Palavras-chave
bulimia
sistema límbico
psicocirugía
imagen corporal
Como Citar
Resumo
La anorexia nerviosa se caracteriza por una restricción estricta de la dieta, atracones o conductas purgativas. No puede mantener la masa corporal normal y existe un temor constante a aumentar de peso, distorsión de imagen corporal y pobre introspección de su enfermedad. Ocurre de manera simultánea con trastornos afectivos, trastornos de ansiedad y de personalidad. Es una enfermedad compleja de difícil manejo. Este artículo presenta el reporte de casos de pacientes tratados en tres instituciones de México, Bélgica y Canadá con técnicas quirúrgicas diferentes que buscan alterar el sistema límbico y el circuito frontoestriatal que, se sabe, están implicados en la percepción de la imagen corporal y las propiedades placenteras de los alimentos y en el trastorno depresivo y obsesivo-compulsivo. Los resultados de los casos clínicos son satisfactorios y son una alternativa en el tratamiento de la anorexia nerviosa. Se requiere aún más investigación y el desarrollo de nuevas tecnologías.
Gómez-Restrepo C, Hernández Bayona G, Rojas Urrego A, Santacruz Oleas H, Uribe Restrepo M. Psiquiatría clínica: diagnóstico y tratamiento en niños adolescentes y adultos. 3a ed. Bogotá: Editorial Médica Panamericana; 2007.
Agrawal S, Lask L. Neuroscience of anorexia nervosa: state of the art. Documento presentado en The 9th London International Eating Disorders Conference; London, UK; 31 March-2 April, 2009.
Yager J, Devlin MJ, Halmi KA et al. Practice guideline for the treatment of patients with eating disorders. 3rd ed. Washington: American Psychiatric Association; 2006.
Sadock BJ, Sadock V, Ruiz P. Kaplan and Sadock’s comprehensive textbook of psychiatry. 9th ed. Philadelphia: Lippincott Williams and Wilkins; 2009.
Bunout D. Regulación de la ingesta alimentaria. s. d.
Hirst J. Biological causes of anorexia nervosa and bulimia nervosa. Biology [internet]. 1998;202. Disponible en: http://serendip.brynmawr.edu/bb/neuro/neuro98/202s98-paper3/Hirst3.html.
Chowdhury U, Gordon I, Lask B, Watkins B, Watt H, Christie D. Early-onset anorexia nervosa: is there evidence of limbic system imbalance? Int J Eating Disord. 2003;33(4):388-96.
Hernández M, Zarate A, Valencia FJ, Meneses O, Ochoa MG, Torre M et al. El papel actual de la cirugía del sistema límbico, el caso de la anorexia y la bulimia terminales. Arch Neurocien (Méx). 2009;14(1):11-21.
Goodman WK, Insel TR. Deep brain stimulation in psychiatry: Concentrating on the road ahead. Biol Psychiatry. 2009;65(4):263-6.
van Kuyck K, Gérard N, Van Laere K, Casteels C, Pieters G, Gabriëls L, Nuttin B- Towards a neurocircuitry in anorexia nervosa: Evidence from functional neuroimaging studies. J Psychiatr Res. 2009;43(14):1133-45.
Israel M, Steiger H. Deep brain stimulation in the subgenual cingulate cortex for an intractable eating disorder. Biol Psychiatry. 2010;67:e53-4.
Barbier J, Gabriels L. Successful anterior capsulotomy in comorbid anorexia nervosa and obsessive-compulsive disorder: case report. Neurosurgery. 20011; 69:e745-51.
Greenberg BD, Gabriels LA, Malone DA Jr et al. Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience. Mol Psychiatry. 2010;15(1):64-79.
Ruck C, Karlsson A, Steele JD et al. Capsulotomy for obsessive-compulsive disorder: long-term follow-up of 25 patients. Arch Gen Psychiatry. 2008;65(8): 914-21.
Marsh R, Maia TV, Peterson BS. Functional disturbances within frontostriatal circuits across multiple childhood psychopathologies. Am J Psychiatry. 2009; 166(6):664-674.
This journal is registered under a Creative Commons Attribution 4.0 International Public License. Thus, this work may be reproduced, distributed, and publicly shared in digital format, as long as the names of the authors and Pontificia Universidad Javeriana are acknowledged. Others are allowed to quote, adapt, transform, auto-archive, republish, and create based on this material, for any purpose (even commercial ones), provided the authorship is duly acknowledged, a link to the original work is provided, and it is specified if changes have been made. Pontificia Universidad Javeriana does not hold the rights of published works and the authors are solely responsible for the contents of their works; they keep the moral, intellectual, privacy, and publicity rights.
Approving the intervention of the work (review, copy-editing, translation, layout) and the following outreach, are granted through an use license and not through an assignment of rights. This means the journal and Pontificia Universidad Javeriana cannot be held responsible for any ethical malpractice by the authors. As a consequence of the protection granted by the use license, the journal is not required to publish recantations or modify information already published, unless the errata stems from the editorial management process. Publishing contents in this journal does not generate royalties for contributors.