From: hubermanlab
Deep brain stimulation (DBS) has emerged as a promising technique for the treatment of a variety of neurological and psychiatric conditions, including eating disorders. Dr. Casey Halpern, a neurosurgeon, and his team are at the forefront of exploring DBS specifically for obesity and binge eating disorder, conditions which are increasingly prevalent in modern society.
Understanding Deep Brain Stimulation
Deep Brain Stimulation involves the surgical implantation of electrodes into specific areas of the brain. These electrodes deliver controlled electrical impulses to target regions involved in pathological brain activity, thereby providing symptom relief. Traditionally, DBS has been deployed effectively for movement disorders like Parkinson’s disease and essential tremor, but its application is broadening to include psychiatric conditions and now, eating disorders.
Focus on the Nucleus Accumbens
Dr. Halpern’s team focuses particularly on the nucleus accumbens, a critical hub in the brain’s reward circuit, which plays a significant role in regulating hunger and reward-seeking behaviors. The nucleus accumbens is deeply connected with areas responsible for decision-making and impulse control, making it a strategic target for addressing compulsive eating behaviors. The aim is to modulate this area to reduce the desire to binge eat, even in patients who have undergone procedures like gastric bypass surgery but continue to struggle with eating control [00:01:02].
How DBS is Used for Eating Disorders
According to Dr. Halpern, patients with binge eating disorder exhibit what’s known as “loss of control eating.” This condition involves consuming large quantities of food in a short period, hence constituting a binge, and typically stems from abnormal functioning of the reward circuits in the brain [00:52:06]. In his ongoing research, Dr. Halpern’s team utilizes DBS to modulate the activity in the nucleus accumbens to mitigate this compulsive eating behavior.
Initially, they identify and study “craving cells” within the nucleus accumbens during simulated binge scenarios. By doing so, they can better understand the aberrant electrical activity associated with binge eating and target this for therapeutic interventions. Once identified, the DBS device is programmed to deliver electrical impulses precisely when the craving signal is detected, thereby interrupting the urge and preventing the binge episode from occurring [01:08:06].
The Potential for Broader Application
The modality of DBS treatment for eating disorders is still in investigative stages, yet it holds promising advances over existing treatment methods. Unlike pharmacological interventions, DBS offers a non-systemic and potentially more precise way to address the neural malfunctioning underlying disorders like binge eating and bulimia. The technique’s ability to specifically target and modulate brain circuits could also pave the way for treating other impulse-related disorders such as addiction and obsessive-compulsive behaviors [00:56:16].
Future Directions
The research into DBS for eating disorders represents a hopeful frontier in both neuroscience and therapeutic intervention for some of the most challenging eating disorders today. With continued research, Dr. Halpern’s team aims to refine the DBS process and provides insight into examining and manipulating brain circuits responsible for reward and compulsion in diseases beyond eating disorders.
Research and Trials
The ongoing feasibility studies and patient trials are crucial in understanding DBS’s efficacy for treating binge eating disorder. For those interested in potential treatment options, accessing detailed studies and the outcomes is essential, as more trials will help establish this technique’s validity and safety for broader clinical use [01:45:00].
Through these innovative approaches, there is optimism for more effective, targeted treatments that address the complex interplay of biology, behavior, and environment in conditions like binge eating disorder.