PMID- 36967879
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230328
IS  - 2405-8440 (Print)
IS  - 2405-8440 (Electronic)
IS  - 2405-8440 (Linking)
VI  - 9
IP  - 3
DP  - 2023 Mar
TI  - Could deep brain stimulation be a possible solution for acquired hypothalamic 
      obesity?
PG  - e14411
LID - 10.1016/j.heliyon.2023.e14411 [doi]
LID - e14411
AB  - OBJECTIVE: Hypothalamic dysfunction may result in morbid obesity as a consequence 
      of decreased energy expenditure, decreased feelings of satiety, and increased fat 
      storage. In patients with hypothalamic dysfunction, neurobehavioral dysfunction 
      is also often present. Currently, no effective treatment has been found for 
      hypothalamic obesity (HO). We hypothesize that deep brain stimulation (DBS) may 
      be an effective treatment for patients with hypothalamic dysfunction, aiming to 
      treat HO as well as the neurobehavioral dysfunction. METHODS: A systematic search 
      was conducted in the PubMed, EMBASE and Cochrane Library databases for studies 
      published until May 2022 reporting on DBS for the treatment of HO. RESULTS: Three 
      studies met the predetermined inclusion criteria, with in total six patients 
      treated with DBS for HO, of which five patients with Prader-Willi syndrome (PWS) 
      and one patient with HO after treatment for craniopharyngioma (CP). Targets of 
      DBS included the lateral hypothalamic area (LHA) and the nucleus accumbens 
      (NAcc). In patients with PWS, LHA-DBS was associated with a mean increase of Body 
      Mass Index (BMI) (+5.8%), with no change in hormonal levels, results of blood 
      workup, sleep, or neuropsychological evaluation. In the patient with CP, NAcc-DBS 
      was associated with a decrease in BMI (-8.7%) and a subjective increase in mental 
      health, energy and willingness to act, and no feeling of increased appetite. No 
      objective measurements on neurobehavioral function were reported. No severe 
      adverse events were reported in these cases. Mild to moderate adverse events 
      included hypomanic symptoms and infection. All patients with a described 
      follow-up period (n = 5) were able to sustain the treatment for at least 6 months 
      with few interruptions. CONCLUSION: There is limited research reporting on DBS 
      for HO. The effectiveness differed across studies and the evidence is limited. 
      Although there may be potential for DBS treatment in the severe-refractory 
      condition of HO in patients with CP, more research is needed for target selection 
      and evaluation of effectiveness.
CI  - (c) 2023 The Authors.
FAU - Dassen, Amber R
AU  - Dassen AR
AD  - Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, Utrecht, 
      the Netherlands.
FAU - van Schaik, Jiska
AU  - van Schaik J
AD  - Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, Utrecht, 
      the Netherlands.
AD  - Department of Pediatric Oncology, Princess Maxima Center, Utrecht, the 
      Netherlands.
FAU - van den Munckhof, Pepijn
AU  - van den Munckhof P
AD  - Department of Neuro-Surgery, Amsterdam UMC, Amsterdam, the Netherlands.
FAU - Schuurman, P R
AU  - Schuurman PR
AD  - Department of Neuro-Surgery, Amsterdam UMC, Amsterdam, the Netherlands.
FAU - Hoving, Eelco W
AU  - Hoving EW
AD  - Department of Neuro-Surgery, Princess Maxima Center, Utrecht, the Netherlands.
FAU - van Santen, Hanneke M
AU  - van Santen HM
AD  - Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, Utrecht, 
      the Netherlands.
AD  - Department of Pediatric Oncology, Princess Maxima Center, Utrecht, the 
      Netherlands.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230309
PL  - England
TA  - Heliyon
JT  - Heliyon
JID - 101672560
PMC - PMC10036662
OTO - NOTNLM
OT  - Craniopharyngioma
OT  - Deep brain stimulation
OT  - Hypothalamic obesity
OT  - Nucleus accumbens
OT  - Prader-Willi syndrome
COIS- The authors declare no competing interests.
EDAT- 2023/03/28 06:00
MHDA- 2023/03/28 06:01
PMCR- 2023/03/09
CRDT- 2023/03/27 03:17
PHST- 2022/08/03 00:00 [received]
PHST- 2023/02/20 00:00 [revised]
PHST- 2023/03/03 00:00 [accepted]
PHST- 2023/03/27 03:17 [entrez]
PHST- 2023/03/28 06:00 [pubmed]
PHST- 2023/03/28 06:01 [medline]
PHST- 2023/03/09 00:00 [pmc-release]
AID - S2405-8440(23)01618-3 [pii]
AID - e14411 [pii]
AID - 10.1016/j.heliyon.2023.e14411 [doi]
PST - epublish
SO  - Heliyon. 2023 Mar 9;9(3):e14411. doi: 10.1016/j.heliyon.2023.e14411. eCollection 
      2023 Mar.