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神经调控技术在进食障碍中的应用

Application of neuromodulation therapy on eating disorder

摘要随着社会的发展,进食障碍因其易慢性化、高致死率、社会负担重而受到人们的关注。目前其治疗手段主要包括心理治疗和药物治疗,效果却不尽如人意。既往研究认为进食障碍患者存在前额叶相关的脑功能异常。近年来兴起的神经调控技术,尤其是无创性调控技术,因副作用少、使用方便成为研究的热点,在抑郁症、强迫症、物质成瘾等精神疾病中已得到运用,在进食障碍中也有少量的研究。本文章综述了这些神经调控技术在神经性厌食和神经性贪食中的相关研究,介绍了深部脑刺激、经颅磁刺激、直流电刺激等工作原理以及其对进食障碍的疗效。已有研究显示神经调控技术对进食障碍有一定的疗效,但现有研究结果不尽相同,最佳治疗方案还有待于进一步明确。在今后的研究中,尚需综合认知、神经影像学、生物标志物等数据来识别进食障碍不同的内表型,方能有助于阐明疾病机制,帮助进食障碍患者制定个体化的治疗方案,改善临床症状,为未来研究和应用提供依据。

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abstractsWith the development of society, eating disorders(EDs) have attracted people's attention because of their chronicity, high fatality rate and heavy social burden. However, the current treatment mainly includes psychotherapy and drug therapy, but the therapeutic effect is not satisfactory. Studies suggest that patients with EDs have brain abnormalities related to the prefrontal cortex. In recent years, the neuromodulation therapies, especially the non-invasive neuromodulation therapies, have become a research hotspot because of their few side effects and easy to use. At present, they have been used in mental disorders such as depression, obsessive-compulsive disorder, substance addiction and so on. A small number of studies on EDs have also been carried out. This paper reviews the related studies on anorexia nervosa and bulimia nervosa, and introduces the working principles of deep brain stimulation, transcranial magnetic stimulation and direct current stimulation and their efficacy in the treatment of EDs. Previous studies have shown that neuromodulation therapies are effective in the treatment of EDs. However, the existing research results are not exactly same, and the best parameters need to be clarified. In the future study, it is necessary to integrate cognitive, neuroimaging and biomarker data to identify different endophenotypes in EDs, so as to help clarify the disease mechanism, help patients with EDs to formulate individual treatment plans, improve clinical symptoms, and put forward suggestions and prospects for future research and application.

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