Abstract
Appetite modulation in conjunction with enhancing metabolic rate with hypothalamic lesions has been widely documented in animal and even in humans. It appears these effects can be reproduced by DBS, and the titratability and reversibility of this procedure, in addition to well established safety profile, make DBS an appealing option for obesity treatment. Targeting the hypothalamus with DBS has already been shown to be feasible and potentially effective in managing patients with intractable chronic cluster headache [26]. The surgical risk however must be cautiously taken into account when targeting the hypothalamus, where some mortality cases have been reported when targeting the posterior part [34]. The development of new surgical approach will probably reduce this surgical risk. Moreover, the role of functional neurosurgery in obesity is not a new idea. In fact, LH was targeted in obese humans with electrocoagulation more than 30 years ago, resulting in significant yet transient appetite suppression and slight weight reduction [36]. All those elements have made possible the recent regain of interest in DBS for morbid obesity and open an exciting new area of research in neurosurgery and endocrinology.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Anand BK, Brobeck JR (1951) Localization of a “feeding center” in the hypothalamus of the rat. Proc Soc Exp Biol Med 77(2): 323–24
Anand BK, Dua S, et al. (1955) Hypothalamic control of food intake in cats and monkeys. J Physiol 127(1): 143–52
Beltt BM, Keesey RE (1975) Hypothalamic map of stimulation current thresholds for inhibition of feeding in rats. Am J Physiol 229(4): 1124–33
Benabid AL, Wallace B, et al. (2005) Therapeutic electrical stimulation of the central nervous system. C R Biol 328(2): 177–86
Benabid AL, Wallace B, et al. (2005) A putative generalized model of the effects and mechanism of action of high frequency electrical stimulation of the central nervous system. Acta Neurol Belg 105(3): 149–57
Bernardis LL, Bellinger LL (1996) The lateral hypothalamic area revisited: ingestive behavior. Neurosci Biobehav Rev 20(2): 189–287
Blundell JE, Gillett A (2001) Control of food intake in the obese. Obes Res 9 (Suppl. 4): 263S–70S
Brobeck JR (1963) Hypothalamus, appetite, and obesity. Physiol Pharmacol Physicians 18: 1–6
Brolin, RE (1992) Critical analysis of results: weight loss and quality of data. Am J Clin Nutr 55 (Suppl. 2): 577S–81S
Brown FD, Fessler RG, et al. (1984) Changes in food intake with electrical stimulation of the ventromedial hypothalamus in dogs. J Neurosurg 60(6): 1253–57
Cortelli P, Guaraldi P, et al. (2007) Effect of deep brain stimulation of the posterior hypothalamic area on the cardiovascular system in chronic cluster headache patients. Eur J Neurol 14(9): 1008–15
Covalin A, Feshali A, et al. (2005) Deep Brain Stimulation for Obesity Control: Analyzing Stimulation Parameters to Modulate Energy Expenditure. Neural Engineering, 2005. Conference Proceedings. 2nd International IEEE EMBS Conference, pp 482–85
Cox JE, Powley TL (1981) Intragastric pair feeding fails to prevent VMH obesity or hyperinsulinemia. Am J Physiol 240(5): E566–72
Dhillon H, Zigman JM, et al. (2006) Leptin directly activates SF1 neurons in the VMH, and this action by leptin is required for normal body-weight homeostasis. Neuron 49(2): 191–203
Fontaine KR, Redden DT, et al. (2003) Years of life lost due to obesity. JAMA 289(2): 187–93
Franzini A, Marras C, et al. (2007) Chronic high frequency stimulation of the posteromedial hypothalamus in facial pain syndromes and behaviour disorders. Acta Neurochir Suppl 97(Pt 2): 399–406
Hamani C, McAndrews MP, et al. (2008) Memory enhancement induced by hypothalamic= fornix deep brain stimulation. Ann Neurol 63(1): 119–23
Heini AF, Lara-Castro C, et al. (1998) Association of leptin and hunger-satiety ratings in obese women. Int J Obes Relat Metab Disord 22(11): 1084–87
Hetherington AW (1944) Non-production of hypothalamic obesity in the rat by lesions rostral or dorsal to the ventro-medial hypothalamic nuclei. The Journal of Comparative Neurology 80(1): 33–45
Kahane P, Ryvlin P, et al. (2003) From hypothalamic hamartoma to cortex: what can be learnt from depth recordings and stimulation? Epileptic Disord 5(4): 205–17
Kennedy GC (1950) The hypothalamic control of food intake in rats. Proceedings of the Royal Society of London. Series B, Biological Sciences (1934-1990) 137(889): 535–49
Korner J, Aronne LJ (2003) The emerging science of body weight regulation and its impact on obesity treatment. J Clin Invest 111(5): 565–70.
Krack P, Batir A, et al. (2003) Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 349(20): 1925–34
Lacan G, De Salles AA, et al. (2008) Modulation of food intake following deep brain stimulation of the ventromedial hypothalamus in the vervet monkey. Laboratory investigation. J Neurosurg 108(2): 336–42
Leitner GC, Roob JM, et al. (2000) Leptin deficiency due to lipid apheresis: a possible reason for ravenous hunger and weight gain. Int J Obes Relat Metab Disord 24(2): 259–60
Leone M, Franzini A, et al. (2003) Hypothalamic deep brain stimulation for intractable chronic cluster headache: a 3-year follow-up. Neurol Sci 24(Suppl 2): S143–45
Maschke M, Tuite PJ, et al. (2005) The effect of subthalamic nucleus stimulation on kinaesthesia in Parkinson’s disease. J Neurol Neurosurg Psychiatry 76(4): 569–71
Matsuda M, Liu Y, et al. (1999) Altered hypothalamic function in response to glucose ingestion in obese humans. Diabetes 48(9): 1801–06
McIntyre CC, Grill WM (2002) Extracellular stimulation of central neurons: influence of stimulus waveform and frequency on neuronal output. J Neurophysiol 88(4): 1592–604
Must A, Spadano J, et al. (1999) The disease burden associated with overweight and obesity. JAMA 282(16): 1523–29
Novakova L, Ruzicka E, et al. (2007) Increase in body weight is a non-motor side effect of deep brain stimulation of the subthalamic nucleus in Parkinson’s disease. Neuro Endocrinol Lett 28(1): 21–25
Pawson PA, Preston E, Haas N, Foster DO (1987) Hypothalamic sites where electrical stimulation increases metabolic rate in the rat. Soc Neurosci Abstr 13: 1163
Paxinos G, Watson C (1998) The Rat Brain in Stereotaxic Coordinates. New York: Academic Press
Pinsker MO, Bartsch T, et al. (2008) Failure of deep brain stimulation of the posterior inferior hypothalamus in chronic cluster headache — report of two cases and review of the literature. Zentralbl Neurochir 69(2): 76–79
Pories WJ, MacDonald KG (1993) The surgical treatment of morbid obesity. Curr Opin Gen Surg: 195–205
Quaade F (1974) Letter: Stereotaxy for obesity. Lancet 1(7851): 267
Roe DA, Eickwort KR (1976) Relationships between obesity and associated health factors with unemployment among low income women. J Am Med Womens Assoc 31(5): 193–94, 198-99, 203-04
Ruffin M, Nicolaidis S (1999) Electrical stimulation of the ventromedial hypothalamus enhances both fat utilization and metabolic rate that precede and parallel the inhibition of feeding behavior. Brain Res 846(1): 23–29
Ruffin MP, Caulliez R, et al. (1995) Parallel metabolic and feeding responses to lateral hypothalamic stimulation. Brain Res 700(1–2): 121–28
Saito M, Minokoshi Y, et al. (1989) Accelerated norepinephrine turnover in peripheral tissues after ventromedial hypothalamic stimulation in rats. Brain Res 481(2): 298–303
Sani S, Jobe K, et al. (2007) Deep brain stimulation for treatment of obesity in rats. J Neurosurg 107(4): 809–13
Sano K, Mayanagi Y, et al. (1970) Results of timulation and destruction of the posterior hypothalamus in man. J Neurosurg 33(6): 689–707
Schwartz MW, Woods SC, et al. (2000) Central nervous system control of food intake. Nature 404(6778): 661–71
Seijo FJ, Alvarez-Vega MA, et al. (2007) Complications in subthalamic nucleus stimulation surgery for treatment of Parkinson’s disease. Review of 272 procedures. Acta Neurochir (Wien) 149(9): 867–75; discussion 876
Takaki A, Aou S, et al. (1992) Feeding suppression elicited by electrical and chemical stimulations of monkey hypothalamus. Am J Physiol 262(4 Pt 2): R586–94
Teitelbaum P, Epstein AN (1962) The lateral hypothalamic syndrome: recovery of feeding and drinking after lateral hypothalamic lesions. Psychol Rev 69: 74–90
Tuite PJ, Maxwell RE, et al. (2005) Weight and body mass index in Parkinson’s disease patients after deep brain stimulation surgery. Parkinsonism Relat Disord 11(4): 247–52
Voges J, Waerzeggers Y, et al. (2006) Deep-brain stimulation: long-term analysis of complications caused by hardware and surgery — experiences from a single centre. J Neurol Neurosurg Psychiatry 77(7): 868–72
Zhang Y, Proenca R, et al. (1994) Positional cloning of the mouse obese gene and its human homologue. Nature 372(6505): 425–32
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag/Wien
About this chapter
Cite this chapter
Torres, N., Chabardès, S., Benabid, A.L. (2011). Rationale for hypothalamus-deep brain stimulation in food intake disorders and obesity. In: Pickard, J.D., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 36. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0179-7_2
Download citation
DOI: https://doi.org/10.1007/978-3-7091-0179-7_2
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-0178-0
Online ISBN: 978-3-7091-0179-7
eBook Packages: MedicineMedicine (R0)