Costanzo Floriana, Menghini Deny, Maritato Antonella, Castiglioni Maria C, Mereu Alberta, Varuzza Cristiana, Zanna Valeria, Vicari Stefano
Child Neuropsychiatric Unit, Department of Neuroscience, Bambino Gesù Children Hospital, Rome, Italy.
Front Behav Neurosci. 2018 Jul 20;12:133. doi: 10.3389/fnbeh.2018.00133. eCollection 2018.
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, = 1.8 years) or a family based therapy (FBT+AU = n12, mean age = 15.1, = 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.
神经性厌食症（AN）的治疗效果不佳，急需治疗创新。最近，非侵入性神经调节工具显示出针对大脑改变减轻AN症状的潜力。本研究的目的是验证左侧阳极/右侧阴极前额叶皮质经颅直流电刺激（tDCS）是否有助于改变/重置AN患者的半球间平衡，重新建立对饮食行为的控制。23名患有AN的青少年接受了常规治疗（AU），包括营养、药物和心理教育治疗，外加18次tDCS治疗（TDCS+AU = n11；平均年龄 = 13.9，标准差 = 1.8岁）或基于家庭的治疗（FBT+AU = n12，平均年龄 = 15.1，标准差 = 1.5岁）。在治疗前后评估心理病理量表和体重指数（BMI）。治疗6周后，仅tDCS组的BMI值增加，即使在1个月的随访中也是如此。无论治疗方式如何，所有参与者在多项心理病理指标上都有改善，包括AN心理病理以及情绪和焦虑症状。我们的结果首次证明了左侧阳极/右侧阴极tDCS治疗方案对体重稳定增加有特定效果，且与AN青少年的积极对照治疗相比具有优越性。结果被解释为tDCS可能对AN的某些病理生理机制产生直接/间接影响，涉及中皮质多巴胺能通路并促进食物摄入。这项初步研究为青少年AN的治疗开辟了新的前景，支持了基于大脑的治疗的靶向和有益效果。
