Abstract
Poor treatment outcomes are available for anorexia nervosa (AN) and treatment innovations are urgently needed. Recently, non-invasive neuromodulation tools have suggested to have potential for reducing an symptomatology targeting brain alterations. The objective of the study was to verify whether left anodal/right cathodal prefrontal cortex transcranial direct current stimulation (tDCS), may aid in altering/resetting inter-hemispheric balance in patients with AN, re-establishing control over eating behaviors. Twenty-three adolescents with an underwent a treatment as usual (AU), including nutritional, pharmacological, and psychoeducational treatment, plus 18 sessions of tDCS (TDCS+AU = n11; mean age = 13.9, SD = 1.8 years) or a family based therapy (FBT+AU = n12, mean age = 15.1, SD = 1.5 years). Psychopathological scales and the body mass index (BMI) were assessed before and after treatment. After 6 weeks of treatment, the BMI values increased only in the tDCS group, even at 1-month follow-up. Independently of the treatment, all participants improved in several psychopathological measures, included AN psychopathology and mood and anxiety symptoms. Our results demonstrated for the first time a specific effect of the left anodal/right cathodal tDCS treatment protocol on stable weight gain and a superiority compared to an active control treatment for adolescents with AN. Results were interpreted as a possible direct/indirect effect of tDCS in into some pathophysiological mechanisms of AN, involving the mesocortical dopaminergic pathways and the promotion of food intake. This pilot study opens new perspectives in the treatment of an in adolescence, supporting the targeted and beneficial effects of a brain-based treatment.
Highlights
Eating disorders (ED) are highly distinctive disorders characterized by pathological eating behaviors and body image disturbance. according to the diagnostic and statistical manual of mental disorders, fifth edition (Dsm-5), ED shall be considered as a spectrum of over-eating and under-eating, associated with altered weight and with altered food reward that results in significant biologic, psychological, and social complications
Baselines Measures transcranial direct current stimulation (tDCS)+as usual (AU) and Family Based Therapy (FBT)+AU groups did not differ for body mass index (BMI) as well as for baseline psychopathological measures: EDI-3 [t(21) = −1.14, p = 0.27], EAT-26 [t(21) = −0.70, p = 0.49], BUT [t(21) = −1.33, p = 0.20], MASC [t(21) = 1.11, p = 0.28], CDI [t(21) = 0.46, p = 0.65]
BMI improved significantly in the tDCS+AU (p < 0.001), while in the FBT+AU no difference emerged in BMI after treatment compared to baseline (p = 0.2)
Summary
Eating disorders (ED) are highly distinctive disorders characterized by pathological eating behaviors and body image disturbance. according to the diagnostic and statistical manual of mental disorders, fifth edition (Dsm-5), ED shall be considered as a spectrum of over-eating and under-eating, associated with altered weight and with altered food reward that results in significant biologic, psychological, and social complications. According to the diagnostic and statistical manual of mental disorders, fifth edition (Dsm-5), ED shall be considered as a spectrum of over-eating and under-eating, associated with altered weight and with altered food reward that results in significant biologic, psychological, and social complications. Anorexia nervosa (AN) is a severe ED associated whit other important physical and psychological comorbidities. It is defined by an extremely low. Pharmacological treatment plays a limited role (Aigner et al, 2011; Gustavsson et al, 2011; Dold et al, 2015; Garner et al, 2016). No Food and Drug Administration indication for any pharmacological treatment for AN is given
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