Effects of repetitive transcranial magnetic stimulation of the right inferior parietal lobe on the body image perception in anorexia nervosa: A pilot randomized controlled study.

Nathalie Chastan, Marie-Laure Welter, Marie-Astrid Piquet, Sébastien Guillaume, Pierre Dechelotte, Najate Achamrah, Olivier Etard, Clément Nathou, Jérôme Attal, André Gillibert, Olivier Guillin

Journal: Brain and behavior 2024;14(7):e3617

PMID: 38970216

Abstract

INTRODUCTION

Restrictive anorexia nervosa (AN) is associated with distorted perception of body shape, previously linked to hypoactivity and reduced excitability of the right inferior parietal lobe (rIPL). Here, we investigated the impact of high-frequency repetitive transcranial magnetic stimulation (HF rTMS) of the rIPL on body shape perception in patients with AN.

METHODS

Seventeen patients with AN (median [Q1_Q3] age, 35 [27_39] years; disease duration, 12 [6_18] years) were randomly assigned to receive real or sham HF (10 Hz) rTMS of the rIPL over a period of 2 weeks, comprising 10 sessions. The primary outcome measure was the Body Shape Questionnaire (BSQ). Secondary outcomes included eating disorder symptoms, body mass index, mood, anxiety, and safety. Data collection were done at baseline, post-rTMS, and at 2 weeks and 3 months post-rTMS.

RESULTS

Following both real and sham rTMS of the rIPL, no significant differences were observed in body shape perception or other parameters. Both real and sham rTMS interventions were deemed safe and well tolerated. Notably, serious adverse events were associated with the underlying eating and mood disorders, resulting in hospitalization for undernutrition (five patients) or suicidal attempts (two patients).

CONCLUSION

This pilot study does not support the use of rTMS of the rIPL as an effective method for improving body shape perception in individuals with the restrictive form of AN. Further research is warranted to comprehensively explore both the clinical and neurophysiological effects of HF rTMS in this population.

© 2024 The Author(s). Brain and Behavior published by Wiley Periodicals LLC.

Address: Department of Neurophysiology, Normandie University, UNIROUEN, Rouen University Hospital, Rouen, France.; Department of Nutrition, Normandie University, UNIROUEN, INSERM UMR1073, Rouen University Hospital, Rouen, France.; Department of Neurophysiology, Normandie University, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, Caen, France.; Department of Neurophysiology, Normandie University, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, Caen, France.; Department of Psychiatry, CHU Caen, Caen, France.; Department of Nutrition, CHU Caen, Caen, France.; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.; Department of Biostatistics, CHU Rouen, Rouen, France.; Department of Psychiatry, Normandie University, UNIROUEN, Rouen University Hospital, Rouen, France.
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