A small device that detects food craving-related brain activity in a key brain region, and responds by electrically stimulating that region, has shown promise in a pilot clinical trial in two patients with loss-of-control binge eating disorder (BED), according to researchers at the Perelman School of Medicine.

A brain on a plate with a fork and knife set out.

The trial, described in a paper in Nature Medicine, followed the two patients for six months, during which the implanted device—of a type normally used to treat drug-resistant epilepsy—monitored activity in a brain region called the nucleus accumbens. The nucleus accumbens is involved in processing pleasure and reward, and has been implicated in addiction. Whenever the device sensed nucleus accumbens signals that had been found to predict food cravings in prior studies, it automatically stimulated that brain region, disrupting the craving-related signals. Over six months of treatment, the patients reported far fewer binge episodes, and lost weight.

“This was an early feasibility study in which we were primarily assessing safety, but certainly the robust clinical benefits these patients reported to us are really impressive and exciting,” says study senior author Casey Halpern, an associate professor of neurosurgery and chief of Stereotactic and Functional Neurosurgery at Penn Medicine and the Corporal Michael J. Crescenz Veterans Affairs Medical Center.

BED features frequent binge-eating episodes without the purging of bulimia, and typically is associated with obesity. The bingeing individual has a sense of losing control over eating, so that they continue to eat beyond the usual point of feeling sated.

“This was a beautiful demonstration of how translational science can work in the best of cases,” says study co-lead author Camarin Rolle, a postdoctoral researcher with Halpern’s group.

The scientists have continued to follow the subjects for another six months, and have begun enrolling new patients for a larger study. They note that, in principle, the same treatment approach could be applied to other loss-of-control-related disorders including bulimia.

Read more at Penn Medicine News.



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