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Completed

NCT Number: NCT03650309

Deep Brain Stimulation for Morbid Obesity

This is an open-label, phase I pilot trial designed to evaluate the safety and feasibility of deep brain stimulation (DBS) for the treatment of refractory morbid obesity. Patients with diagnoses of morbid obesity will be recruited and enrolled. All patients will receive DBS targeting two brains areas involved in the pathophysiology of obesity and will be followed post-operatively for 12 months.

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Key information

Conditions

Obesity Behavior Behavior, Addictive Body Weight Body Weight Changes Compulsive Behavior Impulsive Behavior Nutrition Disorders Nutritional and Metabolic Diseases Obesity, Morbid Overnutrition Overweight Pathological Conditions, Signs and Symptoms Signs and Symptoms Weight Loss

Age range

20 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Toronto Western Hospital, University Health Network

Toronto, Ontario, M5T 2S8, Canada

About this study

This study will establish 1)the safety of deep brain stimulation (DBS) in a patient population with treatment refractory morbid obesity. DBS has been used safely and effectively in thousands of patients for numerous disorders. Recent evidence (outlined above) has shown that DBS can also be used to manage refractory psychiatric conditions, such as depression and obsessive-compulsive disorder, as well as in eating disorders such as anorexia nervosa. Such studies indicate that a targeted therapy informed by the neuroanatomic and circuitry literature can be effective in altering pathological mood and behaviour. 2) evaluate the effectiveness of the procedure, which will be evaluated by the actual weight loss and resolution of the core symptoms of morbid obesity, including BMI, as well of, depression, self-esteem, and binge eating scores surrounding with loss or weight gain.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Female or Male patients between age 20-60
  • Diagnosis of Morbid Obesity (defined as a BMI>40kg/m2 or BMI>35 with 1 obesity related comorbidity) OR a diagnosis of Binge Eating Disorder not responsive to recommended treatments (as defined by the DSM-5)
  • Failure or non eligibility of bariatric surgery with <50% of excess weight loss, with or without BMI>35 kg/m2, at 18 months or more after the operation; OR diagnosis of binge eating disorder for over 18 months
  • Diagnosis of food dependence via Yale Food Addiction Scale (YFAS) criteria
  • Normal neurological exam
  • Normal head CT scan and cerebral MRI
  • Patient informed and able to give written consent
  • Able to comply with all testing, follow-ups and study appointments and protocols

Exclusion criteria

  • Active neurologic disease such as epilepsy
  • Alcohol or substance dependence or abuse in the last 6 months, excluding caffeine and nicotine
  • Any contraindication to magnetic resonance imaging (MRI) or positron emission tomography (PET) scanning
  • Likely to relocate or move during the study's one year duration
  • Presence of cardiac arrhythmias, or other cardiac, respiratory, renal or endocrine conditions as a result of morbid obesity, that will result in significant risk from a surgical procedure.
  • Presence of epilepsy, stroke or degenerative disorder of the nervous system
  • Pregnancy

Treatment and study plan

Deep brain stimulation

Device

All patients will undergo surgical implantation of a deep brain stimulation (DBS) system, which involves placement of stimulating electrodes in the brain. These electrodes will be used to deliver electrical current to target two brain structures involved in the pathophysiology of obesity.

Primary outcomes

  1. Incidence of Treatment-Emergent Adverse Events

    Time frame: 12 months

    Patients will be closely monitored for adverse events following DBS surgery with regular check-ups.

Secondary outcomes

  1. Weight

    Time frame: 12 months

    Weight (in kilograms) will be frequently assessed prior to and following DBS surgery.

  2. 'Quality of Life Scale' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 16-item Quality of Life Scale questionnaire (worst score = 16, best score = 112) to assess psychosocial function.

  3. 'Behavioral Inhibition System/Behavioral Activation System Scales (BIS/BAS Scales)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 24-item BIS/BAS Scales questionnaire to assess psychosocial behaviour. This questionnaire has 3 sub-scales: 'BAS drive' (highest score = 16, lowest score = 4), 'BAS fun seeking' (highest score = 20, lowest score = 5), 'BAS reward responsiveness' (highest score = 20, lowest score = 5), and 'BIS' (highest score = 28, lowest score = 7).

  4. 'Patient Health Questionnaire (PHQ-9)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 9-item PHQ-9 questionnaire (worst score = 27, best score = 0) to assess mood and depression symptoms.

  5. 'Generalized Anxiety Disorder 7-item (GAD-7)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 7-item GAD-7 questionnaire (worst score = 21, best score = 0) to assess anxiety symptoms.

  6. 'Difficulties in Emotion Regulation Scale (DERS)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 36-item DERS questionnaire (worst score = 180, best score = 36) to assess emotional dysregulation.

  7. 'Yale-Brown Obsessive Compulsive Scale (Y-BOCS)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 10-item Y-BOCS questionnaire (worst score = 40, best score = 0) to assess severity of obsessive and compulsive symptoms

  8. 'Binge Eating Scale (BES)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 16-item BES questionnaire (worst score = 43, best score = 0) to assess binge eating symptoms

  9. 'Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 19-item YBC-EDS questionnaire (worst score = 32, best score = 0) to assess eating-related preoccupations and rituals

  10. 'Emotional Eating Scale (EES)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 25-item EES questionnaire (worst score = 100, best score = 0) to assess their emotional relationship with food.

  11. 'Power of Food (POF)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 15-item POF questionnaire (worst score = 75, best score = 15) to assess the degree of influence food exerts on their day-to-day life.

  12. 'Eating Disorder Examination Questionnaire (EDE-Q)'

    Time frame: 12 months

    Patients will regularly complete the 28-item EDE-Q (worst score = 6, best score = 0) to assess aspects of eating behaviour including restraint, eating concern, shape concern, and weight concern.

  13. 'Yale Food Addiction Scale (YFAS)' Questionnaire

    Time frame: 12 months

    Patients will regularly complete the 25-item YFAS (higher numbers = more severe symptoms) to assess the severity of food addiction.

Sponsors and collaborators

Lead sponsor

University Health Network, Toronto

Other

Registry information

Official study title

Deep Brain Stimulation for the Treatment of Refractory Morbid Obesity

Important dates

Study start
2018
Primary completion
2022
Study completion
2022
First posted
Aug 28, 2018
Registry last updated
May 8, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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