Pilot study of responsive nucleus accumbens deep brain stimulation for loss-of-control eating

Rajat S Shivacharan; Camarin E Rolle; Daniel A N Barbosa; Tricia N Cunningham; Austin Feng; Noriah D Johnson; Debra L Safer; Cara Bohon; Corey Keller; Vivek P Buch; Jonathon J Parker; Dan E Azagury; Peter A Tass; Mahendra T Bhati; Robert C Malenka; James D Lock; Casey H Halpern

doi:10.1038/s41591-022-01941-w

Pilot study of responsive nucleus accumbens deep brain stimulation for loss-of-control eating

Nat Med. 2022 Sep;28(9):1791-1796. doi: 10.1038/s41591-022-01941-w. Epub 2022 Aug 29.

Authors

Rajat S Shivacharan^#¹, Camarin E Rolle^#², Daniel A N Barbosa², Tricia N Cunningham¹, Austin Feng¹, Noriah D Johnson^{1

3}, Debra L Safer³, Cara Bohon³, Corey Keller^{3

4}, Vivek P Buch¹, Jonathon J Parker¹, Dan E Azagury⁵, Peter A Tass¹, Mahendra T Bhati^{1

3}, Robert C Malenka⁶, James D Lock³, Casey H Halpern^{7

8}

Affiliations

¹ Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
² Department of Neurosurgery, Perelman School of Medicine, Richards Medical Research Laboratories, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, PA, USA.
³ Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
⁴ Veterans Affairs Palo Alto Healthcare System and the Sierra-Pacific Mental Illness Research Education, and Clinical Center, Palo Alto, CA, USA.
⁵ Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
⁶ Nancy Pritzker Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
⁷ Department of Neurosurgery, Perelman School of Medicine, Richards Medical Research Laboratories, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, PA, USA. casey.halpern@pennmedicine.upenn.edu.
⁸ Department of Surgery, Corporal Michael J. Crescenz Veterans Affairs Medical Center, PA, USA. casey.halpern@pennmedicine.upenn.edu.

^# Contributed equally.

Abstract

Cravings that precede loss of control (LOC) over food consumption present an opportunity for intervention in patients with the binge eating disorder (BED). In this pilot study, we used responsive deep brain stimulation (DBS) to record nucleus accumbens (NAc) electrophysiology during food cravings preceding LOC eating in two patients with BED and severe obesity (trial registration no. NCT03868670). Increased NAc low-frequency oscillations, prominent during food cravings, were used to guide DBS delivery. Over 6 months, we observed improved self-control of food intake and weight loss. These findings provide early support for restoring inhibitory control with electrophysiologically-guided NAc DBS. Further work with increased sample sizes is required to determine the scalability of this approach.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Deep Brain Stimulation*
Eating
Humans
Nucleus Accumbens
Obesity, Morbid*
Pilot Projects
Synaptic Transmission

Associated data

ClinicalTrials.gov/NCT03868670

Abstract

Publication types

MeSH terms

Associated data

Grants and funding