Treatment Of Anorexia Nervosa By Stereotactic Surgical Intervention Of Nucleus Accumbens

AN is one kind of eating disorders. AN patients intentionally control their diet andhence have significantly lower weight than the normal standard. The characteristics of ANis refusal to maintain a body weight which is greater than or equal to the lowest level ofnormal body weight (i.e.,85%of the expected body weight according age and height, orBMI of17.5kg/m2), or lack of expected weight gain in certain growth and developmentstages. Majority of the patients are young women; the average rate of AN incidence inwomen is19/100,000/year, which is about10times of that in men.Psychiatric treatment (including drugs and psycho-behavioral therapy) accompaniedby nutritional therapy is the most popular treatment for AN so far. However, about20%ofthe AN patients are refractory to above treatments, and this is one of the main reasonscausing high mortality of AN.NAc is an important part of the limbic system of brain and a critical structure of brain’s reward loop. Based on the results from our previous works of treating drug abuseand alcoholism by NAc ablation and the adverse therapeutic effect of NAc ablation onobsessive-compulsive disorders, the present study aims to investigate the effect ofstereotactic surgical intervention of NAc on the treatment of AN.The purpose of this experiment was to effectively treat AN through stereotacticsurgery and implantation of deep brain stimulation.12female patients were randomlyassigned into two groups.6patients underwent bilateral ablation of NAc.6patientsunderwent bilateral ablation of NAc, anterior limb of internal capsule and cingulate gyrus.The BMI、HAMD、HAMA、Y-BOCS and SF-36scoles of patients who received bilateralablation of NAc have shown immediate improvements（P<0.05）. And the such scolesshowed no significant difference （P＞0.05）between two groups. Other5patients whoreceived deep brain stimulation also shown immediate improvements in the BMI、HAMD、HAMA、Y-BOCS and SF-36scoles（P<0.05）. And the such scoles also showedno significant difference （P＞0.05）between patients who received stereotactic surgeryand implantation of deep brain stimulation. Taking together, the study indicates that NAcis an effective target for AN treatment. Stereotactic surgical intervention of NAc caneffectively improve the symptoms in AN patients.