Deep brain stimulation in the treatment of obesity

被引:104
作者
Halpern, Casey H. [1 ]
Wolf, John A. [3 ]
Bale, Tracy L. [2 ]
Stunkard, Albert J. [3 ,5 ]
Danish, Shabbar F. [1 ]
Grossman, Murray [4 ]
Jaggi, Jurg L. [1 ]
Grady, M. Sean [1 ]
Baltuch, Gordon H. [1 ]
机构
[1] Univ Penn, Sch Med, Dept Neurosurg, Philadelphia, PA 19104 USA
[2] Univ Penn, Sch Med, Dept Neurosci, Philadelphia, PA 19104 USA
[3] Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA
[4] Univ Penn, Sch Med, Dept Neurol, Philadelphia, PA 19104 USA
[5] Univ Penn, Sch Med, Ctr Weight Eating Disorders, Philadelphia, PA 19104 USA
关键词
deep brain stimulation; hypothalamus; obesity; nucleus accumbens; reward;
D O I
10.3171/JNS/2008/109/10/0625
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Obesity is a growing global health problem frequently intractable to Current treatment options. Recent evidence suggests that deep brain stimulation (DBS) may be effective and safe in the management of various, refractory neuropsychiatric disorders, including obesity. The authors review the literature implicating various neural regions in the pathophysiology of obesity, its well as the evidence supporting these regions as targets for DBS, in order to explore the therapeutic promise of DBS in obesity. The lateral hypothalamus and ventromedial hypothalamus are the appetite and satiety centers in the brain, respectively. Substantial data support targeting these regions with DBS for the purpose of appetite suppression and weight loss. However, reward sensation associated with highly caloric food has been implicated in overconsumption as well as obesity, and may in part explain the failure rates of conservative management and bariatric surgery. Thus, regions of the brain's reward circuitry, Such its the nucleus accumbens. are promising alternatives for DBS in obesity control. The authors conclude that deep brain stimulation should be strongly considered as a promising therapeutic option for patients Suffering from refractory obesity.
引用
收藏
页码:625 / 634
页数:10
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