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The insertion of electrodes into the deep areas of the patient's brain, ie using deep brain stimulation, can be an effective technique in the treatment of the patient. ;anorexia nervosa. This is being studied by a team from the Hospital del Mar (Catalonia, Spain) led by neurosurgeons and psychiatrists from the center. Until now, they used this technique with four patients. All recover without complications due to surgery or brain stimulation. The response to treatment varies depending on the person.
Surgery involves placing electrodes in a certain area of the brain, in the subcallular region or in the nucleus accumbens, which is chosen according to the characteristics of the patient. To do this, a robot is used, the Rosa robot, which allows neurosurgeons to control the point where they are at any time. The selected cerebral points do not stimulate hunger, but stimulate them, they want to improve the functioning of the brain circuits that control mood, anxiety and motivation mechanism and reward and, therefore, take weight.
This is a precision intervention, which requires extensive planning and prior work, using a specific computer planning program. During the procedure, the battery that will send the stimulus to the electrodes is also inserted under the patient's skin. This is a reversible and adjustable technique, as Dr. Glòria Villalba, the neurosurgeon responsible for the project, explains.
"The risk involved in surgery is low, so it can be badumed in patients who are very serious and do not have any other type of treatment possible." Therefore, we think that this compensates for participating in the study, "says the neurosurgeon.
This type of intervention addresses certain patients. Before being operated, they are selected in collaboration with the Institute of Food Trastorns (ITA). They are sick with a long history, with more than 10 years of evolution, and in which other conventional treatments have failed. Their weight must be less than a body mbad index (BMI) of 16, but greater than 13.
Patients with anorexia nervosa often suffer from secondary psychiatric disorders. As noted by Dr. Víctor Pérez, Chief of the Hospital Psychiatry Department and Director of the Institute of Neuropsychiatry and Addiction, these types of disorders have comorbidities, the most common being "depression and obsessive-compulsive disorder" . demonstrated the effectiveness of deep brain stimulation. "
This technique has been used for years as a technique in neurosurgery to treat pathologies such as Parkinson's disease, tremor or dystonia.But in anorexia nervosa, it has not been used only in some cases in Canada and China and is currently being studied in Europe The Hospital del Mar project is the first on the continent and is funded by a grant from the Health Research Fund (FIS) and Cibersam from the Ministry of Health In the case where the results are positive, this technique will be incorporated into the service portfolio of the Department of Neurosurgery of the Hospital del Mar and Hospital Santa Creu in Sant Pau.
In three Of the four cases treated This technique, three women and one man, had a variable but positive response.The first two patients, operated on a year ago, have already completed the study.At the same time, Dr. Villalba stresses that the p Athologies badociated with anorexia have also improved.
"In addition to responding by weight, we also observed a positive response to the badociated problems in these patients, such as depression, anxiety, and obsessions.The first patient treated acknowledged that" with treatment, you learn that the disease does not go away, but that you learn to yield, and that involves improvements not only in weight, but also in mood and anxiety. "
case, which has crossed the operating room in November 2017, still has not responded, although it is proven that they can take up to a year to respond, and in the last one , intervened last April, the evolution is very positive.In spite of this, it is still too early to say whether the intervention has reached the same level of success.
Anorexia Nervosa is a eating disorder that is characterized by abnormally low body weight, distorted perception by the patient's own weight and an intense fear of increasing it. It can cause various health problems, dizziness, fatigue, alterations in blood tests, fragile hair, osteoporosis, and, in women, menstrual withdrawal, among others. At the same time, it affects their personal, social and professional lives and, in extreme cases, causes the death of the patient.
It is the third most prevalent disease among adolescents, since the age of onset is between 13 and 18 years old It affects one in every 100 young people between these ages, especially women (five to ten percent of those affected are men). In the state, it is estimated that the allocation of eating disorders is less than five percent in the teenage population. This includes anorexia, which affects 0.3% of the female population aged 12 to 21 years.
Anorexia is the mental illness that has the highest mortality and morbidity rate. 30% of cases become chronic and do not respond to any treatment and patients have a high rate of suicide.
Source: Hospital del Mar .-
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