Abstract
Obesity is a growing global health problem frequently intractable
to current treatment options. Recent evidence suggests that deep
brain stimulation (DBS) may be effective and safe in the management
of various, refractory neuropsychiatric disorders, including obesity.
The authors review the literature implicating various neural regions
in the pathophysiology of obesity, as well as the evidence supporting
these regions as targets for DBS, in order to explore the therapeutic
promise of DBS in obesity. The lateral hypothalamus and ventromedial
hypothalamus are the appetite and satiety centers in the brain, respectively.
Substantial data support targeting these regions with DBS for the
purpose of appetite suppression and weight loss. However, reward
sensation associated with highly caloric food has been implicated
in overconsumption as well as obesity, and may in part explain the
failure rates of conservative management and bariatric surgery. Thus,
regions of the brain's reward circuitry, such as the nucleus accumbens,
are promising alternatives for DBS in obesity control. The authors
conclude that deep brain stimulation should be strongly considered
as a promising therapeutic option for patients suffering from refractory
obesity.
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