Deciphering the Neural Mechanisms of Restrictive Eating in Anorexia Nervosa Using Repetitive Transcranial Magnetic Stimulation
New York State Psychiatric Institute
Summary
This study will examine the impact of high-frequency repetitive transcranial magnetic stimulation on food choice behavior and related neural activity.
Description
Anorexia nervosa (AN) is a devastating illness with morbidity and mortality rates among the highest associated with any psychiatric disorder. Treatments for adults with AN have limited efficacy due to an inadequate understanding of the mechanisms underlying AN's core symptoms. The salient feature of AN is extreme restriction of food, particularly dietary fat intake, a behavior both highly resistant to change and central to relapse. Neuroimaging research of food restriction in AN has found that compared to healthy controls, patients with AN exhibit greater choice-related dorsal striatum activat…
Eligibility
- Age range
- 18–35 years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: * DSM-5 Diagnosis of Anorexia Nervosa * Age 18-30 years * Female * Right-handed * Body Mass Index (BMI) ≥ 16.0 * Voluntarily admitted to inpatient eating disorders unit at NYSPI * Competent to provide informed consent * English-speaking * Medically stable Exclusion Criteria: * High risk of suicide * Current substance use disorder or other co- morbid psychiatric condition requiring specialized treatment (e.g., psychosis) * Diagnosis of major medical or neurological problem or taking medication that significantly increases risk for seizure or affects interpretation of find…
Interventions
- DeviceHigh-frequency repetitive transcranial magnetic stimulation (active rTMS)
HF-rTMS is applied with a figure-of-8 coil using the Magstim TMS System. Participants receive one administration of HF-rTMS, delivered to the region of the right dorsolateral prefrontal cortex (DLPFC) with greatest resting-state functional connectivity to the dorsal striatum (individualized per participant). HF-rTMS is delivered at a frequency of 10 Hz for approximately 37 minutes (3000 total pulses).
- DeviceSham repetitive transcranial magnetic stimulation (sham rTMS)
Sham rTMS is applied with a figure-of-8 sham coil using the Magstim TMS System, which is identical to the active coil, replicates the sounds of HF-rTMS, and is designed to mimic sensations of HF-rTMS. Participants receive one administration of sham rTMS, delivered to the region of the right dorsolateral prefrontal cortex (DLPFC) with greatest resting-state functional connectivity to the dorsal striatum (individualized per participant). Sham rTMS is delivered for approximately 37 minutes (3000 total pulses).
Location
- New York State Psychiatric InstituteNew York, New York