Effects of neuromodulation on eating and body weight

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A systematic review of the effects of neuromodulation on eating and body weight: evidence from human and animal studies

Authors: Jessica McClelland*, Natali Bozhilova, Iain Campbell & Ulrike Schmidt, Section of Eating Disorders, Institute of Psychiatry, King’s College London, London, UK

Source: European Eating Disorder Review 21 (6) 436-455

Purpose:

To examine the effects of neuromodulation techniques on eating behaviours and body weight and to assess their potential for therapeutic use in eating disorders (ED).

Method:

All articles in PubMed, PsychInfo and Web of Knowledge were considered and screened against a priori inclusion/exclusion criteria. The effects of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, vagus nerve stimulation (VNS) and deep brain stimulation (DBS) were examined across studies in ED samples, other psychiatric and neurological disorders, and animal models.

Results:

Sixty studies were identified. There is evidence for ED symptom reduction following rTMS and DBS in both AN and bulimia nervosa. Findings from studies of other psychiatric and neurological disorders and from animal studies demonstrate that increases in food intake and body weight can be achieved following DBS and that VNS has potential value as a means of controlling eating and inducing weight loss.

Conclusions:

Neuromodulation tools have potential for reducing ED symptomatology and related behaviours, and for altering food intake and body weight. In response to such findings, and emerging neural models of ED, treatment approaches are highly unlikely to remain ‘brainless’. More research is required to evaluate the potential of neuromodulation procedures for improving long-term outcomes in ED.

http://www.ncbi.nlm.nih.gov/pubmed/24155246

Comments reviewer, Prof Van Nieuwenhuizen:

Eating disorders (ED) are chronic and sometimes deadly illnesses. Existing treatments have limited proven efficacy, especially in the case of adults with anorexia nervosa (AN). MRI studies in patients with ED have demonstrated altered activity in the insula, abnormalities in processing rewards and alterations in the frontal regions. Subsequently, development of neural models emerged; e.g. a model consisting of “bottom-up” emotion generation arising from subcortical limbic neural structures and “top-down” regulation by dorsal prefrontal cortical regions. Three studies on changes in body weight/BMI in epilepsy patients after VNS implantation have been found: one of them showed significant loss of body weight. Concerning animal models, 8 studies on the effects of VNS and DBS on binge eating/obesity were found; three (in pigs) showed decreased food consumption. All four studies in rats on changes in food intake and body weight after VNS implantation showed reduction of food intake / body weight and / or weight gain. In conclusion: VNS has a potential as an alternative to more invasive treatment in patients with eating disorders.

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