Khedr Eman M, Elfetoh Noha Abo, Ali Anwer M, Noamany Mostafa
Department of Neuropsychiatry, Assiut University Hospital, Assiut, Egypt.
Restor Neurol Neurosci. 2014;32(6):789-97. doi: 10.3233/RNN-140392.
Existing treatments for adults with anorexia nervosa (AN) have limited proven efficacy. New treatments that have been suggested involve targeted, brain-directed interventions such as transcranial direct current stimulation (tDCS). We describe findings from seven individuals with treatment-resistant AN who received 10 sessions of anodal tDCS, over the left dorsolateral prefrontal cortex (DLPFC).
In this open-label, single-arm study, seven patients received anodal tDCS (2mA) for 25 minutes over the left dorsolateral prefrontal cortex daily for ten days. Assessments pre-tDCS, post-tDCS and one month later included the Eating Attitude Test (EAT), Eating Disorder Inventory (EDI) and Beck Depression Inventory (BDI).
Three patients improved in all three rating scales immediately after the treatment sessions and one month later. Two patients showed improvement at the end of treatment but returned to the baseline after one month. One subject improved only on the BDI scale but not eating scales. The scores in the three rating scales were unaffected by treatment in the remaining patient. There was a significant effect of time (pre, post and 1 month later) on the three rating scores; BDI (P = 0.016), EDI (P = 0.018) and EAT (P = 0.016) and a significant correlation between the percent improvement of BDI and EAT (p = 0.01), and between BDI and EDI (P = 0.006).
These findings suggest that tDCS has potential as an adjuvant treatment for AN and deserves further study.
现有针对神经性厌食症(AN)成人患者的治疗方法,其已证实的疗效有限。新提出的治疗方法包括针对性的、针对大脑的干预措施,如经颅直流电刺激(tDCS)。我们描述了7名难治性AN患者接受10次阳极tDCS治疗(刺激左侧背外侧前额叶皮质)的研究结果。
在这项开放标签、单臂研究中,7名患者每天在左侧背外侧前额叶皮质接受25分钟的阳极tDCS(2毫安)治疗,持续10天。在tDCS治疗前、治疗后及1个月后进行的评估包括饮食态度测试(EAT)、饮食失调量表(EDI)和贝克抑郁量表(BDI)。
3名患者在治疗结束后及1个月后的所有三个评分量表上均有改善。2名患者在治疗结束时有所改善,但1个月后恢复至基线水平。1名受试者仅在BDI量表上有所改善,饮食量表未改善。其余患者的三个评分量表得分未受治疗影响。时间(治疗前、治疗后及1个月后)对三个评分量表有显著影响;BDI(P = 0.016)、EDI(P = 0.018)和EAT(P = 0.016),且BDI与EAT的改善百分比之间(p = 0.01)以及BDI与EDI之间(P = 0.006)存在显著相关性。
这些发现表明,tDCS作为AN的辅助治疗具有潜力,值得进一步研究。