A Randomised Controlled Trial of Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Anorexia Nervosa

Jessica McClelland, Maria Kekic, Natali Bozhilova, Steffen Nestler, Tracy Dew, Frederique Van den Eynde, Anthony S David, Katya Rubia, Iain C Campbell, Ulrike Schmidt, Jessica McClelland, Maria Kekic, Natali Bozhilova, Steffen Nestler, Tracy Dew, Frederique Van den Eynde, Anthony S David, Katya Rubia, Iain C Campbell, Ulrike Schmidt

Abstract

Background: Anorexia nervosa (AN) is associated with morbid fear of fatness, extreme food restriction and altered self-regulation. Neuroimaging data implicate fronto-striatal circuitry, including the dorsolateral prefrontal cortex (DLPFC).

Methods: In this double-blind parallel group study, we investigated the effects of one session of sham-controlled high-frequency repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC (l-DLPFC) in 60 individuals with AN. A food exposure task was administered before and after the procedure to elicit AN-related symptoms.

Outcomes: The primary outcome measure was 'core AN symptoms', a variable which combined several subjective AN-related experiences. The effects of rTMS on other measures of psychopathology (e.g. mood), temporal discounting (TD; intertemporal choice behaviour) and on salivary cortisol concentrations were also investigated. Safety, tolerability and acceptability were assessed.

Results: Fourty-nine participants completed the study. Whilst there were no interaction effects of rTMS on core AN symptoms, there was a trend for group differences (p = 0.056): after controlling for pre-rTMS scores, individuals who received real rTMS had reduced symptoms post-rTMS and at 24-hour follow-up, relative to those who received sham stimulation. Other psychopathology was not altered differentially following real/sham rTMS. In relation to TD, there was an interaction trend (p = 0.060): real versus sham rTMS resulted in reduced rates of TD (more reflective choice behaviour). Salivary cortisol concentrations were unchanged by stimulation. rTMS was safe, well-tolerated and was considered an acceptable intervention.

Conclusions: This study provides modest evidence that rTMS to the l-DLPFC transiently reduces core symptoms of AN and encourages prudent decision making. Importantly, individuals with AN considered rTMS to be a viable treatment option. These findings require replication in multiple-session studies to evaluate therapeutic efficacy.

Trial registration: www.Controlled-Trials.com ISRCTN22851337.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Recruitment and randomization CONSORT diagram.
Fig 1. Recruitment and randomization CONSORT diagram.
Fig 2. Testing protocol timeline.
Fig 2. Testing protocol timeline.
FCTpre & FCTpost: food challenge task before and after rTMS. TDpre & TDpost: temporal discounting task before and after rTMS. Collection of main visual analogue scales (VAS) at TP0 (pre-FCT); main VAS & additional VAS at TP1 (post-FCT/pre-rTMS) & TP2 (post-rTMS & FCT); main VAS only at TP3 (end of session) & TP4 (24 hours following). Saliva samples collected at S0 (pre-FCT), S1 (post-FCT/pre-rTMS), S2 (immediately after rTMS), S3 (post-rTMS/post-FCT) and S4 (end of session).
Fig 3. Mean ± SD of core…
Fig 3. Mean ± SD of core AN symptoms pre-rTMS, post-rTMS, at the end of the session and after 24 hours.
* p < .05 (prior to Bonferroni corrections). This composite core AN symptom outcome was composed of the urge to restrict (0–10), levels of feeling full (0–10) and levels of feeling fat (0–10) VAS and therefore scores can range from 0–30.
Fig 4. Mean + SD area under…
Fig 4. Mean + SD area under the curve (AUC) analysis of the temporal discounting (TD) task pre and post real/sham rTMS.
Increased AUC represents reduced TD i.e. less steep TD/more prudent decision making.

References

    1. Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry. 2011;68(7):724–31. Epub 2011/07/06. 10.1001/archgenpsychiatry.2011.74 .
    1. Steinhausen HC. The outcome of anorexia nervosa in the 20th century. American Journal of Psychiatry. 2002;159(8):1284–93.
    1. Schmidt U, Oldershaw A, Jichi F, Sternheim L, Startup H, McIntosh V, et al. Out-patient psychological therapies for adults with anorexia nervosa: randomised controlled trial. Br J Psychiatry. 2012;201(5):392–9. Epub 2012/09/22. 10.1192/bjp.bp.112.112078 .
    1. Zipfel S, Löwe B, Reas DL, Deter H-C, Herzog W. Long-term prognosis in anorexia nervosa: lessons from a 21-year follow-up study. The Lancet. 2000;355(9205):721–2. 10.1016/s0140-6736(99)05363-5
    1. Mitchell JE, Roerig J, Steffen K. Biological therapies for eating disorders. International Journal of Eating Disorders. 2013;46(5):470–7. Epub 2013/05/10. 10.1002/eat.22104 .
    1. Tortorella A, Fabrazzo M, Monteleone A, Steardo L, Monteleone P. The role of drug therapies in the treatment of anorexia and bulimia nervosa: a review of the literature. Journal of Psychopathology. 2014;20:50–65.
    1. NICE. National Institute for Health and Care Excellence, Eating Disorders CG9. In: NICE, editor. London: 2004.
    1. Watson HJ, Bulik CM. Update on the treatment of anorexia nervosa: review of clinical trials, practice guidelines and emerging interventions. Psychological Medicine. 2012;10:1–24. Epub 2012/12/12. 10.1017/s0033291712002620 .
    1. Insel TR, Gogtay N. National Institute of Mental Health clinical trials: new opportunities, new expectations. JAMA psychiatry. 2014;71(7):745–6. Epub 2014/05/09. 10.1001/jamapsychiatry.2014.426 .
    1. Schmidt U, Campbell IC. Treatment of eating disorders can not remain 'brainless': the case for brain-directed treatments. European Eating Disorders Review. 2013;21(6):425–7. Epub 2013/10/15. 10.1002/erv.2257 .
    1. Val-Laillet D, Aarts E, Weber B, Ferrari M, Quaresima V, Stoeckel L, et al. Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity. NeuroImage: Clinical. 2015;8:1–31.
    1. Van den Eynde F, Suda M, Broadbent H, Guillaume S, Van den Eynde M, Steiger H, et al. Structural magnetic resonance imaging in eating disorders: a systematic review of voxel-based morphometry studies. European Eating Disorders Review. 2012;20(2):94–105. Epub 2011/11/05. 10.1002/erv.1163 .
    1. Titova OE, Hjorth OC, Schiöth HB, Brooks SJ. Anorexia nervosa is linked to reduced brain structure in reward and somatosensory regions: a meta-analysis of VBM studies. BMC psychiatry. 2013;13(1):110.
    1. Zhu Y, Hu X, Wang J, Chen J, Guo Q, Li C, et al. Processing of food, body and emotional stimuli in anorexia nervosa: a systematic review and meta-analysis of functional magnetic resonance imaging studies. European Eating Disorders Review. 2012;20(6):439–50. Epub 2012/09/05. 10.1002/erv.2197 .
    1. Phillipou A, Rossell SL, Castle DJ. The neurobiology of anorexia nervosa: a systematic review. Aust N Z J Psychiatry. 2014;48(2):128–52. Epub 2013/11/07. 10.1177/0004867413509693 .
    1. Brandys MK, Kas MJ, van Elburg AA, Campbell IC, Adan RA. A meta-analysis of circulating BDNF concentrations in anorexia nervosa. World J Biol Psychiatry. 2011;12(6):444–54. Epub 2011/04/14. 10.3109/15622975.2011.562244 .
    1. Kaye W, Fudge J, Paulus M. New insights into symptoms and neurocircuit function of anorexia nervosa. Nature Reviews Neuroscience. 2009;10(8):573–84. 10.1038/nrn2682
    1. Friederich HC, Wu M, Simon JJ, Herzog W. Neurocircuit function in eating disorders. International Journal of Eating Disorders. 2013;46(5):425–32. Epub 2013/05/10. 10.1002/eat.22099 .
    1. Lipsman N, Woodside DB, Lozano AM. Neurocircuitry of limbic dysfunction in anorexia nervosa. Cortex. 2014;Epub ahead of print. 10.1016/j.cortex.2014.02.020 .
    1. Marsh R, Maia TV, Peterson BS. Functional disturbances within frontostriatal circuits across multiple childhood psychopathologies. American Journal Psychiatry. 2009;166(6):664–74. Epub 2009/05/19. 10.1176/appi.ajp.2009.08091354
    1. Park RJ, Godier LR, Cowdrey FA. Hungry for reward: How can neuroscience inform the development of treatment for Anorexia Nervosa? Behav Res Ther. 2014. Epub 2014/08/26. 10.1016/j.brat.2014.07.007 .
    1. Sanders N, Smeets PA, van Elburg AA, Danner UN, van Meer F, Hoek HW, et al. Altered food-cue processing in chronically ill and recovered women with anorexia nervosa. Front Behav Neurosci. 2015;9:46 Epub 2015/03/17. 10.3389/fnbeh.2015.00046 .
    1. Brooks SJ, Rask-Andersen M, Benedict C, Schioth HB. A debate on current eating disorder diagnoses in light of neurobiological findings: is it time for a spectrum model? BMC psychiatry. 2012;12:76 Epub 2012/07/10. 10.1186/1471-244x-12-76
    1. O'Hara CB, Campbell IC, Schmidt U. A reward-centred model of anorexia nervosa: A focussed narrative review of the neurological and psychophysiological literature. Neurosci Biobehav Rev. 2015;52:131–52. Epub 2015/03/05. 10.1016/j.neubiorev.2015.02.012 .
    1. Oberndorfer TA, Kaye WH, Simmons AN, Strigo IA, Matthews SC. Demand-specific alteration of medial prefrontal cortex response during an inhibition task in recovered anorexic women. International Journal of Eating Disorders. 2011;44(1):1–8. Epub 2010/02/04. 10.1002/eat.20750 .
    1. Wierenga C, Bischoff-Grethe A, Melrose AJ, Grenesko-Stevens E, Irvine Z, Wagner A, et al. Altered BOLD response during inhibitory and error processing in adolescents with anorexia nervosa. PloS one. 2014;9(3):e92017 Epub 2014/03/22. 10.1371/journal.pone.0092017
    1. Sato Y, Saito N, Utsumi A, Aizawa E, Shoji T, Izumiyama M, et al. Neural basis of impaired cognitive flexibility in patients with anorexia nervosa. PloS one. 2013;8(5):e61108 Epub 2013/05/16. 10.1371/journal.pone.0061108
    1. Monsell S. Task switching. Trends in cognitive sciences. 2003;7(3):134–40. 10.1016/S1364-6613(03)00028-7
    1. Gaynes BN, Lloyd SW, Lux L, Gartlehner G, Hansen RA, Brode S, et al. Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis. J Clin Psychiatry. 2014;75(5):477–89. Epub 2014/06/13. 10.4088/JCP.13r08815 .
    1. Barr MS, Farzan F, Wing VC, George TP, Fitzgerald PB, Daskalakis ZJ. Repetitive transcranial magnetic stimulation and drug addiction. International Review of Psychiatry. 2011;23(5):454–66. Epub 2011/12/28. 10.3109/09540261.2011.618827 .
    1. Grall-Bronnec M, Sauvaget A. The use of repetitive transcranial magnetic stimulation for modulating craving and addictive behaviours: a critical literature review of efficacy, technical and methodological considerations. Neurosci Biobehav Rev. 2014;47:592–613. Epub 2014/12/03. 10.1016/j.neubiorev.2014.10.013 .
    1. Gorelick DA, Zangen A, George MS. Transcranial magnetic stimulation in the treatment of substance addiction. Ann N Y Acad Sci. 2014;1327:79–93. Epub 2014/07/30. 10.1111/nyas.12479
    1. Jansen JM, Daams JG, Koeter MW, Veltman DJ, van den Brink W, Goudriaan AE. Effects of non-invasive neurostimulation on craving: a meta-analysis. Neurosci Biobehav Rev. 2013;37(10 Pt 2):2472–80. Epub 2013/08/07. 10.1016/j.neubiorev.2013.07.009 .
    1. Uher R, Yoganathan D, Mogg A, Eranti SV, Treasure J, Campbell IC, et al. Effect of left prefrontal repetitive transcranial magnetic stimulation on food craving. Biol Psychiatry. 2005;58(10):840–2. 10.1016/j.biopsych.2005.05.043 .
    1. Van den Eynde F, Claudino AM, Mogg A, Horrell L, Stahl D, Ribeiro W, et al. Repetitive transcranial magnetic stimulation reduces cue-induced food craving in bulimic disorders. Biol Psychiatry. 2010;67(8):793–5. 10.1016/j.biopsych.2009.11.023 .
    1. Barth KS, Rydin-Gray S, Kose S, Borckardt JJ, O'Neil PM, Shaw D, et al. Food cravings and the effects of left prefrontal repetitive transcranial magnetic stimulation using an improved sham condition. Frontiers in psychiatry. 2011;2:9 Epub 2011/05/11. 10.3389/fpsyt.2011.00009
    1. Walpoth M, Hoertnagl C, Mangweth-Matzek B, Kemmler G, Hinterholzl J, Conca A, et al. Repetitive transcranial magnetic stimulation in bulimia nervosa: preliminary results of a single-centre, randomised, double-blind, sham-controlled trial in female outpatients. Psychother Psychosom. 2008;77(1):57–60. 10.1159/000110061 .
    1. Downar J, Sankar A, Giacobbe P, Woodside B, Colton P. 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. 2012;3:30 Epub 2012/04/25. 10.3389/fpsyt.2012.00030
    1. Hausmann A, Mangweth B, Walpoth M, Hoertnagel C, Kramer-Reinstadler K, Rupp CI, et al. Repetitive transcranial magnetic stimulation (rTMS) in the double-blind treatment of a depressed patient suffering from bulimia nervosa: a case report. International Journal of Neuropsychopharmacology. 2004;7(3):371–3. Epub 2004/05/25. 10.1017/s1461145704004420 .
    1. McClelland J, Bozhilova N, Campbell I, Schmidt U. A systematic review of the effects of neuromodulation on eating and body weight: evidence from human and animal studies. European Eating Disorders Review. 2013;21(6):436–55. 10.1002/erv.2256 .
    1. Van den Eynde F, Guillaume S, Broadbent H, Campbell IC, Schmidt U. Repetitive transcranial magnetic stimulation in anorexia nervosa: a pilot study. European Psychiatry. 2013;28(2):98–101. Epub 2011/09/02. 10.1016/j.eurpsy.2011.06.002 .
    1. Kamolz S, Richter MM, Schmidtke A, Fallgatter AJ. Transcranial magnetic stimulation for comorbid depression in anorexia. Nervenarzt. 2008;79(9):1071–3. 10.1007/s00115-008-2537-8 WOS:000259157700009.
    1. McClelland J, Bozhilova N, Nestler S, Campbell IC, Jacob S, Johnson-Sabine E, et al. Improvements in symptoms following neuronavigated repetitive transcranial magnetic stimulation (rTMS) in severe and enduring anorexia nervosa: findings from two case studies. European Eating Disorders Review. 2013;21(6):500–6. Epub 2013/10/25. 10.1002/erv.2266 .
    1. McClelland J, Kekic M, Campbell IC, Schmidt U. Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment in Enduring Anorexia Nervosa: A Case Series. European Eating Disorders Review. 2015. Epub 4 Nov 2015. 10.1002/erv.2414
    1. Ochsner KN, Gross JJ. The neural architecture of emotion regulation. Handbook of emotion regulation. 2007;1(1):87–109.
    1. Kaye W. Neurobiology of anorexia and bulimia nervosa. Physiology and Behaviour. 2008;94(1):121–35. Epub 2008/01/01. 10.1016/j.physbeh.2007.11.037
    1. Gersner R, Kravetz E, Feil J, Pell G, Zangen A. Long-term effects of repetitive transcranial magnetic stimulation on markers for neuroplasticity: differential outcomes in anesthetized and awake animals. Journal of Neuroscience. 2011;31(20):7521–6. Epub 2011/05/20. 10.1523/jneurosci.6751-10.2011 .
    1. Medina FJ, Tunez I. Mechanisms and pathways underlying the therapeutic effect of transcranial magnetic stimulation. Rev Neurosci. 2013;24(5):507–25. 10.1515/revneuro-2013-0024 .
    1. Ridding MC, Rothwell JC. Is there a future for therapeutic use of transcranial magnetic stimulation? Nature Reviews Neuroscience. 2007;8(7):559–67.
    1. Zanardini R, Gazzoli A, Ventriglia M, Perez J, Bignotti S, Rossini PM, et al. Effect of repetitive transcranial magnetic stimulation on serum brain derived neurotrophic factor in drug resistant depressed patients. Journal of Affective Disorders. 2006;91(1):83–6. Epub 2006/02/02. 10.1016/j.jad.2005.12.029 .
    1. Cho SS, Strafella AP. rTMS of the left dorsolateral prefrontal cortex modulates dopamine release in the ipsilateral anterior cingulate cortex and orbitofrontal cortex. PloS one. 2009;4(8):e6725 10.1371/journal.pone.0006725
    1. Baeken C, De Raedt R, Bossuyt A, Van Hove C, Mertens J, Dobbeleir A, et al. The impact of HF-rTMS treatment on serotonin(2A) receptors in unipolar melancholic depression. Brain Stimulation. 2011;4(2):104–11. Epub 2011/04/23. 10.1016/j.brs.2010.09.002 .
    1. Kekic M, McClelland J, Campbell I, Nestler S, Rubia K, David AS, et al. The effects of prefrontal cortex transcranial direct current stimulation (tDCS) on food craving and temporal discounting in women with frequent food cravings. Appetite. 2014;78:55–62. 10.1016/j.appet.2014.03.010 .
    1. Wang XT, Dvorak RD. Sweet future: fluctuating blood glucose levels affect future discounting. Psychol Sci. 2010;21(2):183–8. Epub 2010/04/29. 10.1177/0956797609358096 .
    1. Ritschel F, King JA, Geisler D, Flohr L, Neidel F, Boehm I, et al. Temporal delay discounting in acutely ill and weight-recovered patients with anorexia nervosa. Psychological Medicine. 2015:1–11. Epub 2015/01/13. 10.1017/s0033291714002311 .
    1. Steinglass JE, Figner B, Berkowitz S, Simpson HB, Weber EU, Walsh BT. Increased capacity to delay reward in anorexia nervosa. J Int Neuropsychol Soc. 2012;18(4):773–80. 10.1017/S1355617712000446
    1. Decker JH, Figner B, Steinglass JE. On Weight and Waiting: Delay Discounting in Anorexia Nervosa Pretreatment and Posttreatment. Biological psychiatry. 2014. Epub 2015/02/03. 10.1016/j.biopsych.2014.12.016 .
    1. Wierenga CE, Bischoff-Grethe A, Melrose AJ, Irvine Z, Torres L, Bailer UF, et al. Hunger does not motivate reward in women remitted from anorexia nervosa. Biological psychiatry. 2015;77(7):642–52. Epub 2014/12/08. 10.1016/j.biopsych.2014.09.024
    1. Wesley MJ, Bickel WK. Remember the future II: meta-analyses and functional overlap of working memory and delay discounting. Biological psychiatry. 2014;75(6):435–48. Epub 2013/09/18. 10.1016/j.biopsych.2013.08.008
    1. Figner B, Knoch D, Johnson EJ, Krosch AR, Lisanby SH, Fehr E, et al. Lateral prefrontal cortex and self-control in intertemporal choice. Nat Neurosci. 2010;13(5):538–9. 10.1038/nn.2516 .
    1. Sheffer CE, Mennemeier M, Landes RD, Bickel WK, Brackman S, Dornhoffer J, et al. Neuromodulation of delay discounting, the reflection effect, and cigarette consumption. J Subst Abuse Treat. 2013;45(2):206–14. Epub 2013/03/23. 10.1016/j.jsat.2013.01.012 ; PubMed Central PMCID: PMCPmc3690153.
    1. Cho SS, Koshimori Y, Aminian K, Obeso I, Rusjan P, Lang AE, et al. Investing in the Future: Stimulation of the Medial Prefrontal Cortex Reduces Discounting of Delayed Rewards. Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology. 2014;Epub ahead of print. Epub 2014/08/30. 10.1038/npp.2014.211 .
    1. Lawson EA, Holsen LM, Desanti R, Santin M, Meenaghan E, Herzog DB, et al. Increased hypothalamic-pituitary-adrenal drive is associated with decreased appetite and hypoactivation of food-motivation neurocircuitry in anorexia nervosa. Eur J Endocrinol. 2013;169(5):639–47. Epub 2013/08/16. 10.1530/eje-13-0433 ; PubMed Central PMCID: PMCPmc3807591.
    1. Connan F, Lightman SL, Landau S, Wheeler M, Treasure J, Campbell IC. An investigation of hypothalamic-pituitary-adrenal axis hyperactivity in anorexia nervosa: the role of CRH and AVP. Journal of Psychiatric Research. 2007;41(1–2):131–43. Epub 2006/02/04. 10.1016/j.jpsychires.2005.12.005 .
    1. Baeken C, Vanderhasselt MA, Remue J, Rossi V, Schiettecatte J, Anckaert E, et al. One left dorsolateral prefrontal cortical HF-rTMS session attenuates HPA-system sensitivity to critical feedback in healthy females. Neuropsychologia. 2014;57:112–21. Epub 2014/03/07. 10.1016/j.neuropsychologia.2014.02.019 .
    1. Baeken C, De Raedt R, Leyman L, Schiettecatte J, Kaufman L, Poppe K, et al. The impact of one HF-rTMS session on mood and salivary cortisol in treatment resistant unipolar melancholic depressed patients. Journal of Affective Disorders. 2009;113(1–2):100–8. Epub 2008/06/24. 10.1016/j.jad.2008.05.008 .
    1. Claudino A, Van den Eynde F, Stahl D, Dew T, Andiappan M, Kalthoff J, et al. Repetitive transcranial magnetic stimulation reduces cortisol concentrations in bulimic disorders. Psychological Medicine. 2011;41(6):1329–36. 10.1017/S0033291710001881 Peer Reviewed Journal: 2011-12534-021.
    1. Stice E, Telch CF, Rizvi SL. Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder. Psychol Assess. 2000;12(2):123–31. Epub 2000/07/11. .
    1. Keel JC, Smith MJ, Wassermann EM. A safety screening questionnaire for transcranial magnetic stimulation. Clinical Neurophysiology. 2001;112(4):720 Epub 2001/05/03. .
    1. NHS. National Health Service 2013 [cited 2014 11 September 2014]. Available from: .
    1. Brunoni AR, Fregni F. Clinical trial design in non-invasive brain stimulation psychiatric research. Int J Methods Psychiatr Res. 2011;20(2):19–30. Epub 2011/05/04. 10.1002/mpr.338 .
    1. First M, Spitzer R, Gibbon M, Williams J. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-Patient Edition (SCID-I/NP) New York, New York State Psychiatric Institute; Biometrics Research. 2002.
    1. Fitzgerald, Hoy K, McQueen S, Maller JJ, Herring S, Segrave R, et al. A randomized trial of rTMS targeted with MRI based neuro-navigation in treatment-resistant depression. Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology. 2009;34(5):1255–62. 10.1038/npp.2008.233 .
    1. Fairburn CG. Eating Disorder Examination (Edition 16.0D) and Eating Disorder Examination Questionnaire (EDE-Q 6.0) Cognitive therapy and eating disorders. New York, USA: Guilford Press; 2009. p. 265.
    1. Lovibond PF, Lovibond SH. Manual for the Depression Anxiety and Stress Scale (2nd. Ed.). Sydney: Psychology Foundation; 1995.
    1. Rossini PM, Barker AT, Berardelli A, Caramia MD, Caruso G, Cracco RQ, et al. Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application. Report of an IFCN committee. Electroencephalogr Clin Neurophysiol. 1994;91(2):79–92. Epub 1994/08/01. .
    1. Rothwell JC, Hallett M, Berardelli A, Eisen A, Rossini P, Paulus W. Magnetic stimulation: motor evoked potentials. The International Federation of Clinical Neurophysiology. Electroencephalogr Clin Neurophysiol Suppl. 1999;52:97–103. Epub 1999/12/11. .
    1. Rubia K, Halari R, Christakou A, Taylor E. Impulsiveness as a timing disturbance: neurocognitive abnormalities in attention-deficit hyperactivity disorder during temporal processes and normalization with methylphenidate. Philosophical transactions of the Royal Society of London Series B, Biological sciences. 2009;364(1525):1919–31. 10.1098/rstb.2009.0014
    1. Christakou A, Brammer M, Rubia K. Maturation of limbic corticostriatal activation and connectivity associated with developmental changes in temporal discounting. NeuroImage. 2011;54(2):1344–54. 10.1016/j.neuroimage.2010.08.067 .
    1. Myerson J, Green L, Warusawitharana M. Area under the curve as a measure of discounting. J Exp Anal Behav. 2001;76(2):235–43. Epub 2001/10/16. 10.1901/jeab.2001.76-235 ; PubMed Central PMCID: PMCPmc1284836.
    1. Kudielka BM, Hellhammer DH, Wust S. Why do we respond so differently? Reviewing determinants of human salivary cortisol responses to challenge. Psychoneuroendocrinology. 2009;34(1):2–18. Epub 2008/12/02. 10.1016/j.psyneuen.2008.10.004 .
    1. Khedr EM, Elfetoh NA, Ali AM, Noamany M. Anodal transcranial direct current stimulation over the dorsolateral prefrontal cortex improves anorexia nervosa: A pilot Study. Restor Neurol Neurosci. 2014. Epub 2014/09/06. 10.3233/rnn-140392 .
    1. Hecht D, Walsh V, Lavidor M. Bi-frontal direct current stimulation affects delay discounting choices. Cogn Neurosci. 2013;4(1):7–11. Epub 2013/10/01. 10.1080/17588928.2011.638139 .
    1. Rossi S, Hallett M, Rossini PM, Pascual-Leone A. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clinical Neurophysiology. 2009;120(12):2008–39. Epub 2009/10/17. 10.1016/j.clinph.2009.08.016
    1. Herwig U, Padberg F, Unger J, Spitzer M, Schönfeldt-Lecuona C. Transcranial magnetic stimulation in therapy studies: examination of the reliability of “standard” coil positioning by neuronavigation. Biol Psychiatry. 2001;50(1):58–61.
    1. Godier LR, Park RJ. Compulsivity in anorexia nervosa: a transdiagnostic concept. Front Psychol. 2014;5:778 Epub 2014/08/08. 10.3389/fpsyg.2014.00778 ; PubMed Central PMCID: PMCPmc4101893.
    1. Bartholdy S, McClelland J, Kekic M, O’Daly OG, Campbell IC, Werthmann J, et al. Clinical outcomes and neural correlates of 20 sessions of repetitive transcranial magnetic stimulation in severe and enduring anorexia nervosa (the TIARA study): study protocol for a randomised controlled feasibility trial. Trials. 2015;16(1):1–13.

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