Assessment of Safety and Outcome of Lateral Hypothalamic Deep Brain Stimulation for Obesity in a Small Series of Patients With Prader-Willi Syndrome

Página do item simplificado
dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFRANCO, Ruth R.
dc.contributor.authorFONOFF, Erich T.
dc.contributor.authorALVARENGA, Pedro G.
dc.contributor.authorALHO, Eduardo J. L.
dc.contributor.authorLOPES, Antonio Carlos
dc.contributor.authorHOEXTER, Marcelo Q.
dc.contributor.authorBATISTUZZO, Marcelo C.
dc.contributor.authorPAIVA, Raquel R.
dc.contributor.authorTAUB, Anita
dc.contributor.authorSHAVITT, Roseli G.
dc.contributor.authorMIGUEL, Euripides C.
dc.contributor.authorTEIXEIRA, Manoel J.
dc.contributor.authorDAMIANI, Durval
dc.contributor.authorHAMANI, Clement
dc.date.accessioned2019-01-17T13:33:53Z
dc.date.available2019-01-17T13:33:53Z
dc.date.issued2018
dc.description.abstractIMPORTANCE Deep brain stimulation (DBS) has been investigated for treatment of morbid obesity with variable results. Patients with Prader-Willi syndrome (PWS) present with obesity that is often difficult to treat. OBJECTIVE To test the safety and study the outcome of DBS in patients with PWS. DESIGN, SETTING, AND PARTICIPANTS This case series was conducted in the Hospital das Clinicas, University of Sao Paulo, Brazil. Four patients with genetically confirmed PWS presenting with severe obesity were included. EXPOSURE Deep brain stimulation electrodes were bilaterally implanted in the lateral hypothalamic area. After DBS implantation, the treatment included the following phases: titration (1-2 months), stimulation off (2 months), low-frequency DBS (40 Hz; 1 month), washout (15 days), high-frequency DBS (130 Hz; 1 month), and long-term follow-up (6 months). MAIN OUTCOMES AND MEASURES Primary outcome measures were adverse events recorded during stimulation and long-term DBS treatment. Secondary outcomes consisted of changes in anthropometric measures (weight, body mass index [calculated as weight in kilograms divided by height in meters squared], and abdominal and neck circumference), bioimpedanciometry, and calorimetry after 6 months of treatment compared with baseline. The following evaluations and measurements were conducted before and after DBS: clinical, neurological, psychiatric, neuropsychological, anthropometry, calorimetry, blood workup, hormonal levels, and sleep studies. Adverse effects were monitored during all follow-up visits. RESULTS Four patients with PWS were included (2 male and 2 female; ages 18-28 years). Baseline mean (SD) body mass index was 39.6 (11.1). Two patients had previous bariatric surgery, and all presented with psychiatric comorbidity, which was well controlled with the use of medications. At 6 months after long-term DBS, patients had a mean 9.6% increase in weight, 5.8% increase in body mass index, 8.4% increase in abdominal circumference, 4.2% increase in neck circumference, 5.3% increase in the percentage of body fat, and 0% change in calorimetry compared with baseline. Also unchanged were hormonal levels and results of blood workup, sleep studies, and neuropsychological evaluations. Two patients developed stimulation-induced manic symptoms. Discontinuation of DBS controlled this symptom in 1 patient. The other required adjustments in medication dosage. Two infections were documented, 1 associated with skin picking. CONCLUSIONS AND RELEVANCE Safety of lateral hypothalamic area stimulation was in the range of that demonstrated in patients with similar psychiatric conditions receiving DBS. In the small cohort of patients with PWS treated in our study, DBS was largely ineffective.eng
dc.description.indexPubMedeng
dc.identifier.citationJAMA NETWORK OPEN, v.1, n.7, article ID e185275, 9p, 2018
dc.identifier.doi10.1001/jamanetworkopen.2018.5275
dc.identifier.issn2574-3805
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/29953
dc.language.isoeng
dc.publisherAMER MEDICAL ASSOCeng
dc.relation.ispartofJama Network Open
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright AMER MEDICAL ASSOCeng
dc.subject.otherventromedial hypothalamuseng
dc.subject.otherelectrical-stimulationeng
dc.subject.othersatiated ratseng
dc.subject.otherweight-gaineng
dc.subject.otherbody-weighteng
dc.subject.otherfood-intakeeng
dc.subject.otherhypomaniaeng
dc.subject.otherorexineng
dc.subject.othermodeleng
dc.subject.otherareaeng
dc.subject.wosMedicine, General & Internaleng
dc.titleAssessment of Safety and Outcome of Lateral Hypothalamic Deep Brain Stimulation for Obesity in a Small Series of Patients With Prader-Willi Syndromeeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus31
hcfmusp.contributor.author-fmusphcRUTH ROCHA FRANCO
hcfmusp.contributor.author-fmusphcERICH TALAMONI FONOFF
hcfmusp.contributor.author-fmusphcPEDRO GOMES DE ALVARENGA
hcfmusp.contributor.author-fmusphcEDUARDO JOAQUIM LOPES ALHO
hcfmusp.contributor.author-fmusphcANTONIO CARLOS LOPES
hcfmusp.contributor.author-fmusphcMARCELO QUEIROZ HOEXTER
hcfmusp.contributor.author-fmusphcMARCELO CAMARGO BATISTUZZO
hcfmusp.contributor.author-fmusphcRAQUEL REIS DE PAIVA
hcfmusp.contributor.author-fmusphcANITA TAUB
hcfmusp.contributor.author-fmusphcROSELI GEDANKE SHAVITT
hcfmusp.contributor.author-fmusphcEURIPEDES CONSTANTINO MIGUEL FILHO
hcfmusp.contributor.author-fmusphcMANOEL JACOBSEN TEIXEIRA
hcfmusp.contributor.author-fmusphcDURVAL DAMIANI
hcfmusp.contributor.author-fmusphcCLEMENT HAMANI
hcfmusp.description.articlenumbere185275
hcfmusp.description.issue7
hcfmusp.description.volume1
hcfmusp.origemWOS
hcfmusp.origem.pubmed30646396
hcfmusp.origem.scopus2-s2.0-85072394964
hcfmusp.origem.wosWOS:000452649500021
hcfmusp.publisher.cityCHICAGOeng
hcfmusp.publisher.countryUSAeng
hcfmusp.relation.referenceBIELAJEW C, 1994, BEHAV BRAIN RES, V62, P143, DOI 10.1016/0166-4328(94)90021-3eng
hcfmusp.relation.referenceBROWN FD, 1984, J NEUROSURG, V60, P1253, DOI 10.3171/jns.1984.60.6.1253eng
hcfmusp.relation.referenceCalandrella D, 2017, J NEUROL SCI, V373, P342, DOI 10.1016/j.jns.2017.01.034eng
hcfmusp.relation.referenceCassidy SB, 2012, GENET MED, V14, P10, DOI 10.1038/gim.0b013e31822bead0eng
hcfmusp.relation.referenceChang CY, 2017, MEDICINE, V96, DOI 10.1097/MD.0000000000006128eng
hcfmusp.relation.referenceChang CH, 2010, J NEUROSURG, V112, P1299, DOI 10.3171/2009.10.JNS09918eng
hcfmusp.relation.referenceDELGADO JMR, 1953, AM J PHYSIOL, V172, P162eng
hcfmusp.relation.referenceDoucette WT, 2015, TRANSL PSYCHIAT, V5, DOI 10.1038/tp.2015.197eng
hcfmusp.relation.referenceEttrup KS, 2012, STEREOT FUNCT NEUROS, V90, P281, DOI 10.1159/000338087eng
hcfmusp.relation.referenceFranco R, 2016, BRAIN SCI, V6, DOI 10.3390/brainsci6030021eng
hcfmusp.relation.referenceFronczek R, 2005, J CLIN ENDOCR METAB, V90, P5466, DOI 10.1210/jc.2005-0296eng
hcfmusp.relation.referenceHalpern CH, 2013, J NEUROSCI, V33, P7122, DOI 10.1523/JNEUROSCI.3237-12.2013eng
hcfmusp.relation.referenceHamani C, 2008, ANN NEUROL, V63, P119, DOI 10.1002/ana.21295eng
hcfmusp.relation.referenceHarat M, 2016, NEUROL NEUROCHIR POL, V50, P207, DOI 10.1016/j.pjnns.2016.01.014eng
hcfmusp.relation.referenceKRASNE FB, 1962, SCIENCE, V138, P822, DOI 10.1126/science.138.3542.822eng
hcfmusp.relation.referenceLacan G, 2008, J NEUROSURG, V108, P336, DOI 10.3171/JNS/2008/108/2/0336eng
hcfmusp.relation.referenceAlho EJL, 2018, BRAIN STRUCT FUNCT, V223, P1121, DOI 10.1007/s00429-017-1548-2eng
hcfmusp.relation.referenceSoto-Montenegro ML, 2014, MOL IMAGING BIOL, V16, P830, DOI 10.1007/s11307-014-0753-0eng
hcfmusp.relation.referenceManzardo AM, 2016, AM J MED GENET A, V170, P2097, DOI 10.1002/ajmg.a.37749eng
hcfmusp.relation.referenceMelega WP, 2012, PLOS ONE, V7, DOI 10.1371/journal.pone.0030672eng
hcfmusp.relation.referenceMENDELSON J, 1967, SCIENCE, V157, P1077, DOI 10.1126/science.157.3792.1077eng
hcfmusp.relation.referenceMENDELSON J, 1965, SCIENCE, V149, P559, DOI 10.1126/science.149.3683.559eng
hcfmusp.relation.referenceMiller JL, 2007, J NEUROL NEUROSUR PS, V78, P615, DOI 10.1136/jnnp.2006.099044eng
hcfmusp.relation.referenceRezai AR, 2018, NEUROSURGERY, V82, pE136, DOI 10.1093/neuros/nyx630eng
hcfmusp.relation.referenceRuffin MP, 1999, BRAIN RES, V846, P23, DOI 10.1016/S0006-8993(99)01922-8eng
hcfmusp.relation.referenceSani S, 2007, J NEUROSURG, V107, P809, DOI 10.3171/JNS-07/10/0809eng
hcfmusp.relation.referenceSTENGER J, 1991, PHYSIOL BEHAV, V50, P1209, DOI 10.1016/0031-9384(91)90584-Beng
hcfmusp.relation.referenceStuber GD, 2016, NAT NEUROSCI, V19, P198, DOI 10.1038/nn.4220eng
hcfmusp.relation.referenceTalakoub O, 2017, ANN CLIN TRANSL NEUR, V4, P897, DOI 10.1002/acn3.466eng
hcfmusp.relation.referenceTorres N, 2012, INT J OBESITY, V36, P1537, DOI 10.1038/ijo.2011.271eng
hcfmusp.relation.referenceWhiting DM, 2013, J NEUROSURG, V119, P56, DOI 10.3171/2013.2.JNS12903eng
hcfmusp.relation.referenceWidge AS, 2016, J NEUROPSYCH CLIN N, V28, P38, DOI 10.1176/appi.neuropsych.15040089eng
hcfmusp.relation.referenceZhang C, 2015, NEUROSCI LETT, V589, P1, DOI 10.1016/j.neulet.2015.01.019eng
hcfmusp.scopus.lastupdate2024-05-10
relation.isAuthorOfPublication6fd88ded-eb8f-480f-95e1-137279235708
relation.isAuthorOfPublication4c02c3a0-da5e-4a38-ba96-49611c964133
relation.isAuthorOfPublication7c15e840-c33e-4f0b-a163-47a6648a76fd
relation.isAuthorOfPublicationa2857c7b-3a5c-4f94-8777-713ee6ca6c84
relation.isAuthorOfPublication38e2fa1c-d9b2-4bfc-9716-e8d713a780b2
relation.isAuthorOfPublicationfb3862ee-3c68-42fa-b08a-2658c28981ee
relation.isAuthorOfPublicationf75cdb10-0083-43b0-bcf4-9adb94f8d17b
relation.isAuthorOfPublication47cc5ba3-ac21-46bc-9573-40dc6e2e818d
relation.isAuthorOfPublication5fa12243-7f3f-4304-bad4-2c5bd0be6cda
relation.isAuthorOfPublication2efe96f8-ccb2-4d43-b2b7-6862bbb3d2fa
relation.isAuthorOfPublication587b0a62-5611-4071-ae48-19a46c43b55d
relation.isAuthorOfPublicationb665cf91-624e-4b90-92bc-9df755eeeaaf
relation.isAuthorOfPublicationf9f29f57-31b6-47f2-902d-a02aedc66ca8
relation.isAuthorOfPublication66d83e08-539d-4568-a026-f77b3a784a9e
relation.isAuthorOfPublication.latestForDiscovery587b0a62-5611-4071-ae48-19a46c43b55d
Arquivos
Pacote Original
Agora exibindo 1 - 1 de 1
Nenhuma Miniatura disponível
Nome:
art_FRANCO_Assessment_of_Safety_and_Outcome_of_Lateral_Hypothalamic_2018.PDF
Tamanho:
1.03 MB
Formato:
Adobe Portable Document Format
Descrição:
publishedVersion (English)
Baixar
Coleções
Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - FM/MPS
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/21
Artigos e Materiais de Revistas Científicas - LIM/26
Carregar mais