Archive for March 8th, 2013
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Mar. 6, 2013 — In a world first, a team of researchers at the Krembil Neuroscience Centre and the University Health Network have shown that Deep Brain Stimulation (DBS) in patients with chronic, severe and treatment-resistant Anorexia Nervosa (anorexia) helps some patients achieve and maintain improvements in body weight, mood, and anxiety.
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The results of this trial, entitled Deep Brain Stimulation of the Subcallosal Cingulate Area for Treatment-Refractory Anorexia Nervosa: A Phase I Pilot Trial, are published today in the medical journal The Lancet. The study is a collaboration between lead author Dr. Nir Lipsman a neurosurgery resident at the University of Toronto and PhD student at the Krembil Neuroscience Centre; Dr. Andres Lozano, a neurosurgeon, at the Krembil Neuroscience Centre of Toronto Western Hospital and a professor and chairman of neurosurgery at the University of Toronto, whose research lab was instrumental in conducting the DBS research; and Dr. Blake Woodside, medical director of Canada’s largest eating disorders program at Toronto General Hospital and a professor of psychiatry at the University of Toronto.
The phase one safety trial investigated the procedure in six patients who would likely continue with a chronic illness and/or die a premature death because of the severity of their condition. The study’s participants had an average age of 38, and a mean duration of illness of 18 years. In addition to the anorexia, all patients, except one, also suffered from psychiatric conditions such as major depressive disorder and obsessive-compulsive disorder. At the time of the study, all patients currently, or had previously, suffered multiple medical complications related to their anorexia — altogether, the six patients had a history of close to 50 hospitalizations during their illnesses.
Study participants were treated with Deep Brain Stimulation (DBS), a neurosurgical procedure that moderates the activity of dysfunctional brain circuits. Neuroimaging has shown that there are both structural and functional differences between anorexia patients and healthy controls in brain circuits which regulate mood, anxiety, reward and body-perception.
Patients were awake when they underwent the procedure which implanted electrodes into a specific part of the brain involved with emotion, and found to be highly important in disorders such as depression. During the procedure, each electrode contact was stimulated to look for patient response of changes in mood, anxiety or adverse effects. Once implanted, the electrodes were connected to an implanted pulse generator below the right clavicle, much like a heart pacemaker.
Testing of patients was repeated at one, three, and six-month intervals after activation of the pulse generator device. After a nine-month period following surgery, the team observed that three of the six patients had achieved weight gain which was defined as a body-mass index (BMI) significantly greater than ever experienced by the patients. For these patients, this was the longest period of sustained weight gain since the onset of their illness. Furthermore, four of the six patients also experienced simultaneous changes in mood, anxiety, control over emotional responses, urges to binge and purge and other symptoms related to anorexia, such as obsessions and compulsions. As a result of these changes, two of these patients completed an inpatient eating disorders program for the first time in the course of their illness.
“We are truly ushering in a new of era of understanding of the brain and the role it can play in certain neurological disorders,” says Dr. Lozano. “By pinpointing and correcting the precise circuits in the brain associated with the symptoms of some of these conditions, we are finding additional options to treat these illnesses.”
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While the treatment is still considered experimental, it is believed to work by stimulating a specific area of the brain to reverse abnormalities linked to mood, anxiety, emotional control, obsessions and compulsions all of which are common in anorexia. In some cases after surgery, patients are then able to complete previously unsuccessful treatments for the disease. The research may not only provide an additional therapy option for these patients in the future, but also furthers practitioners’ understanding of anorexia and the factors that cause it to be persistent.
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“There is an urgent need for additional therapies to help those suffering from severe anorexia,” says Dr. Woodside. “Eating disorders have the highest death rate of any mental illness and more and more women are dying from anorexia. Any treatment that could potentially change the natural course of this illness is not just offering hope but saving the lives for those that suffer from the extreme form of this condition.”
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Read in Full:
ARTICLES
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Anorexia Nervosa in Autistic Women/Disorders Are Common In Adults Who Have Had Anorexia/Milkshakes for Anorexia:
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(Health Care Advice)Anorexia:
http://healthcareadvice.org/anorexia/anorexia-nervosa-effects-on-family/
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(HelpGuide.org)Anorexia Nervosa: Signs, Symptoms, Causes, and Treatment:
http://www.helpguide.org/mental/anorexia_signs_symptoms_causes_treatment.htm
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Eating Disorders Organizations(USA):
http://www.something-fishy.org/other/organizations.php
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Eating Disorders Organizations(UK):
http://www.disordered-eating.co.uk/help-for-eating-disorders/eating-disorders-organisations-uk.html
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MGEDT – Men Get Eating Disorders Too
‘Men Get Eating Disorders Too’ is a UK based charity dedicated to representing and supporting the needs of men with eating disorders. The website provides essential information that is specific to the unique needs of men and an online space for men to get their voices heard.
http://mengetedstoo.co.uk/
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If you or a loved one has anorexia…Call the National Eating Disorders Association’s toll-free hotline at 1-800-931-2237 for free referrals, information, and advice.
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BOOKS
Anorexia Nervosa: A Survival Guide for Families, Friends and Sufferers [Paperback]
http://www.amazon.co.uk/An-Apple-Day-Recovery-ebook/dp/B0080S2A20/ref=pd_sim_kinc_4
http://www.amazon.co.uk/Mealtimes-and-Milestones-ebook/dp/B003NX6TXS/ref=pd_sim_kinc_3
http://www.amazon.co.uk/Thinspo-ebook/dp/B009R8AH2W/ref=pd_sim_kinc_3
http://www.amazon.co.uk/Thin-ebook/dp/B002RI90Q8/ref=pd_sim_kinc_4
Georgetown University is a private, Jesuit, research university whose main campus is in the Georgetown neighborhood of Washington, D.C. Founded in 1789, it is the oldest Catholic university in the United States. Georgetown administers 180 academic programs in four undergraduate and three graduate and professional schools, and the programs in international affairs and law are particularly selective and well regarded. In addition to its main campus, renowned for the neo-Romanesque Healy Hall, Georgetown operates a law center on Capitol Hill, as well as auxiliary campuses in Italy, Turkey, and Qatar.
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Last month saw the annual two-week frenzy of student government campaigning at Georgetown University, where candidates plaster campus with fliers and organize campaign talks in hopes of winning enough student support to be elected President and Vice President of the student body. After the candidates held a forum on racial diversity at the Black House and addressed women’s issues and feminism in a separate event, I noticed that the four campaign websites all included discussion of social justice, pluralism, and diversity in the candidates’ platforms, but not one of them addressed disability issues.Â
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As a disabled student, I was disappointed that the issues that would directly affect me were going unaddressed in the campus debates, and so I wrote a six item questionnaire on disability issues specific to Georgetown that I posted to Facebook and emailed to the candidates. I asked candidates how they would advocate for Georgetown to be more accessible to students with all types of disabilities, how they would address a stigmatizing environment toward disabled people, what they would do to support my initiative to form a Disability Cultural Center, and how they would include disabled students in campus leadership and in discussions on disability.
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Of the five candidate pairs, four sent written responses to the questionnaire; three thanked me for compiling and distributing it; and the largest campus newspaper, The Hoya, published an article on the disability questionnaire and the candidates’ responses.
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I would never have thought to contact the student government candidates directly had it not been for the training on campus organizing and coalition building that I received during Autism Campus Inclusions’s summer leadership academy last August. If you’re interested in making real change on your campus, you should apply for ACI too.
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– Lydia Brown, Autism Campus Inclusion 2012 Graduate
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