Neuromodulation and Eating Disorders

Gallop, Lucy; Flynn, Michaela; Campbell, Iain C.; Schmidt, Ulrike

doi:10.1007/s11920-022-01321-8

Cited by 28 publications

(14 citation statements)

References 65 publications

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Section: Discussionmentioning

confidence: 99%

“…[42,43] Similar targets for deep brain stimulation are being explored for treatment of addiction and pathologic overeating. [44,45] While our work does not explore the functional neuroanatomic changes underlying hyperorality in early-stage bvFTD, the potential for novel therapies is intriguing. tDCS paired with speech therapy has been used successfully in FTD language variants (nonfluent/agrammatic primary progressive aphasia), improving language abilities.…”

Section: Designing Precision Therapies: Implications For Non-invasive...mentioning

confidence: 99%

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Hyperorality in Frontotemporal Dementia: How Psychiatric and Neural Correlates Change Across the Disease Course

Morrow,

Onyike,

Pantelyat

et al. 2024

Preprint

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ObjectivesHyperorality is one of the core features of behavioral variant frontotemporal dementia (bvFTD), however, the cognitive, psychiatric, and neuroanatomic correlates of hyperorality across disease stages remain unclear. This study works to fill this knowledge gap by exploring these associations in the early and advanced stages of bvFTD.MethodsParticipants with sporadic and genetic bvFTD were enrolled in the ARTFL LEFFTDS Longitudinal Frontotemporal Lobar Degeneration consortium (ALLFTD). The primary analyses used baseline data to compare cognitive and psychiatric symptoms in those with and without hyperorality stratified by disease severity. Linear multivariable regressions adjusting for age and total intracranial volume were used to examine baseline associations between regional gray matter volumes and hyperorality status. Five anatomic regions of interest were pre-selected for analysis based on previously identified neuroanatomic correlates of hyperorality in bvFTD.ResultsHyperorality was present in 50% of early-stage bvFTD participants (n = 136) and was associated with higher rates of ritualistic/compulsive behavior. Hyperorality was present in 63% of advanced-stage participants (n = 208) and was associated higher rates of apathy, and ritualistic/compulsive behavior. Regional gray matter volumes were similar in those with and without hyperorality in early-stage participants. In the advanced-stage participants, hyperorality was associated with lower gray matter volumes in the right dorsal and ventral striatum.ConclusionsHyperorality emerges early in bvFTD and is accompanied by deficits in social cognition and complex-ritualistic behavior prior to clinically significant gray matter volume loss. These findings suggest that early identification and treatment of hyperorality could improve neuropsychiatric trajectories in bvFTD.

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Section: Discussionmentioning

confidence: 99%

Section: Designing Precision Therapies: Implications For Non-invasive...mentioning

confidence: 99%

Hyperorality in Frontotemporal Dementia: How Psychiatric and Neural Correlates Change Across the Disease Course

Morrow,

Onyike,

Pantelyat

et al. 2024

Preprint

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“…As previously discussed, there are numerous aberrant brain networks involved in disordered eating. Most of the studies of non-invasive brain stimulation have targeted the dlPFC, and several have targeted the dmPFC [ 32 , 49 ]. Likewise, the dmPFC has been shown to have differential activity in AN, BN, and BED when compared to healthy controls [ 50 ].…”

Section: Current Neuromodulatory Options and Their Target Network/nodesmentioning

confidence: 99%

Neuromodulation of Eating Disorders: A Review of Underlying Neural Network Activity and Neuromodulatory Treatments

Wu,

Lo,

Cavaleri

et al. 2024

Brain Sciences

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Eating disorders are a group of psychiatric conditions that involve pathological relationships between patients and food. The most prolific of these disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. The current standard of care involves psychotherapy, pharmacotherapy, and the management of comorbid conditions, with nutritional rehabilitation reserved for severe cases of anorexia nervosa. Unfortunately, many patients often fail to respond, leaving a concerning treatment gap between the current and requisite treatments for eating disorders. To better understand the neurobiology underlying these eating disorders, investigations have been undertaken to characterize the activity of various neural networks, primarily those activated during tasks of executive inhibition, reward processing, and self-reference. Various neuromodulatory techniques have been proposed to stimulate these networks with the goal of improving patients’ BMI and mental health. The aim of this review is to compile a comprehensive summarization of the current literature regarding the underlying neural connectivity of anorexia nervosa, bulimia nervosa, and binge eating disorder as well as the numerous neuromodulatory modalities that have been investigated. Importantly, we aimed to summarize the most significant clinical trials to date as well as to provide an updated assessment of the role of deep brain stimulation, summarizing numerous recently published clinical studies that have greatly contributed to the literature. In this review, we found therapeutic evidence for transcranial magnetic stimulation and transcranial direct current stimulation in treating individuals suffering from anorexia nervosa, bulimia nervosa, and binge eating disorder. We also found significant evidence for the role of deep brain stimulation, particularly as an escalatory therapy option for the those who failed standard therapy. Finally, we hope to provide promising directions for future clinical investigations.

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“…Excitatory rTMS for AN may therefore be strengthening the top-down cognitive control of the DLPFC on limbic regions such as the amygdala, aiding with emotion regulation and possibly reducing fears around food. The left DLPFC has been the most investigated potential target and, therefore, has the most supporting evidence (Gallop et al, 2022). A key proposed mechanism of HF-rTMS to the left DLPFC is positive effects on emotion regulation, with Lantrip et al (2019) comparing left and right DLPFC stimulation in healthy women and finding that emotion regulation was improved following left and not right DLPFC rTMS.…”

Section: Introductionmentioning

confidence: 99%

“…Neuromodulation is increasingly being explored for the treatment of AN (Gallop et al., 2022). Repetitive transcranial magnetic stimulation (rTMS) is a neuromodulation technique employing brief magnetic pulses, delivered via an electromagnetic coil placed on the scalp, to modulate cortical excitability in targeted AN‐relevant brain regions.…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled feasibility trial of intermittent theta burst stimulation with an open longer‐term follow‐up for young people with persistent anorexia nervosa (RaISE): Study protocol

Hemmings,

Gallop,

İnce

et al. 2024

Euro Eating Disorders Rev

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ObjectiveWe present the protocol of a feasibility randomised controlled trial (RCT) of intermittent theta burst stimulation (iTBS) for young people with anorexia nervosa (AN). Effective first‐line psychological therapies exist for young people with AN, but little is known about how to treat those who do not respond. Non‐invasive neuromodulation, such as iTBS, could address unmet treatment needs by targeting neurocircuitry associated with the development and/or maintenance of AN.DesignSixty‐six young people (aged 13–30 years) with persistent AN will be randomly allocated to receive 20 sessions of real or sham iTBS over the left dorsolateral prefrontal cortex in addition to their usual treatment. Outcomes will be measured at baseline, post‐treatment (1‐month post‐randomisation) and 4‐months post‐randomisation (when unblinding will occur). Additional open follow‐ups will be conducted at 12‐ and 24‐months post‐randomisation. The primary feasibility outcome is the proportion of participants retained in the study at 4‐months. Secondary outcomes include AN symptomatology, other psychopathology, quality of life, service utilisation, neurocognitive processes, and neuroimaging measures.DiscussionFindings will inform the development of a future large‐scale RCT. They will also provide exploratory data on treatment efficacy, and neural and neurocognitive predictors and correlates of treatment response to iTBS in AN.

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Neuromodulation and Eating Disorders

Cited by 28 publications

References 65 publications

Hyperorality in Frontotemporal Dementia: How Psychiatric and Neural Correlates Change Across the Disease Course

Hyperorality in Frontotemporal Dementia: How Psychiatric and Neural Correlates Change Across the Disease Course

Neuromodulation of Eating Disorders: A Review of Underlying Neural Network Activity and Neuromodulatory Treatments

A randomised controlled feasibility trial of intermittent theta burst stimulation with an open longer‐term follow‐up for young people with persistent anorexia nervosa (RaISE): Study protocol

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