Unanticipated rapid remission of refractory bulimia nervosa, during high-dose repetitive transcranial magnetic stimulation of the dorsomedial prefrontal cortex: a case report

Frontiers in Psychiatry

Peter eGiacobbe²  Blake eWoodside²  Patricia eColton²  Ashwin eSankar²  Jonathan eDownar² 

[1] University Health Network;University of Toronto;

关键词: Anorexia;    Bulimia;    Depression;    impulsivity;    prefrontal;    rTMS;   

DOI  :  10.3389/fpsyt.2012.00030

来源: DOAJ

【 摘 要 】

A woman with severe, refractory bulimia nervosa underwent treatment for comorbid depression using repetitive transcranial magnetic stimulation (rTMS) of the dorsomedial prefrontal cortex (DMPFC) using a novel technique.Unexpectedly, she showed a rapid, dramatic remission from bulimia nervosa. For 5 months pre-treatment, she had reported two 5-hour binge-purge episodes per day.After rTMS session 2 the episodes stopped entirely for 1 week; after session 10 there were no further recurrences.Depression scores improved more gradually to remission at session 10.Full remission from depression and binge-eating/purging episodes was sustained more than 2 months after treatment completion.In neuroimaging studies, the DMPFC is important in impulse control, and is underactive in bulimia nervosa.DMPFC-rTMS may have enhanced the patient’s ability to deploy previously acquired strategies to avoid binge-eating and purging via a reduction in her impulsivity.A larger sham-controlled trial of DMPFC-rTMS for binge-eating and purging behavior may be warranted.

【 授权许可】

Unknown