Can Electrical Brain Stimulation Treat Bulimia?

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A new small study suggests that electrical brain stimulation may be able to help people who live with bulimia resist symptoms like the urge to binge-eat and restrict food intake.

The report, published in the journal PLOS One, claims that sending a small and non-invasive electrical current into a region of the brain called the dorsolateral prefrontal cortex reduced behaviors associated with bulimia in almost 40 people who participated in a small trial. The dorsolateral prefrontal cortex is believed to play a role in regulating behavior.

The team from King’s College London says it “suppressed the self-reported urge to binge-eat,” increased self-control and improved mood by “normalizing altered neural circuit activity.”

The findings are tentative because of the small sample size, but the researchers believe their findings show the need for larger trials to see if electrical stimulation therapies may be an alternative to talk therapies.

Talking therapies like cognitive behavioral therapy are currently the most commonly used therapies to treat eating disorders like bulimia. However, not all people with bulimia respond to this technique.

“A substantial proportion do not get better with talking therapies,” King’s College London said in a statement. “There is a pressing need for new techniques and researchers are increasingly looking towards neuroscience-based technologies that could target the underlying neural basis of eating disorders, such as problems with reward processing or self-control.”

The specific technique used in the study is called transcranial direct current stimulation (tDCS), which uses electrodes placed on the head to stimulate specific areas of the brain. The technique has already been approved for treating depression in the United States, but research has shown it could be useful for several brain-related diseases ranging from Alzheimer’s to eating disorders.

To assess the effectiveness of tDCS to treat bulimia, the team had participants complete questionnaires before and after each session about their urge to binge eat, concerns about weight and shape, restriction of food intake, levels of self-control, and self-esteem.

According to the report, those who underwent tDCS showed significantly fewer bulimia symptoms compared to those who received placebo treatments. Those who received tDCS also performed better on decision-making tasks where they had to choose between a smaller amount of money available immediately and a larger amount available in three months.

Doctoral student Maria Kekic, first author of the study, said: “Our study suggests that a non-invasive brain stimulation technique suppresses the urge to binge eat and reduces the severity of other common symptoms in people with bulimia nervosa, at least temporarily. We think it does this by improving cognitive control over compulsive features of the disorder.

“Although these are modest, early findings, there is a clear improvement in symptoms and decision-making abilities following just one session of tDCS. With a larger sample and multiple sessions of treatment over a longer period of time, it is likely that the effects would be even stronger. This is something we’re now looking to explore in future studies.

Professor Ulrike Schmidt, senior author of the study, also comments: “The advantage of tDCS is that it’s much less expensive and more portable than other brain stimulation techniques, which raises the prospect of one day offering treatment that could be self-delivered at home by patients with bulimia.

“This could either be as an addition to talking therapies such as CBT to improve outcomes, or as a stand-alone alternative approach.”

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