Deep brain stimulation that targets the reward centers of the brain rather than only feeding behaviors could be effective in treating obesity, according to a review published in the August issue of Neurosurgery.
Alexander Taghva, M.D., from The Ohio State University Medical Center in Columbus, and colleagues note that most treatments for obesity have focused on the homeostatic mechanisms of weight control that regulate appetite and body weight and are centered in the hypothalamus. These have involved behavioral, pharmacologic, and surgical approaches, which have had limited success.
An alternate approach has been to target the reward circuitry of the brain, according to the authors, which is highly connected with homeostatic mechanisms and is impaired in obesity. Deep brain stimulation has been safely used for over 20 years on more than 80,000 patients for movement disorders such as Parkinson's disease and psychiatric disorders such as obsessive compulsive disorder, and is being investigated for other conditions, including addiction. Given the increased morbidity and mortality in obese individuals as well as the relatively high rates of relapse and complications rates in current treatment options, deep brain stimulation should be considered. In addition, deep brain stimulation is reversible and titratable and can be applied at multiple locations for a single illness.