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Randomized Controlled Trial
. 2024 Jul;14(7):e3617.
doi: 10.1002/brb3.3617.

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  1 , Najate Achamrah  2 , Olivier Etard  3 , Clément Nathou  3   4 , Marie-Astrid Piquet  5 , Sébastien Guillaume  6 , Jérôme Attal  6 , André Gillibert  7 , Pierre Dechelotte  2 , Olivier Guillin  8 , Marie-Laure Welter  1
Affiliations
Randomized Controlled Trial

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 et al. Brain Behav. 2024 Jul.

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.

Keywords: anorexia nervosa; body image; repetitive transcranial magnetic stimulation; right inferior parietal lobe.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Study design and effects of real and sham high‐frequency repetitive transcranial magnetic stimulation (rTMS) of the right inferior parietal lobe (IPL) on the Body Shape Questionnaire in patients with Anorexia Nervosa (AN). Study design (left panel) and Body Shape Questionnaire scores obtained in AN patients randomized in the real (blue) or sham (red) groups. Each line represents one individual patient.
See this image and copyright information in PMC

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