Neurosurgery and neuromodulation for anorexia nervosa in the 21st century: a systematic review of treatment outcomes.
Neurosurgery and neuromodulation for anorexia nervosa in the 21st century: a systematic review of treatment outcomes.
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DOI：
10.1080/10640266.2020.1790270
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发表时间：
2022-01
期刊：
影响因子：
3.3
通讯作者：
Feusner JD
中科院分区：
文献类型：
--
作者：
Murray SB;Strober M;Tadayonnejad R;Bari AA;Feusner JD
由于目前的心理社会和药理学干预在治疗神经性厌食症（AN）方面显示出有限的疗效，因此对神经外科干预和神经调节在管理严重和持久疾病中的潜在价值的兴趣已经增长。我们对20项神经外科和神经调节治疗AN的试验进行了系统评价，包括神经外科消融、脑深部电刺激（DBS）、重复经颅磁刺激（rTMS）和经颅直流电刺激（tDCS）。总体而言，有证据支持立体定向消融和DBS在AN治疗中的作用。相比之下，rTMS和tDCS的结果是适度的，通常更复杂。神经外科治疗可能为AN的治疗提供重要的新途径。将需要具有可比患者人群的额外随机临床试验，其中仔细记录干预前后情感、认知和感知症状现象的变化以及目标电路的询问。
As current psychosocial and pharmacological interventions show limited efficacy in the treatment of anorexia nervosa (AN), interest in the potential value of neurosurgical intervention and neuromodulation in managing severe and enduring illness has grown. We conducted a systematic review of 20 trials of neurosurgical and neuromodulatory treatments for AN, including neurosurgical ablation, deep brain stimulation (DBS), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS). Overall, there is evidence to support the role of stereotactic ablation and DBS in the treatment of AN. In contrast, results for rTMS and tDCS have been modest and generally more mixed. Neurosurgical treatment may offer important new avenues for the treatment of AN. Additional randomized clinical trials with comparable patient populations will be needed, in which change in affective, cognitive, and perceptual symptom phenomena, and interrogation of targeted circuits, pre- and post-intervention, are carefully documented.
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