WOMEN
03/08/2013 12:43 pm ET

Deep Brain Stimulation For Anorexia Trial Shows Promise

At 36, Kim Rollins has already suffered a massive heart attack and several strokes. She has osteoporosis in her spine and hips, and has broken her legs a total of eight times, all the result of severe anorexia she has grappled with for more than 20 years. She once shrunk to a low of 71 pounds.

Rollins has tried to get help, entering inpatient programs 10 or 11 times, she told HuffPost, but treatment never worked until doctors implanted a device similar to a pacemaker into her brain -- an experiment they hoped would help modulate the brain circuits that relate to her illness. Within one month, Rollins' mood was brighter.

"[It was] a lifting feeling ... a lifting of darkness," she said. For the first time, she found success in an inpatient treatment program and now maintains a healthy weight for her body.

The results from a preliminary trial of deep brain stimulation in six women with persistent, life threatening anorexia found the treatment is generally safe and might also have significant benefits in individuals who have struggled for years to get better. Nine months after treatment, half of the patients, including Rollins, maintained a higher body mass index.

"This is phase 1 of the trial, which means our main objective was to establish the safety of deep brain stimulation in patients," lead author Dr. Nir Lipsman, a neurosurgery resident at the Krembil Neuroscience Centre in Toronto told HuffPost. "These patients were sick for a very long time, and they were still quite sick, so it was never a forgone conclusion that this would be safe."

Several of the patients had side effects, including pain and nausea, and one patient had a seizure, but that was the only serious adverse reaction. Further, Lipsman said he and his colleagues were pleased to see that the treatment also appeared to help several, though not all, of the patients.

Deep brain stimulation (DBS) has been used to help treat Parkinson's disease and severe depression, but the new trial is the first to assess its safety among patients with anorexia. The results were published in the scientific journal The Lancet on Wednesday.

"The underlying principal of DBS, how exactly it works in the brain, is still under active investigation," said Lipsman. "We believe it works by resetting and regulating the activity of circuits in the brain." Doctors implant electrodes along those brain circuits, as well as other areas in the brain, in an attempt to reset them.

The six women in the trial were between 24 and 57, and had been struggling with anorexia for between four and 37 years. Doctors inserted electrodes in a region of the brain that is tied to the regulation of emotions and compulsions. The wire extends down the neck and attaches to a pulse generator a third of the size of an iPhone, placed right under the collar bone.

For the first three months after surgery, the women in the trial did not change their treatment; if they were on medication, they stayed on it. But after three months, those who wanted treatment or a new therapy were allowed to pursue it. The goal of the deep brain stimulation was not to cure the patients, Lipsman stressed, but to help make them more responsive to treatment.

In an editorial The Lancet ran alongside the pilot study, Janet Treasure and Ulrike Schmidt, two leading professors in eating disorders at King's College, London, who did not work on the trial, offered cautious praise.

Many questions remain, they wrote, including the "choice of targets," or where, exactly, doctors implant electrodes, "mechanisms of action" -- how the electrodes affect patients' ability to respond to treatment -- as well as "practical issues such as patient selection and acceptability of the treatment to patients and their families."

"Nonetheless, the findings of this proof-of-concept study are promising and will give hope to patients with especially pernicious forms of the disorder and their families," they wrote.

Rollins is more effusive: She believes the procedure gave her back her life. She goes to the movies now, something she never did before because, as a compulsive exerciser, she could not abide sitting still for so long. She rides horses and goes out to dinner with her brother and mother, who she said once planned her funeral.

"Anybody, I think, thinks 'Wow, brain surgery. That's something very severe,'" Rollins said. "I wasn't sure that I was ready to do that. I also knew, on the other hand, that I wasn't going to be around long if I didn't try something unconventional."

The researchers will continue to follow the initial six patients and have since implanted devices in another six. They are in the process of expanding the trial to include 32 total patients.

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