Percutaneous Electrical Neurostimulation of Dermatome T6 for Appetite Reduction and Weight Loss in Morbidly Obese Patients

Ruíz-Tóvar, Jaime; Oller, Inmaculada; Díez, María Asunción Castro; Zubiaga, Lorea; Arroyo, Antonio; Calpena, Rafael

doi:10.1007/s11695-013-1091-z

Cited by 25 publications

(33 citation statements)

References 16 publications

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“…Based on these assumptions, non-invasive VNS was supposed as a treatment option for obesity ( Page et al, 2012 ). First findings indeed suggest a reduction in appetite and body weight ( Ruiz-Tovar et al, 2014 ; Ruiz-Tovar and Llavero, 2016 ) (see Supplementary Table S1 ).…”

Section: Resultsmentioning

confidence: 84%

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Invasive and Non-invasive Stimulation of the Obese Human Brain

Pleger

2018

Front. Neurosci.

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Accumulating evidence suggests that non-invasive and invasive brain stimulation may reduce food craving and calorie consumption rendering these techniques potential treatment options for obesity. Non-invasive transcranial direct current stimulation (tDCS) or repetitive transcranial magnet stimulation (rTMS) are used to modulate activity in superficially located executive control regions, such as the dorsolateral prefrontal cortex (DLPFC). Modulation of the DLPFC’s activity may alter executive functioning and food reward processing in interconnected dopamine-rich regions such as the striatum or orbitofrontal cortex. Modulation of reward processing can also be achieved by invasive deep brain stimulation (DBS) targeting the nucleus accumbens. Another target for DBS is the lateral hypothalamic area potentially leading to improved energy expenditure. To date, available evidence is, however, restricted to few exceptional cases of morbid obesity. The vagal nerve plays a crucial role in signaling the homeostatic demand to the brain. Invasive or non-invasive vagal nerve stimulation (VNS) is thus assumed to reduce appetite, rendering VNS another possible treatment option for obesity. Based on currently available evidence, the U.S. Food and Drug Administration recently approved VNS for the treatment of obesity. This review summarizes scientific evidence regarding these techniques’ efficacy in modulating food craving and calorie intake. It is time for large controlled clinical trials that are necessary to translate currently available research discoveries into patient care.

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Section: Resultsmentioning

confidence: 84%

“…In a well-controlled proof-of-concept study, Ruiz-Tovar et al (2014) found in 45 mainly female, obese individuals that diet in combination with non-invasive VNS delivered to the T6 dermatome led to reductions of body weight and appetite. In a follow-up study they also evaluated the long-term effect of non-invasive VNS.…”

Section: Resultsmentioning

confidence: 99%

Invasive and Non-invasive Stimulation of the Obese Human Brain

Pleger

2018

Front. Neurosci.

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“…In this regard, PENS of dermatome T6 has been proposed as an alternative to pharmacological products and surgical procedures to decrease appetite and weight loss, allowing a better compliance of hypocaloric diets. PENS was initially applied to morbidly obese patients awaiting bariatric surgery, in order to reduce the pre-surgery body weight [ 10 ]. Later, we and others extended this technique to patients with overweight and mild-to-moderate obesity.…”

Section: Discussionmentioning

confidence: 99%

“…The PENS of dermatome T6 was performed as previously described [ 10 ] by using the Urgent PC 200 Neuromodulation System ® (Uroplasty, Minnetonka, MN, USA). Patients were placed in a supine position without anesthesia, and PENS was delivered by a needle electrode inserted in the left upper quadrant along the medio-clavicular line, at two centimeters below the ribcage, at a 90° angle towards the abdominal wall, and at 0.5–1 cm of depth.…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, the associated modulation of neuronal activities influences on appetite reduction [ 8 ]. Indeed, we previously demonstrated that PENS achieved a significantly greater weight loss than an isolated hypocaloric diet in patients with BMI > 30 kg/m 2 , and this effect could be due, at least in part, to ghrelin inhibition [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Addition of Probiotics to Anti-Obesity Therapy by Percutaneous Electrical Stimulation of Dermatome T6. A Pilot Study

Lorenzo

Crespo-Yanguas

Hang

et al. 2020

IJERPH

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Obesity is becoming a pandemic and percutaneous electrical stimulation (PENS) of dermatome T6 has been demonstrated to reduce stomach motility and appetite, allowing greater weight loss than isolated hypocaloric diets. However, modulation of intestinal microbiota could improve this effect and control cardiovascular risk factors. Our objective was to test whether addition of probiotics could improve weight loss and cardiovascular risk factors in obese subjects after PENS and a hypocaloric diet. A pilot prospective study was performed in patients (n = 20) with a body mass index (BMI) > 30 kg/m2. Half of them underwent ten weeks of PENS in conjunction with a hypocaloric diet (PENS-Diet), and the other half was treated with a PENS-Diet plus multistrain probiotics (L. plantarum LP115, B. brevis B3, and L. acidophilus LA14) administration. Fecal samples were obtained before and after interventions. The weight loss and changes in blood pressure, glycemic and lipid profile, and in gut microbiota were investigated. Weight loss was significantly higher (16.2 vs. 11.1 kg, p = 0.022), whereas glycated hemoglobin and triglycerides were lower (−0.46 vs. −0.05%, p = 0.032, and −47.0 vs. −8.5 mg/dL, p = 0.002, respectively) in patients receiving PENS-Diet + probiotics compared with those with a PENS-Diet. Moreover, an enrichment of anti-obesogenic bacteria, including Bifidobacterium spp, Akkermansia spp, Prevotella spp, and the attenuation of the Firmicutes/Bacteroidetes ratio were noted in fecal samples after probiotics administration. In obese patients, the addition of probiotics to a PENS intervention under a hypocaloric diet could further improve weight loss and glycemic and lipid profile in parallel to the amelioration of gut dysbiosis.

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Optical birefringence changes in myelinated and unmyelinated nerves: A comparative study

Cury

Smets

Bouzin

et al. 2022

Journal of Biophotonics

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The measurement of birefringence variations related to nerve activity is a promising label-free technique for sensing compound neural action potentials (CNAPs). While widely applied in crustaceans, little is known about its efficiency on mammal peripheral nerves. In this work, birefringence recordings to detect CNAPs, and Stokes parameters measurements were performed in rat and lobster nerves. While single-trial detection of nerve activity in crustaceans was achieved successfully, no optical signal was detected in rats, even after extensive signal filtering and averaging. The Stokes parameters showed that a high degree of polarization of light is maintained in lobster sample, whereas an almost complete light depolarization occurs in rat nerve. Our results indicate that depolarization itself is not sufficient to explain the absence of birefringence signals in rats. We hypothesize that this absence comes from the myelin sheets, which constraint the birefringence changes to only take place at the nodes of Ranvier.

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Percutaneous Electrical Neurostimulation of Dermatome T6 for Appetite Reduction and Weight Loss in Morbidly Obese Patients

Abstract: PENS of dermatome T6 was associated with appetite reduction in all of the patients and, along with a proper diet, achieved a significantly greater weight reduction than diet alone.

Cited by 25 publications

References 16 publications

Invasive and Non-invasive Stimulation of the Obese Human Brain

Invasive and Non-invasive Stimulation of the Obese Human Brain

Addition of Probiotics to Anti-Obesity Therapy by Percutaneous Electrical Stimulation of Dermatome T6. A Pilot Study

Optical birefringence changes in myelinated and unmyelinated nerves: A comparative study

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