Augmentative effects of tDCS on a body-related attentional retraining in women with bulimia nervosa

经颅直流电刺激 (tDCS) 对神经性贪食症女性身体相关注意力再训练的增强作用

• 批准号: 317556626
• 负责人: Professor Dr. Andreas Jochen Fallgatter
• 金额: --
• 依托单位: Abteilung Klinische Psychologie und Psychotherapie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2016
• 资助国家: 德国
• 起止时间: 2015-12-31 至 2019-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/317556626?language=en
• 关键词: Augmentative; effects; tDCS; body; related

Overvaluation of shape and weight on self-esteem and corresponding body dissatisfaction are a core diagnostic feature of both bulimia nervosa (BN) and subthreshold BN (Other Specified Feeding or Eating Disorder [OSFED]). Cognitive models of eating disorders suggest that salient stimuli such as the exposure with the self-body or the comparison with another body activate selective memory, interpretation and attentional processes, assumed to substantially contribute to behavior typically associated with eating disorders such as body checking, body avoidance and pathological eating behavior. In accordance, eye movement studies showed that women with a (sub)clinical eating disorder preferentially process body parts typically associated with weight change or body parts which they subjectively dislike (compared to like). Of note, experimental evidence suggests a causal link between the selective attentional bias for body parts and body dissatisfaction, in that a retraining of attention towards self-defined unattractive body parts reduces, while a retraining of attention towards attractive body parts increases body satisfaction in body dissatisfied women. However the latter was shown to be more difficult, needing a more extensive retraining.Recent evidence suggests that the cortical stimulation of the dorsolateral prefrontal cortex (dlPFC) by transcranial direct current stimulation (tDCS) can ameliorate attentional biases and increase the effects of attentional retraining. Therefore, the aim of the present project is to investigate whether a positive body-related attentional retraining reduces selective attention for unattractive body parts and increases body satisfaction in a group of women with BN, as well as subthreshold BN (OSFED), and whether these effects can be enhanced by tDCS.To this end we will recruit a total of 80 women with BN or BN-OSFED according to DSM-5 criteria and will compare them to a group of 40 weight and age matched women without lifetime eating disorders with regard to attention allocation towards three self-defined most (un)attractive self-body parts and its neurophysiological signatures by means of a combined eye tracking and electroencephalogram (EEG) paradigm as well as a combined near-infrared spectroscopy (NIRS) and eye tracking paradigm. Subsequently, only patients with BN/BN-OSFED will be administered active tDCS or sham tDCS during a repeated body-related attentional retraining (AR) which aims to increase the selective processing of self-defined attractive body parts, or a respective attentional retraining control condition (AR-CC) in a double-blind between-subject comparison. After the last training session, attention allocation towards the three self-defined most (un)attractive self-body parts will be assessed once more by the experimental paradigms. Body dissatisfaction will be assessed by questionnaires at the experimental sessions, prior to and after the training and at four-week and three months follow-up.

对自尊的形状和体重的高估以及相应的身体不满是神经性贪食症（BN）和阈下BN（其他特定进食障碍[OSFED]）的核心诊断特征。进食障碍的认知模型表明，显著的刺激，如与自我身体的接触或与另一个身体的比较，激活选择性记忆，解释和注意力的过程，假设实质上有助于与进食障碍相关的行为，如身体检查，身体回避和病理性进食行为。与此相一致，眼动研究表明，患有（亚）临床饮食障碍的女性优先处理通常与体重变化相关的身体部位或他们主观不喜欢的身体部位（与喜欢相比）。值得注意的是，实验证据表明，身体部位的选择性注意力偏差和身体不满之间存在因果关系，因为对自我定义的不吸引人的身体部位的注意力的再培训减少，而对有吸引力的身体部位的注意力的再培训增加身体不满的女性的身体满意度。最近的证据表明，通过经颅直流电刺激（tDCS）来刺激背外侧前额叶皮层（dlPFC）可以改善注意偏差，提高注意力再训练的效果。因此，本项目的目的是调查一个积极的身体相关的注意力再训练是否减少了对不吸引人的身体部位的选择性注意力，并增加了一组BN女性的身体满意度，以及阈下BN（OSFED），以及这些效果是否可以通过tDCS增强。为此，我们将根据DSM招募总共80名患有BN或BN-OSFED的女性-5个标准，并将它们与一组40名体重和年龄匹配的女性进行比较，这些女性没有终身饮食失调，通过结合眼动跟踪和脑电图（EEG）范例以及结合近红外光谱（NIRS），将注意力分配到三个自我定义的最（不）有吸引力的自我身体部位及其神经生理学特征和眼动追踪模式。随后，仅BN/BN-OSFED患者将在重复的身体相关注意力再训练（AR）期间接受活性tDCS或假tDCS，其目的是增加对自我定义的有吸引力的身体部位的选择性处理，或在双盲受试者间比较中接受相应的注意力再训练控制条件（AR-CC）。在最后一次训练后，对三个自我定义的最有吸引力的自我身体部位的注意分配将再次通过实验范式进行评估。在实验阶段、训练前后、四周和三个月随访时，通过问卷调查评估身体不满意度。