Repetitive transcranial magnetic stimulation treatment in severe, enduring anorexia nervosa: An open longer-term follow-up

Dalton, B.; Lewis, Y. D.; Bartholdy, S.; Kekic, M.; McClelland, J.; Campbell, I. C.; Schmidt, U.

Abstract:

Objective: this study assessed longer-term outcomes from a randomised controlled feasibility trial of 20 sessions of real versus sham high-frequency repetitive transcranial magnetic stimulation (rTMS) to the left dorsolateral prefrontal cortex in adults with severe, enduring anorexia nervosa (SE-AN). Methods: thirty participants who completed the original study protocol were invited to take part in an open follow-up (18-months post-randomisation), assessing body mass index (BMI), eating disorder (ED) symptoms and other psychopathology. Results: twenty-four participants (12 each originally allocated to real/sham) completed the 18-month follow-up. Ten of 12 participants who originally received sham treatment had real rTMS at some stage during the follow-up. A medium between-group effect size was seen for BMI change from baseline to 18-months, favouring those originally allocated to real rTMS. In this group at 18-months, five participants were weight recovered (BMI ≥18.5 kg/m2), compared with one participant in the original sham group. Both groups showed further improvement in ED symptoms during the follow-up. Effects on mood were largely maintained at follow-up, with catch-up effects in the original sham group. Conclusions: findings suggest that rTMS treatment effects on mood are durable and that BMI and ED symptom improvements need time to emerge. Large-scale trials are needed.

Patologie/Applicazioni:

• Stimolazione Magnetica Transcranica (TMS)
• Disturbi alimentari

Anno:

2020

Tipo di pubblicazione:

Articolo

Parola chiave:

stimolazione magnetica transcranica; anoressia; DCA; disturbi del comportamento alimentare

Testata scientifica:

Online library - Wiley

Mese:

07

Nota:

Questo studio analizza i risultati a lungo termine di un trattamento rTMS per l’anoressia nervosa grave e persistente. A 18 mesi dal trattamento, il gruppo trattato ha mostrato un miglioramento stabile dell’umore e una progressiva crescita del BMI, con il 46% che ha raggiunto un peso nella norma rispetto al 9% del gruppo sham. Le analisi qualitative rivelano che molti pazienti hanno sperimentato un cambiamento positivo nel modo di pensare e nel rapporto con sé stessi, spesso emerso settimane o mesi dopo il trattamento, segno di un effetto terapeutico duraturo.

DOI:

10.1002/erv.2766