Repetitive transcranial magnetic stimulation (rTMS) in the double-blind treatment of a depressed patient suffering from bulimia nervosa: a case report

Hausmann, Armand; Mangweth, Barbara; Walpoth, Michaela; Hoertnagel, Christine; Kramer-Reinstadler, Karin; Rupp, Claudia I.; Hinterhuber, Hartmann

doi:10.1017/s1461145704004420

Cited by 24 publications

(19 citation statements)

References 8 publications

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“…Several case reports (Kamolz et al, 2008; McClelland et al, 2013b) and an open-label study (Van den Eynde et al, 2013) (not included in the table) suggest potential for rTMS in anorexia nervosa, but findings should be replicated in placebo-controlled trials. For the case of B N, an early case report suggested potential benefits with rTMS (Hausmann et al, 2004), but this was not confirmed in a subsequent clinical trial that used this technique over 3 weeks (Walpoth et al, 2008). A recent case study reported beneficial effects using 10 Hz rTMS applied over a different target, the dorsomedial prefrontal cortex, in a refractory patient with BN (20 sessions, 4 weeks) (Downar et al, 2012).…”

Section: Non-invasive Neuromodulation Approaches: Recent Developmentsmentioning

confidence: 99%

Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity

Val‐Laillet¹,

Aarts

Weber

et al. 2015

NeuroImage: Clinical

383

321

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Functional, molecular and genetic neuroimaging has highlighted the existence of brain anomalies and neural vulnerability factors related to obesity and eating disorders such as binge eating or anorexia nervosa. In particular, decreased basal metabolism in the prefrontal cortex and striatum as well as dopaminergic alterations have been described in obese subjects, in parallel with increased activation of reward brain areas in response to palatable food cues. Elevated reward region responsivity may trigger food craving and predict future weight gain. This opens the way to prevention studies using functional and molecular neuroimaging to perform early diagnostics and to phenotype subjects at risk by exploring different neurobehavioral dimensions of the food choices and motivation processes. In the first part of this review, advantages and limitations of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), pharmacogenetic fMRI and functional near-infrared spectroscopy (fNIRS) will be discussed in the context of recent work dealing with eating behavior, with a particular focus on obesity. In the second part of the review, non-invasive strategies to modulate food-related brain processes and functions will be presented. At the leading edge of non-invasive brain-based technologies is real-time fMRI (rtfMRI) neurofeedback, which is a powerful tool to better understand the complexity of human brain–behavior relationships. rtfMRI, alone or when combined with other techniques and tools such as EEG and cognitive therapy, could be used to alter neural plasticity and learned behavior to optimize and/or restore healthy cognition and eating behavior. Other promising non-invasive neuromodulation approaches being explored are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). Converging evidence points at the value of these non-invasive neuromodulation strategies to study basic mechanisms underlying eating behavior and to treat its disorders. Both of these approaches will be compared in light of recent work in this field, while addressing technical and practical questions. The third part of this review will be dedicated to invasive neuromodulation strategies, such as vagus nerve stimulation (VNS) and deep brain stimulation (DBS). In combination with neuroimaging approaches, these techniques are promising experimental tools to unravel the intricate relationships between homeostatic and hedonic brain circuits. Their potential as additional therapeutic tools to combat pharmacorefractory morbid obesity or acute eating disorders will be discussed, in terms of technical challenges, applicability and ethics. In a general discussion, we will put the brain at the core of fundamental research, prevention and therapy in the context of obesity and eating disorders. First, we will discuss the possibility to identify new biological markers of brain functions. Second, we will highli...

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Section: Non-invasive Neuromodulation Approaches: Recent Developmentsmentioning

confidence: 99%

Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity

Val‐Laillet¹,

Aarts

Weber

et al. 2015

NeuroImage: Clinical

383

321

View full text Add to dashboard Cite

show abstract

“…[25][26][27] Case reports have appeared regarding the successful use of repeated transcranial magnetic simulation in patients with both major depressive disorder and bulimia nervosa. 28,29 In summary, in examining the literature on biological therapies for bulimia nervosa, there is clear evidence that antidepressants such as the SSRIs are helpful in reducing symptoms and improving comorbid conditions; however, participants rarely achieve abstinence and many who have a favorable response to the drug will discontinue their use prematurely or experience relapse while still on drug therapy. Overall this suggests that drug therapy plays a legitimate but limited role in bulimia nervosa treatment.…”

Section: Psychopharmacological Of Bulimia Nervosamentioning

confidence: 99%

Treatment of bulimia nervosa: Where are we and where are we going?

Mitchell

Agras

Wonderlich

2006

Intl J Eating Disorders

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“…To date, few studies have examined the use of rTMS in patients with eating disorders, and results have been mixed using the conventional rTMS target in the dorsolateral prefrontal cortex (DLPFC; Hausmann et al, 2004; Walpoth et al, 2008; Van den Eynde et al, 2010). However, neuroimaging studies in eating disorders suggest structural and functional abnormalities of other regions, such as the anterior cingulate cortex and the neighboring dorsomedial prefrontal cortex (DMPFC; Muhlau et al, 2007; Schafer et al, 2010; Joos et al, 2011), suggesting that these could be more effective rTMS targets.…”

Section: Introductionmentioning

confidence: 99%

Unanticipated Rapid Remission of Refractory Bulimia Nervosa, during High-Dose Repetitive Transcranial Magnetic Stimulation of the Dorsomedial Prefrontal Cortex: A Case Report

Downar¹,

Sankar²,

Giacobbe³

et al. 2012

Front. Psychiatry

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A woman with severe, refractory bulimia nervosa (BN) underwent treatment for comorbid depression using repetitive transcranial magnetic stimulation (rTMS) of the dorsomedial prefrontal cortex (DMPFC) using a novel technique. Unexpectedly, she showed a rapid, dramatic remission from BN. For 5 months pre-treatment, she had reported two 5-h binge-purge episodes per day. After rTMS session 2 the episodes stopped entirely for 1 week; after session 10 there were no further recurrences. Depression scores improved more gradually to remission at session 10. Full remission from depression and binge-eating/purging episodes was sustained more than 2 months after treatment completion. In neuroimaging studies, the DMPFC is important in impulse control, and is underactive in BN. DMPFC–rTMS may have enhanced the patient’s ability to deploy previously acquired strategies to avoid binge-eating and purging via a reduction in her impulsivity. A larger sham-controlled trial of DMPFC–rTMS for binge-eating and purging behavior may be warranted.

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Repetitive transcranial magnetic stimulation (rTMS) in the double-blind treatment of a depressed patient suffering from bulimia nervosa: a case report

Cited by 24 publications

References 8 publications

Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity

Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity

Treatment of bulimia nervosa: Where are we and where are we going?

Unanticipated Rapid Remission of Refractory Bulimia Nervosa, during High-Dose Repetitive Transcranial Magnetic Stimulation of the Dorsomedial Prefrontal Cortex: A Case Report

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