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Deep Brain Stimulation Studied as Last-Ditch Obesity Treatment

No major side effects seen in 3 patients over nearly 3 years

WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

THURSDAY, June 13 (HealthDay News) -- For the first time, researchers have shown that implanting electrodes in the brain's "feeding center" can be safely done -- in a bid to develop a new treatment option for severely obese people who fail to shed pounds even after weight-loss surgery.

In a preliminary study with three patients, researchers found that they could safely use the therapy, known as deep brain stimulation (DBS). Over almost three years, none of the patients had any serious side effects, and two even lost some weight -- but it was temporary.

"The first thing we needed to do was to see if this is safe," said lead researcher Dr. Donald Whiting, vice chairman of neurosurgery at Allegheny General Hospital in Pittsburgh. "We're at the point now where it looks like it is."

The study, reported in the Journal of Neurosurgery and at a meeting this week of the International Neuromodulation Society in Berlin, Germany, was not meant to test effectiveness.

So the big remaining question is, can deep brain stimulation actually promote lasting weight loss?

"Nobody should get the idea that this has been shown to be effective," Whiting said. "This is not something you can go ask your doctor about."

Right now, deep brain stimulation is sometimes used for tough-to-treat cases of Parkinson's disease, a movement disorder that causes tremors, stiff muscles, and balance and coordination problems. A surgeon implants electrodes into specific movement-related areas of the brain, then attaches those electrodes to a neurostimulator placed under the skin near the collarbone.

The neurostimulator continually sends tiny electrical pulses to the brain, which in turn interferes with the abnormal activity that causes tremors and other symptoms.

What does that have to do with obesity? In theory, Whiting explained, deep brain stimulation might be able to "override" brain signaling involved in eating, metabolism or feelings of fullness. Research in animals has shown that electrical stimulation of a particular area of the brain -- the lateral hypothalamic area -- can spur weight loss even if calorie intake stays the same.

The new study marks the first time that deep brain stimulation has been tried in that brain region. And it's an important first step to show that not only could these three severely obese people get through the surgery, but they also seemed to have no serious effects from the brain stimulation, said Dr. Casey Halpern, a neurosurgeon at the University of Pennsylvania who was not involved in the research.

"That shows us this is a therapy that should be studied further in a larger trial," said Halpern, who has done animal research exploring the idea of using deep brain stimulation for obesity.

"Obesity is a major problem," Halpern said, "and current therapies, even gastric bypass surgery, don't always work. There is a medical need for new therapies."

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