A Randomised Controlled Trial of Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Anorexia Nervosa.




Curated By TMS Solutions on Apr 12, 2017 1:21:00 PM
Curated By TMS Solutions

Authors:

McClelland J; Kekic M; Bozhilova N; Nestler S; Dew T; Van den Eynde F; David AS; Rubia K; Campbell IC; Schmidt U. Institution McClelland,Jessica. Institute of Psychiatry, Psychology and Neuroscienc e, King's College London, London, United Kingdom. Kekic,Maria. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. Bozhilova,Natali. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. Nestler,Steffen. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. Dew,Tracy. Department of Clinical Biochemistry, King's College Hospital , London, United Kingdom. Van den Eynde,Frederique. Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montreal, Quebec, Canada. David,Anthony S. Institute of Psychiatry, Psychology and Neurosci ence, King's College London, London, United Kingdom. Rubia,Katya. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. Campbell,Iain C. Institute of Psychiatry, Psychology and Neuroscienc e, King's College London, London, United Kingdom. Schmidt,Ulrike. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

Title:

A Randomised Controlled Trial of Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Anorexia Nervosa. Source PLoS ONE [Electronic Resource]. 11(3):e0148606, 2016.

Abstract BACKGROUND:

Anorexia nervosa (AN) is associated with morbid fear of fatness, extreme food restriction and altered self-regulation. Neuroimaging data implicate fronto-striatal circuitry, including the dorsolateral prefrontal cortex (DLPFC). METHODS: In this double-blind parallel group study, we invest igated the effects of one session of sham-controlled high-frequency repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC (l-DLPFC) in 60 individuals with AN. A food exposure task was administered before and after the procedure to elicit AN-related symptoms.

OUTCOMES:

The primary outcome measure was 'core AN symptoms', a variable which combined several subjective AN-related experiences. The effects of rTMS on other measures of psychopathology (e.g. mood), temporal discounting (TD; intertemporal choice behaviour) and on salivary cortisol concentrations were also investigated. Safety, tolerability and acceptability were assessed. RESULTS: Fourty-nine participants completed the study. Whilst there were no interaction effects of rTMS on core AN symptoms, there was a trend for group differences (p = 0.056): after controlling for pre-rTMS scores, individuals who received real rTMS had reduced symptoms post-rTMS and at 24 -hour follow-up, relative to those who received sham stimulation. Other psychopathology was not altered differentially following real/sham rTMS. In relation to TD, there was an interaction trend (p = 0.060): real versus sham rTMS resulted in reduced rates of TD (more reflective choice behaviour). Salivary cortisol concentrations were unchanged by stimulation. rTMS was safe, well-tolerated and was considered an acceptable intervention.

CONCLUSIONS:

This study provides modest evidence that rTMS to the l- DLPFC transiently reduces core symptoms of AN and encourages prudent decision making. Importantly, individuals with AN considered rTMS to be a viable tr eatment option. These findings require replication in multiple-session studies to evaluate therapeutic efficacy. Authors McClelland J; Kekic M; Campbell IC; Schmidt U. Institution McClelland,Jessica. Institute of Psychiatry, Psychology and Neuroscienc e, King's College London, London, UK. Kekic,Maria. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Campbell,Iain C. Institute of Psychiatry, Psychology and Neuroscienc e, King's College London, London, UK. Schmidt,Ulrike. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Title Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment in Enduring Anorexia Nervosa: A Case Series. Source European Eating Disorders Review. 24(2):157-63, 2016 Mar.

Abstract OBJECTIVES:

This case series examined the therapeutic potential of repetitive transcranial magnetic stimulation in five women with enduring anorexia nervosa. METHODS: Participants received ~20 sessions of neuronavigated high-frequency repetitive transcranial magnetic stimulation to the left

Topic of this Article:

Topics: rTMS, Eating Disorders


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