Percutaneous Electrical Neurostimulation (PENS) of Dermatome T6 with an Ambulatory Self-applied Patch vs PENS of Dermatome T6 with Conventional Procedure: Effect on Appetite and Weight Loss in Moderately Obese Patients

Abstract

Background

The percutaneous electrical neurostimulation (PENS) of dermatome T6 has emerged as an effective treatment for appetite reduction and weight loss, allowing a better compliance of hypocaloric diets. The main drawback of this approach is the need of attendance to the sanitary institution weekly during 3 months.

Methods

A prospective, randomized study was performed. The patients were randomized into three groups: those undergoing conventional PENS of dermatome T6 associated with a 1200 kcal diet (group 1), those undergoing PENS of dermatome T6 with a self-applied patch associated with diet (group 2), and those following only a 1200 kcal diet (group 3).

Results

One hundred thirty-five patients were included in the study, 45 in each group, 51 males, and 81 females with a mean age of 54.5 years and BMI 35.9 kg/m². The median pain perception in group 1 was 1 (range 0–2), while in group 2, it was 4 (range 2–7) (p = 0.024). Seven patients of group 2 abandoned the treatment because the self-application of the patch was painful. Excess weight loss was 32.7 % in group 1, 3.2 % in group 2, and 2.6 % in group 3 (p = 0.001). Appetite, as measured by VAS, decreased from 6 to 1.5 in group 1, while in the other groups remained similar (p = 0.001).

Conclusions

Conventional PENS of dermatome T6 is associated with an appetite reduction and, along with a proper diet, achieved a significantly greater weight reduction compared to diet alone in morbidly obese patients. PENS of dermatome T6 performed with a self-applied patch failed to demonstrate any effect on appetite and weight loss. Moreover, the self-application therapy was associated with a significantly greater pain, reducing the compliance of the therapy.