A systematic review of the effects of neuromodulation on eating and body weight: evidence from human and animal studies.
A systematic review of the effects of neuromodulation on eating and body weight: evidence from human and animal studies.
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DOI：
10.1002/erv.2256
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发表时间：
2013-11
期刊：
影响因子：
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通讯作者：
J. McClelland;N. Bozhilova;I. Campbell;U. Schmidt
中科院分区：
文献类型：
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作者：
J. McClelland;N. Bozhilova;I. Campbell;U. Schmidt
背景饮食失调（艾德）是一种慢性疾病，有时甚至是致命的疾病。现有的治疗方法已证明疗效有限，特别是在成人神经性厌食症（AN）的情况下。新兴的艾德神经模型为更有针对性的脑定向干预提供了理论基础。目的本系统性综述研究了神经调节技术对饮食行为和体重的影响，并评估了其在ED. METHOD治疗中的潜力。所有文章在PubMed，PsychInfo和Web的知识被认为是和筛选先验的纳入/排除标准。在艾德样本、其他精神和神经系统疾病以及动物模型的研究中，检查了重复经颅磁刺激（rTMS）、经颅直流电刺激、迷走神经刺激（VNS）和脑深部电刺激（DBS）的作用。结果共纳入60项研究。在AN和神经性贪食症中，有证据表明rTMS和DBS后艾德症状减轻。其他精神和神经系统疾病的研究和动物研究的结果表明，DBS后可以增加食物摄入量和体重，VNS作为控制进食和诱导体重减轻的一种手段具有潜在价值。结论：神经调节工具有可能减少艾德痴呆和相关行为，并改变食物摄入量和体重。针对这些发现，以及艾德的新兴神经模型，治疗方法极不可能保持“无脑”。需要更多的研究来评估神经调节程序改善ED长期结局的潜力。
BACKGROUND Eating disorders (ED) are chronic and sometimes deadly illnesses. Existing treatments have limited proven efficacy, especially in the case of adults with anorexia nervosa (AN). Emerging neural models of ED provide a rationale for more targeted, brain-directed interventions. AIMS This systematic review has examined the effects of neuromodulation techniques on eating behaviours and body weight and assessed their potential for therapeutic use in ED. METHOD All articles in PubMed, PsychInfo and Web of Knowledge were considered and screened against a priori inclusion/exclusion criteria. The effects of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, vagus nerve stimulation (VNS) and deep brain stimulation (DBS) were examined across studies in ED samples, other psychiatric and neurological disorders, and animal models. RESULTS Sixty studies were identified. There is evidence for ED symptom reduction following rTMS and DBS in both AN and bulimia nervosa. Findings from studies of other psychiatric and neurological disorders and from animal studies demonstrate that increases in food intake and body weight can be achieved following DBS and that VNS has potential value as a means of controlling eating and inducing weight loss. CONCLUSIONS Neuromodulation tools have potential for reducing ED symptomatology and related behaviours, and for altering food intake and body weight. In response to such findings, and emerging neural models of ED, treatment approaches are highly unlikely to remain 'brainless'. More research is required to evaluate the potential of neuromodulation procedures for improving long-term outcomes in ED.