Neuromodulation in eating disorders and obesity: a promising way of treatment?
Neuromodulation in eating disorders and obesity: a promising way of treatment?
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DOI：
10.2147/ndt.s180231
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发表时间：
2018
影响因子：
3.2
通讯作者：
Martínez-Quiñones JV
中科院分区：
文献类型：
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作者：
Jáuregui-Lobera I;Martínez-Quiñones JV
神经调节可以影响中枢神经系统（CNS）的功能，而情绪/饮食行为是该功能的一个令人兴奋的方面。因此，有可能为精神药物提供替代（或补充）治疗，并针对饮食失调（ED）和肥胖提供不同的心理和营养方法。尽管这些领域已有许多出版物，但迄今为止尚未进行系统综述。摘要、信件、会议报告、论文和评论被排除在外。临床试验和对照人体临床试验被筛选并纳入本研究。纳入的文章基于患有神经性厌食症、神经性贪食症、暴饮暴食、超重和肥胖症的人群。对样本大小没有限制。仅纳入研究通过深部脑刺激 (DBS)、经颅直流电刺激 (tDCS) 和经颅磁刺激 (TMS) 进行神经调节效果的试验。使用以下数据库进行检索：MEDLINE/PubMed、PsycINFO、PsycArticles 和 Cochrane（检索试验，CENTRAL）。研究选择是按照 PRISMA 流程（PRISMA 2009 检查表）进行的。所有试验的参与者总数为 562 人（DBS，25 人；tDCS，138 人；TMS，399 人；范围，3-90；中位数，23.5）。因此，50% 的研究样本有 14 到 38 名参与者。 ED 中的神经调节似乎具有一定的临床潜力，因此，这是一个有前途的进一步研究领域。 ED 神经调节的发展将与神经影像学联系起来，以确定潜在的刺激目标和治疗反应的可能生物标志物。迄今为止，TMS 和/或直流电刺激 (DCS) 还不是一线治疗方法，但它可能成为未来的首选治疗方法。进一步的研究应避免小样本量和使用不同的方法。目前，神经调节技术正处于实验阶段，它们并不是治疗 ED 的循证疗法。
Neuromodulation can affect the functioning of the central nervous system (CNS), and emotional/eating behavior is an exciting facet of that functioning. Therefore, it would be possible to offer an alternative (or complement) treatment to psychotropic medications and different psychological and nutritional approaches to both eating disorders (EDs) and obesity. Although there are a number of publications in these areas, a systematic review has not been conducted to date. Abstracts, letters, conference reports, dissertations, and reviews were excluded. Clinical trials and controlled human clinical trials were filtered and included in this study. Articles included were based on the population suffering from anorexia nervosa, bulimia nervosa, binge ED, overweight, and obesity. No restrictions were placed on the sample size. Only trials investigating the effect of neuromodulation by means of deep brain stimulation (DBS), transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS) were included. The following databases were used to conduct the search: MEDLINE/ PubMed, PsycINFO, PsycArticles, and Cochrane (Search Trials, CENTRAL). Study selection was performed following the PRISMA process (PRISMA 2009 Checklist). The total number of participants in all the trials was 562 (DBS, 25; tDCS, 138; TMS, 399; range, 3–90; median, 23.5). As a result, 50% of the studies had samples of between 14 and 38 participants. Neuro-modulation in ED seems to have certain clinical potential, and therefore, this is a promising area for further research. Developments in ED neuromodulation will be linked to neuroimaging to identify potential stimulation targets and possible biomarkers of treatment response. To date, TMS and/or direct current stimulation (DCS) is not the first-line treatment yet, but it could become a preferred option of treatment in the future. Further studies should avoid small sample sizes and the use of different methodologies. Currently, neuromodulation techniques are in the experimental phase, and they are not an evidence-based treatment for ED.