Brain Stimulation Shows Promise for Eating Disorders
Small study found almost half of those with anorexia, bulimia had symptom relief
Brain scans indicated that those who responded to the treatment may have distinctly different brain-activity patterns than those who didn't.
"Those who did well with [brain stimulation] showed a lack of connection -- of physiological circuitry -- between the part of the brain that is supposed to tamp down on urges and cravings and the regulation area," Downar noted. "So stimulating that area repeatedly helped make the missing connection," he explained.
"But nonresponders seemed to actually have more connections to the regulatory circuitry than average. So [brain stimulation] did nothing for them because a need for more stimulation is not their problem," he added.
"But we think that maybe if we change the stimulation target for these patients, and change it to inhibit rather than excite stimulation, we might ultimately be able to help even these patients," Downar suggested. "We think it's possible."
Dr. Doug Klamp, a specialist in eating disorders with a private practice in Scranton, Pa., said the approach "seems promising."
"Bulimia can be a very difficult problem," Klamp explained. "When patients come to me, 60 to 70 percent will be cured within a year or so. But those other 30 to 40 percent are tough. They can try all the standard antidepressants and antipsychotic medications, and all the behavioral therapy options, but their problem behavior may still go on. For decades," he added.
"So, a new therapy would be very helpful," Klamp said. "And this idea makes sense to me, because I tend to see the same impulsive and destructive behavioral characteristics over and over again in my patients, as if it's hard-wired into people -- hard-wiring that maybe, with this, we can change."
Suzanne Mazzeo, a professor of psychology at Virginia Commonwealth University in Richmond, cautioned that it's still unclear why brain stimulation seems to help some -- but not all -- patients.
"Certainly, we do need more approaches. Eating disorders are very difficult problems to treat because our food environment is stacked against us, with food manufactured to be highly palatable and hard to resist," Mazzeo pointed out.
"So, overcoming any kind of emotional eating issue is going to be hard," she added. "And what we currently have for treatment is certainly not working for everyone."
But, Mazzeo noted, "in addition to ensuring the safety of this new technique and testing it for long-term maintenance, we have to be sure why it works for some and not others, so we can know who would be the most appropriate candidates for it."