title: Improvements in symptoms following neuronavigated repetitive transcranial magnetic stimulation (rTMS) in severe and enduring anorexia nervosa: findings from two case studies.
abstract: BACKGROUND
  Advances in the treatment of anorexia nervosa (AN) are most likely to arise from targeted, brain-directed treatments, such as repetitive transcranial magnetic stimulation (rTMS). We describe findings from two individuals with treatment-resistant AN who received 19-20 sessions of neuronavigated, high frequency rTMS, applied to the left dorsolateral prefrontal cortex.
  
  
  METHODS
  Within-session measures assessed changes pre-rTMS, post-rTMS in subjective eating disorder (ED) experiences. Weight, ED symptoms and mood were assessed pre-treatment, post-treatment and at 1 month follow-up.
  
  
  RESULTS
  In both cases, there was improvement in ED symptomatology and mood after 19-20 sessions of neuronavigated rTMS, and these changes persisted or continued to improve at follow-up. Within sessions, Patient A demonstrated a consistent reduction in subjective ED experiences, and Patient B a reduction in some ED related experiences.
  
  
  CONCLUSIONS
  These findings suggest that rTMS has potential as an adjunct to the treatment of AN and deserves further study.
authors.affiliation: King's College London, Institute of Psychiatry, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: McClelland
authors.forename: Natali
authors.initials: N
authors.lastname: Bozhilova
authors.forename: Steffen
authors.initials: S
authors.lastname: Nestler
authors.forename: Iain C
authors.initials: IC
authors.lastname: Campbell
authors.forename: Shirabdi
authors.initials: S
authors.lastname: Jacob
authors.forename: Eric
authors.initials: E
authors.lastname: Johnson-Sabine
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
mesh_terms: D000339:Affect; D000856:Anorexia Nervosa / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome; D055815:Young Adult
keywords: anorexia nervosa (AN); dorsolateral prefrontal cortex (DLPFC); repetitive transcranial magnetic stimulation (rTMS)