Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.
New York State Psychiatric Institute, New York, New York, USA.
Int J Eat Disord. 2021 Nov;54(11):2031-2036. doi: 10.1002/eat.23597. Epub 2021 Aug 20.
Repetitive transcranial magnetic stimulation (rTMS) is used to modulate neural systems and provides the opportunity for experimental tests of hypotheses regarding mechanisms underlying anorexia nervosa (AN). The present pilot study has investigated whether high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) to a region of the right dorsolateral prefrontal cortex (DLPFC) might be associated with change in food selection among adult inpatients with AN. Ten women received one session of sham and one session of HF-rTMS targeting the right DLPFC while completing a computerized Food Choice Task. Compared to sham, HF-rTMS was associated with changes in food ratings and food choice: inpatients reported higher healthiness ratings of low- and high-fat foods and selected a significantly greater proportion of high-fat foods over a neutrally rated reference item while receiving HF-rTMS. Findings suggest that HF-rTMS to the right DLPFC was associated with a reduction of fat avoidance on a food choice task among inpatients with AN and provide additional support for the possibility that this region, and related neural circuits, may underlie restrictive food choice. Research using rTMS to experimentally test neural mechanisms is needed to elucidate the underpinnings of AN and supports the development of novel treatment targets.
重复经颅磁刺激（rTMS）用于调节神经系统，并为关于神经性厌食症（AN）发病机制的假说提供实验测试的机会。本初步研究调查了高频重复经颅磁刺激（HF-rTMS）右侧背外侧前额叶皮层（DLPFC）是否与 AN 成年住院患者的食物选择变化有关。10 名女性在完成计算机化食物选择任务时，接受了一次假刺激和一次针对右侧 DLPFC 的 HF-rTMS 治疗。与假刺激相比，HF-rTMS 与食物评分和食物选择的变化有关：住院患者在接受 HF-rTMS 治疗时，对低脂肪和高脂肪食物的健康评分更高，并选择了明显更多的高脂肪食物，而不是中性参考项目。研究结果表明，右侧 DLPFC 的 HF-rTMS 与 AN 住院患者在食物选择任务中减少脂肪回避有关，并为该区域及相关神经回路可能是限制食物选择的基础提供了额外支持。需要使用 rTMS 进行研究来实验性测试神经机制，以阐明 AN 的基础，并支持新的治疗靶点的开发。
