Brain Stimulation in Eating Disorders: State of the Art and Future Perspectives

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Abstract

The management of eating disorders (EDs) is still difficult and few treatments are effective. Recently, several studies have described the important contribution of non-invasive brain stimulation (repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and electroconvulsive therapy) and invasive brain stimulation (deep brain stimulation and vagal nerve stimulation) for ED management. This review summarizes the available evidence supporting the use of brain stimulation in ED. All published studies on brain stimulation in ED as well as ongoing trials registered at clinicaltrials.gov were examined. Articles on neuromodulation research and perspective articles were also included. This analysis indicates that brain stimulation in EDs is still in its infancy. Literature data consist mainly of case reports, cases series, open studies, and only a few randomized controlled trials. Consequently, the evidence supporting the use of brain stimulation in EDs remains weak. Finally, this review discusses future directions in this research domain (e.g., sites of modulation, how to enhance neuromodulation efficacy, personalized protocols).

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Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness.

H Mayberg, M Liotti, S Brannan … (1999)

Theories of human behavior from Plato to Freud have repeatedly emphasized links between emotion and reason, a relationship now commonly attributed to pathways connecting phylogenetically "old" and "new" brain regions. Expanding on this theory, this study examined functional interactions between specific limbic and neocortical regions accompanying normal and disease-associated shifts in negative mood state. Regions of concordant functional change accompanying provocation of transient sadness in healthy volunteers and resolution of chronic dysphoric symptoms in depressed patients were examined with two positron emission tomography techniques: [15O]water and [18F]fluorodeoxyglucose, respectively. With sadness, increases in limbic-paralimbic blood flow (subgenual cingulate, anterior insula) and decreases in neocortical regions (right dorsolateral prefrontal, inferior parietal) were identified. With recovery from depression, the reverse pattern, involving the same regions, was seen--limbic metabolic decreases and neocortical increases. A significant inverse correlation between subgenual cingulate and right dorsolateral prefrontal activity was also demonstrated in both conditions. Reciprocal changes involving subgenual cingulate and right prefrontal cortex occur with both transient and chronic changes in negative mood. The presence and maintenance of functional reciprocity between these regions with shifts in mood in either direction suggests that these regional interactions are obligatory and probably mediate the well-recognized relationships between mood and attention seen in both normal and pathological conditions. The bidirectional nature of this limbic-cortical reciprocity provides additional evidence of potential mechanisms mediating cognitive ("top-down"), pharmacological (mixed), and surgical ("bottom-up") treatments of mood disorders such as depression.

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Interoception and Mental Health: A Roadmap

Sahib Khalsa, Ralph Adolphs, Oliver G Cameron … (2017)

Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body’s internal landscape across conscious and unconscious levels. Interoceptive signaling has been considered a component process of reflexes, urges, feelings, drives, adaptive responses, and cognitive and emotional experiences, highlighting its contributions to the maintenance of homeostatic functioning, body regulation, and survival. Dysfunction of interoception is increasingly recognized as an important component of different mental health conditions, including anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders. However, a number of conceptual and methodological challenges have made it difficult for interoceptive constructs to be broadly applied in mental health research and treatment settings. In November 2016, the Laureate Institute for Brain Research organized the first Interoception Summit, a gathering of interoception experts from around the world, with the goal of accelerating progress in understanding the role of interoception in mental health. The discussions at the meeting were organized around four themes: interoceptive assessment, interoceptive integration, interoceptive psychopathology, and the generation of a roadmap that could serve as a guide for future endeavors. This review article presents an overview of the emerging consensus generated by the meeting.

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Noninvasive Deep Brain Stimulation via Temporally Interfering Electric Fields

Nir Grossman, David Bono, Nina Dedic … (2017)

Summary We report a noninvasive strategy for electrically stimulating neurons at depth. By delivering to the brain multiple electric fields at frequencies too high to recruit neural firing, but which differ by a frequency within the dynamic range of neural firing, we can electrically stimulate neurons throughout a region where interference between the multiple fields results in a prominent electric field envelope modulated at the difference frequency. We validated this temporal interference (TI) concept via modeling and physics experiments, and verified that neurons in the living mouse brain could follow the electric field envelope. We demonstrate the utility of TI stimulation by stimulating neurons in the hippocampus of living mice without recruiting neurons of the overlying cortex. Finally, we show that by altering the currents delivered to a set of immobile electrodes, we can steerably evoke different motor patterns in living mice.

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Journal

Journal ID (nlm-ta): J Clin Med

Journal ID (iso-abbrev): J Clin Med

Journal ID (publisher-id): jcm

Title: Journal of Clinical Medicine

Publisher: MDPI

ISSN (Electronic): 2077-0383

Publication date (Electronic): 23 July 2020

Publication date Collection: August 2020

Volume: 9

Issue: 8

Electronic Location Identifier: 2358

Affiliations

[1 ]GHU Paris Psychiatry and Neuroscience, Clinique des Maladies Mentales et de l’Encéphale (CMME), Sainte-Anne Hospital, 75014 Paris, France; phduriez@ 123456gmail.com (P.D.); P.GORWOOD@ 123456ghu-paris.fr (P.G.)

[2 ]Institute of Psychiatry and Neurosciences of Paris (IPNP), UMR_S1266, INSERM, Université de Paris, 102-108 rue de la Santé, 75014 Paris, France

[3 ]Department of Psychiatry, Hotel Dieu de France- Saint Joseph University, 166830 Beirut, Lebanon; ramiboukhalil@ 123456hotmail.com (R.B.K.); yara.chamoun@ 123456hotmail.com (Y.C.)

[4 ]Neuropsychiatry: Epidemiological and Clinical Research, Université Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; maude.seneque@ 123456gmail.com (M.S.); p-courtet@ 123456chu-montpellier.fr (P.C.)

[5 ]Sorbonne Université, AP-HP, Service de Psychiatrie Adulte de la Pitié-Salpêtrière, Institut du Cerveau, ICM, 75013 Paris, France; redwanmaatoug@ 123456gmail.com

[6 ]Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, 03101 Vilnius, Lithuania; robertas.strumila@ 123456gmail.com

[7 ]Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, 34295 Montpellier, France

Author notes

[* ]Correspondence: s-guillaume@ 123456chu-montpellier.fr ; Tel.: +33-467-338-581

[†]

These authors contributed equally to this work.

Author information

Philibert Duriez https://orcid.org/0000-0001-7321-6820

Rami Bou Khalil https://orcid.org/0000-0003-1725-4755

Yara Chamoun https://orcid.org/0000-0003-0825-0920

Redwan Maatoug https://orcid.org/0000-0002-1427-2096

Robertas Strumila https://orcid.org/0000-0002-0530-1537

Philip Gorwood https://orcid.org/0000-0003-1845-3676

Sébastien Guillaume https://orcid.org/0000-0002-6769-9982

Article

Publisher ID: jcm-09-02358

DOI: 10.3390/jcm9082358

PMC ID: 7465000

PubMed ID: 32717984

SO-VID: afd13d9d-d1fa-4edd-b19b-7633ee1691b6

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Brain Stimulation in Eating Disorders: State of the Art and Future Perspectives

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Karger: Neurology and Neuroscience

Most cited references 129

Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness.

Interoception and Mental Health: A Roadmap

Noninvasive Deep Brain Stimulation via Temporally Interfering Electric Fields

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