Abstract
The treatment of obesity and eating disorders such as binge-eating disorder or anorexia nervosa is challenging. Besides lifestyle changes and pharmacological options, bariatric surgery represents a well-established and effective-albeit invasive-treatment of obesity, whereas for binge-eating disorder and anorexia nervosa mostly psychotherapy options exist. Deep brain stimulation (DBS), a method that influences the neuronal network, is by now known for its safe and effective applicability in patients with Parkinson’s disease. However, the use does not seem to be restricted to these patients. Recent preclinical and first clinical evidence points towards the use of DBS in patients with obesity and eating disorders as well. Depending on the targeted area in the brain, DBS can either inhibit food intake and body weight or stimulate energy intake and subsequently body weight. The current review focuses on preclinical and clinical evidence of DBS to modulate food intake and body weight and highlight the different brain areas targeted, stimulation protocols applied and downstream signaling modulated. Lastly, this review will also critically discuss potential safety issues and gaps in knowledge to promote further studies.
Highlights
More than 35% of men and women are overweight or obese [1]
It was shown that the medial shell of the nucleus accumbens (NAcc) as part of the reward circuitry is involved in the regulation of food intake [47]
A circadian shift of food intake was observed with an increase of food intake during the light phase and a reduction of food intake during the dark phase without alterations in 24-hour food consumption [34]. These results show that Deep brain stimulation (DBS) of the NAcc medial shell exerts a rapid onset effect on food intake
Summary
More than 35% of men and women are overweight or obese [1]. Overweight is defined by a body mass index (BMI; kg/m2 ) between 25–30 kg/m2 , whereas obese subjects have a BMI of more than. Since DBS is known to influence the neuronal network, it is tested in various other diseases, including Tourette’s syndrome [25,26], epilepsy [27,28], depression [29,30] or in the treatment of obesity and eating disorders [31,32,33]. Since the treatment of obesity and eating disorders is challenging as described above, new approaches are desired to modulate food intake and body weight. We will discuss the effects of DBS on food intake and body weight in animal studies and will describe studies that performed DBS in patients with obesity or eating disorders as well as other diseases that might pave the way for a prospective application of DBS in the treatment of eating disorders. Hurdles and gaps in knowledge will be highlighted to promote further research in this lively field
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