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Brain stimulation reduces anorexia nervosa symptoms, improves decision-making

One session of repetitive transcranial magnetic stimulation reduced core symptoms of anorexia nervosa, such as the urge to restrict food intake and feeling fat, and improved decision-making, according to recent findings.

“Anorexia nervosa is thought to affect up to 4% of women in their lifetime. With increasing illness duration, anorexia becomes entrenched in the brain and increasingly difficult to treat,” study researcher Ulrike Schmidt, MRCPsych, MD, PhD, of King’s College London, said in a press release. “Our preliminary findings support the potential of novel brain-directed treatments for anorexia, which are desperately needed.”

Ulrike Schmidt

To assess efficacy, safety and tolerability of transcranial magnetic stimulation (TMS) for anorexia nervosa symptoms, researchers conducted a double-blind parallel group study. Individuals with anorexia nervosa (n = 49) received one session of sham-controlled high-frequency repetitive TMS to the left dorsolateral prefrontal cortex. Participants completed a food exposure task before and after TMS.

Although there were no interaction effects of repetitive TMS on core anorexia symptoms, researchers noted a trend for group differences (P = .056).

When controlling for pre-TMS scores, participants who received repetitive TMS had reduced symptoms following the procedure and at 24-hour follow-up, compared with participants who received sham stimulation.

Other psychopathology did not differ between participants who received real or sham repetitive TMS, according to researchers.

Participants who received repetitive TMS exhibited reduced rates of temporal discounting or more reflective choice behavior, compared with participants who received sham stimulation (P = .06).

Stimulation did not affect salivary cortisol concentrations.

Repetitive TMS was safe, well-tolerated and acceptable, according to researchers.

“Given the promising findings from this study, we are now assessing whether [repetitive] TMS has longer-lasting therapeutic benefits in a world-first clinical trial of [repetitive] TMS treatment, involving 20 [repetitive] TMS sessions, in people with anorexia nervosa,” Schmidt said. – by Amanda Oldt

Disclosure: McClelland reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.