá