We may be getting closer to a cure for one of the most deadly eating disorders.
Anorexia nervosa is an extremely serious eating disorder — researchers report that up to 20 percent of people with anorexia die prematurely, and that only 20 to 30 percent of people with anorexia recover from talking therapies.
With those statistics in mind, it’s clear that we desperately need more effective treatments for the disorder, and a new study from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London offers new hope for an effective way to reduce the symptoms of anorexia.
In order to target the underlying neural basis of anorexia, researchers have been looking increasingly into emerging neuroscience-based technologies, like repetitive transcranial magnetic stimulation (rTMS).
Essentially, rTMS works by delivering small bursts of energy to targeted brain regions via an electromagnetic coil, and it’s already an approved treatment for depression, according to the press release.
This new study is the first randomized control trial to assess the effectiveness of rTMS in reducing symptoms of anorexia, and the results were indeed promising.
“We found that one session of rTMS reduced the urge to restrict food intake, levels of feeling full and levels of feeling fat, as well as encouraging more prudent decision-making,” said Dr. Jessica McClelland, post-doctoral researcher at the Institute, in a statement. “Taken together, these findings suggest that brain stimulation may reduce symptoms of anorexia by improving cognitive control over compulsive features of the disorder.”
With rTMS, the scientists targeted an area of the brain that’s thought to be involved in some of the self-regulation difficulties linked to anorexia, called the dorsolateral prefrontal cortex. The magnetic pulses to the brain feel like a gentle tapping sensation on the side of the head, the researchers say.
In the study, 49 participants completed food exposure and decision-making tasks — both before and after a session of either real rTMS or a placebo session. The scientists measured symptoms of anorexia immediately before and after the rTMS, as well as 20 minutes and 24 hours following the session.
Compared to the placebo group, the participants who had real rTMS acted with more prudent decision-making — they waited for the larger, later rewards rather than acting impulsively and choosing the smaller, sooner option.
The researchers also report that just one session of rTMS showed a reduced urge to restrict food intake as well as lower levels of feeling fat.
Although these findings were only a statistical trend, the study authors say that there is clear improvement in anorexia symptoms and decision-making abilities after just one rTMS session. With a larger study sample and multiple session of rTMS, they hypothesize that these effects would only get stronger.
“Anorexia nervosa is thought to affect up to 4 percent of women in their life-time. With increasing illness duration, anorexia becomes entrenched in the brain and increasingly difficult to treat,” said Professor Ulrike Schmidt, senior author of the study. “Our preliminary findings support the potential of novel brain-directed treatments for anorexia, which are desperately needed.”
Since the findings from this study were so promising, the researchers say they will now assess whether rTMS has long-lasting therapeutic benefits in a world-first clinical trial of rTMS treatment. It will involve 20 rTMS sessions, so the results will definitely be telling.
The results are published in the journal PLOS ONE.