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

Abstract

Key Points Question Is lateral hypothalamic deep brain stimulation (DBS) safe for the treatment of obesity in Prader-Willi syndrome? Findings In this case series of 4 patients with Prader-Willi syndrome treated with lateral hypothalamic DBS, 2 developed stimulation-induced manic symptoms and 2 developed infections, 1 of which was associated with skin picking. No major differences were found when postoperative anthropometric and calorimetric data were compared with baseline; hormonal levels, and results of blood workup, sleep studies, and neuropsychological evaluations also showed no change. Meaning Safety of lateral hypothalamic DBS was in the range of that demonstrated in patients with similar psychiatric conditions receiving DBS; however, in the small cohort of patients with Prader-Willi syndrome treated, DBS seemed largely ineffective for the treatment of obesity.

Deep Brain Stimulation-Related Surgical Site Infections: A Systematic Review and Meta-Analysis

“…1). Twenty‐two publications were excluded due to specific reasons (Supporting Information Table S2) (20–41). Among these studies, three were excluded due to duplicate data from a United States (21), a UK (28) and a German registry‐based (GEPESTIM) (30) longitudinal cohorts.…”

A high-resolution in vivo magnetic resonance imaging atlas of the human hypothalamic region

“…In the field of neuroimaging, this effort is primarily directed towards volumetric and topological analyses in healthy and diseased states 9 – 11 . Conversely, probing of the hypothalamus by means of electrical stimulation and lesioning provides insights into the functional role of individual nuclei 12 – 15 . The accurate delineation and targeting of the hypothalamus, however, has conventionally been associated with technological and methodological challenges, namely the lack of structural detail and contrast on routinely acquired magnetic resonance imaging (MRI) scans.…”

Deep Brain Stimulation of the Lateral Hypothalamus Facilitates Extinction and Prevents Reinstatement of Morphine Place Preference in Rats

“…But it should be noted that we applied DBS for a very short duration of time (20 min/day for nine days; or 40 min/day for four days in the previous study) that might not be enough to cause the likely complications. Yet, DBS of the LH was performed with adequate safety in human subjects (60,62,63), where the only side effects reported were nausea, anxiety or "hot of flushed" sensations during programming changes (60).…”