Neurostimulation Approaches in the Treatment of Severe Anorexia Nervosa

Abstract

Psychiatry is seeking interventions that could reliably sustain weight gain and psychosomatic recovery of patients with severe anorexia nervosa (AN). Currently, patients with AN, even after receiving individually-tailored therapeutic interventions, often relapse following marginal weight restoration. Also, the evidence regarding the effectiveness of psychotropic medications in relieving and treating AN symptomology is limited. The research in the field is aiming to mitigate shortcomings associated with common practices and build on strategies including enhanced-CBT. An eminent discordance with conventional treatment modalities gives reason to explore alternative standards of care. This review explores 21st-century studies adopting neurostimulation therapies as an alternative approach for severe AN. The most widely used neurostimulation treatment in psychiatry is electroconvulsive therapy (ECT), but modern transcranial magnetic stimulation (TMS) due to its non-invasive technology has also garnered the attention of practitioners. Deep brain stimulation (DBS) is rapidly emerging as a potential (invasive) treatment. These three treatment options are further explored, and future research directions are discussed.

Updating Prospective Self-Efficacy Beliefs About Cardiac Interoception in Anorexia Nervosa: An Experimental and Computational Study

“…For example, patients may present with an inability to sense a depleted nutritional body state and difficulties in perceiving and interpreting cutaneous, cardiac, and respiratory signals (e.g., Berner et al, 2018 ; Crucianelli et al, 2021 ; Davidovic et al, 2018 ; Kerr et al, 2016 ; Lapidus et al, 2020 ; Pollatos et al, 2008 , 2016 ). Contemporary network analyses identify dysfunctional interoception as a core ED component ( Brown et al, 2020 ; Cascino et al, 2019 ; Olatunji et al, 2018 ; Solmi et al, 2018 ; Vervaet et al, 2021 ), affecting treatment outcomes ( Bizeul et al, 2001 ; Carter et al, 2004 ), unless targeted by interoceptive-based interventions ( Baker, 2020 ; Choquette et al, 2023 ; Dalton et al, 2018 ; Heim et al, 2022 ; Khalsa et al, 2020 ).…”

Updating Prospective, Self-Efficacy Beliefs About Cardiac Interoception in Anorexia Nervosa: An Experimental and Computational Study

“…Crucially, the larger such interoceptive deficits are, the worse the treatment outcome (Bizeul et al, 2001;Carter et al, 2004). Finally, there are some indications of effectiveness in a growing array of interoceptive-based interventions, including behavioural (for systematic review, see (Heim et al, 2022)) and neurostimulation interventions (Baker, 2020;Dalton et al, 2018) for EDs.…”