Title:Neurostimulation in Clinical and Sub-clinical Eating Disorders: A Systematic Update of the Literature
Volume: 16
Issue: 8
Author(s): Bethan Dalton, Savani Bartholdy, Iain C. Campbell and Ulrike Schmidt*
Affiliation:
- Section of Eating Disorders, Department of Psychological Medicine, King`s College London, London,United Kingdom
Keywords:
Anorexia nervosa, bulimia nervosa, binge eating disorder, repetitive transcranial magnetic stimulation, transcranial
direct current stimulation, deep brain stimulation, neurostimulation.
Abstract: Introduction: Whilst psychological therapies are the main approach to treatment of eating
disorders (EDs), advances in aetiological research suggest the need for the development of more
targeted, brain-focused treatments. A range of neurostimulation approaches, most prominently repetitive
transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS)
and deep brain stimulation (DBS), are rapidly emerging as potential novel interventions. We have
previously reviewed these techniques as potential treatments of EDs.
Aim: To provide an update of the literature examining the effects of DBS, rTMS and tDCS on eating
behaviours, body weight and associated symptoms in people with EDs and relevant analogue
populations.
Methods: Using PRISMA guidelines, we reviewed articles in PubMed, Web of Science, and PsycINFO
from 1st January 2013 until 14th August 2017, to update our earlier search. Studies assessing
the effects of neurostimulation techniques on eating and weight-related outcomes in people with
EDs and relevant analogue populations were included. Data from both searches were combined.
Results: We included a total of 32 studies (526 participants); of these, 18 were newly identified by
our update search. Whilst findings are somewhat mixed for bulimia nervosa, neurostimulation techniques
have shown potential in the treatment of other EDs, in terms of reduction of ED and associated
symptoms. Studies exploring cognitive, neural, and hormonal correlates of these techniques are
also beginning to appear.
Conclusions: Neurostimulation approaches show promise as treatments for EDs. As yet, large wellconducted
randomised controlled trials are lacking. More information is needed about treatment
targets, stimulation parameters and mechanisms of action.
