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The following is a summary of “Neuromodulatory techniques in eating disorders: From electroconvulsive therapy to transcranial magnetic stimulation and beyond: A mixed method systematic meta-review,” published in the December 2024 issue of Psychiatry by Longo et al.
Psychosocial and pharmacological treatments for eating disorders (EDs) often yield modest, short-term improvements. Neuromodulation, which targets nerve activity, is an emerging intervention for neuropsychiatric disorders.
Researchers conducted a prospective study to synthesize evidence on neuromodulatory techniques in patients with EDs.
They selected systematic reviews or meta-analyses on neuromodulatory techniques in patients with eating disorders. Data extraction was performed by 3 evaluators, with discrepancies resolved by 2 experienced researchers. Study quality was assessed using AMSTAR-2. Defined outcomes and effect sizes were reported for systematic reviews, while meta-analyses included pooled effect sizes and heterogeneity data.
The results showed 18 systematic reviews (5 meta-analyses) with minimal primary study overlap (<5%). Most focused on anorexia nervosa (AN), with some on treatment-resistant cases, bulimia nervosa (BN), and binge eating disorder (BED). Study quality was critically low, often combining observational studies with randomized-controlled trials (RCTs). Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) showed promising results in managing binge eating and craving levels more effectively than body mass index in AN. Side effects included headaches, nausea, and drowsiness for rTMS and tDCS, with rare seizures and infection associated with deep brain stimulation.
Investigators concluded that neuromodulation showed promise for treating EDs. Future studies should have focused on RCTs, objective outcomes, longer follow-up, and comprehensive adverse event monitoring.
Source: sciencedirect.com/science/article/pii/S0165178124006310
