Acta Neurochirurgica

, Volume 153, Issue 12, pp 2293–2306

Expanding applications of deep brain stimulation: a potential therapeutic role in obesity and addiction management

  • Casey H. Halpern
  • Napoleon Torres
  • Howard I. Hurtig
  • John A. Wolf
  • James Stephen
  • Michael Y. Oh
  • Noel N. Williams
  • Marc A. Dichter
  • Jurg L. Jaggi
  • Arthur L. Caplan
  • Kyle M. Kampman
  • Thomas A. Wadden
  • Donald M. Whiting
  • Gordon H. Baltuch
Review Article

DOI: 10.1007/s00701-011-1166-3

Cite this article as:
Halpern, C.H., Torres, N., Hurtig, H.I. et al. Acta Neurochir (2011) 153: 2293. doi:10.1007/s00701-011-1166-3

Abstract

Background

The indications for deep brain stimulation (DBS) are expanding, and the feasibility and efficacy of this surgical procedure in various neurologic and neuropsychiatric disorders continue to be tested. This review attempts to provide background and rationale for applying this therapeutic option to obesity and addiction. We review neural targets currently under clinical investigation for DBS—the hypothalamus and nucleus accumbens—in conditions such as cluster headache and obsessive-compulsive disorder. These brain regions have also been strongly implicated in obesity and addiction. These disorders are frequently refractory, with very high rates of weight regain or relapse, respectively, despite the best available treatments.

Methods

We performed a structured literature review of the animal studies of DBS, which revealed attenuation of food intake, increased metabolism, or decreased drug seeking. We also review the available radiologic evidence in humans, implicating the hypothalamus and nucleus in obesity and addiction.

Results

The available evidence of the promise of DBS in these conditions combined with significant medical need, support pursuing pilot studies and clinical trials of DBS in order to decrease the risk of dietary and drug relapse.

Conclusions

Well-designed pilot studies and clinical trials enrolling carefully selected patients with obesity or addiction should be initiated.

Keywords

Deep brain stimulationObesityBinge eatingAddictionHypothalamusNucleus accumbens

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Casey H. Halpern
    • 1
  • Napoleon Torres
    • 6
  • Howard I. Hurtig
    • 3
  • John A. Wolf
    • 1
  • James Stephen
    • 1
  • Michael Y. Oh
    • 5
  • Noel N. Williams
    • 8
  • Marc A. Dichter
    • 3
    • 8
  • Jurg L. Jaggi
    • 1
  • Arthur L. Caplan
    • 4
  • Kyle M. Kampman
    • 2
  • Thomas A. Wadden
    • 7
  • Donald M. Whiting
    • 5
  • Gordon H. Baltuch
    • 1
  1. 1.Department of Neurosurgery, Center for Functional and Restorative NeurosurgeryHospital of the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Psychiatry, Center for Studies of AddictionHospital of the University of PennsylvaniaPhiladelphiaUSA
  3. 3.Department of NeurologyHospital of the University of Pennsylvania, Neuroscience Graduate GroupPhiladelphiaUSA
  4. 4.Department of Medical EthicsHospital of the University of PennsylvaniaPhiladelphiaUSA
  5. 5.Department of NeurosurgeryAllegheny General HospitalPittsburghUSA
  6. 6.Département: DRT/DTBS/SBSC/DIR CEA-LETICEA-LETI, CLINATECGrenobleFrance
  7. 7.Department of Psychiatry, Center for Studies of Weight and Eating DisordersHospital of the University of PennsylvaniaPhiladelphiaUSA
  8. 8.Department of Surgery, Division of Bariatric Surgery, Center for Studies of Weight and Eating DisordersHospital of the University of PennsylvaniaPhiladelphiaUSA