Braeutigam Sven, Scaife Jessica Clare, Aziz Tipu, Park Rebecca J
Oxford Centre for Human Brain Activity, Medical Sciences Division, University of Oxford, Oxford, United Kingdom.
Wellcome Centre For Integrative Neuroimaging, Medical Sciences Division, University of Oxford, Oxford, United Kingdom.
Front Behav Neurosci. 2022 May 18;16:841843. doi: 10.3389/fnbeh.2022.841843. eCollection 2022.
Anorexia Nervosa (AN) is a debilitating psychiatric disorder characterized by the relentless pursuit of thinness, leading to severe emaciation. Magnetoencephalography (MEG)was used to record the neuronal response in seven patients with treatment-resistant AN while completing a disorder-relevant food wanting task. The patients underwent a 15-month protocol, where MEG scans were conducted pre-operatively, post-operatively prior to deep brain stimulation (DBS) switch on, twice during a blind on/off month and at protocol end. Electrodes were implanted bilaterally into the nucleus accumbens with stimulation at the anterior limb of the internal capsule using rechargeable implantable pulse generators. Three patients met criteria as responders at 12 months of stimulation, showing reductions of eating disorder psychopathology of over 35%. An increase in alpha power, as well as evoked power at latencies typically associated with visual processing, working memory, and contextual integration was observed in ON compared to OFF sessions across all seven patients. Moreover, an increase in evoked power at P600-like latencies as well as an increase in γ-band phase-locking over anterior-to-posterior regions were observed for high- compared to low-calorie food image only in ON sessions. These findings indicate that DBS modulates neuronal process in regions far outside the stimulation target site and at latencies possibly reflecting task specific processing, thereby providing further evidence that deep brain stimulation can play a role in the treatment of otherwise intractable psychiatric disorders.
神经性厌食症（AN）是一种使人衰弱的精神障碍，其特征是对瘦身的不懈追求，导致严重消瘦。在7名难治性AN患者完成与疾病相关的食物渴望任务时，使用脑磁图（MEG）记录神经元反应。这些患者接受了为期15个月的方案，在术前、术前深部脑刺激（DBS）开启前、在一个盲法开/关月期间进行两次以及在方案结束时进行MEG扫描。使用可充电植入式脉冲发生器将电极双侧植入伏隔核，并在内囊前肢进行刺激。3名患者在刺激12个月时符合反应者标准，饮食失调精神病理学减少超过35%。与所有7名患者的关闭期相比，开启期观察到α功率增加，以及在通常与视觉处理、工作记忆和情境整合相关的潜伏期的诱发功率增加。此外，仅在开启期，与低热量食物图像相比，高热量食物图像在P600样潜伏期的诱发功率增加，以及前后区域的γ波段锁相增加。这些发现表明，DBS调节刺激靶点以外区域的神经元过程，且潜伏期可能反映任务特定处理，从而进一步证明深部脑刺激可在治疗其他难治性精神障碍中发挥作用。
