Document Detail


Neurosurgical Treatment of Anorexia Nervosa: Review of the Literature from Leucotomy to Deep Brain Stimulation.
MedLine Citation:
PMID:  23873668     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
Authors:
Nir Lipsman; D Blake Woodside; Peter Giacobbe; Andres M Lozano
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-7-19
Journal Detail:
Title:  European eating disorders review : the journal of the Eating Disorders Association     Volume:  -     ISSN:  1099-0968     ISO Abbreviation:  Eur Eat Disord Rev     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-7-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9436977     Medline TA:  Eur Eat Disord Rev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
Affiliation:
Division of Neurosurgery, University Health Network, University of Toronto, Toronto, ON, Canada.
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