Project ID NS-MH2024_47

ThemeNS-MH

Co Supervisor 1A Institute of Psychiatry, Psychology & Neuroscience, School of Neuroscience, Department of NeuroimagingWebsite

Co Supervisor 1B Institute of Psychiatry, Psychology & Neuroscience, School of Academic Psychiatry, Department of Psychological MedicineWebsite

Additional Supervisor Prof. Ulrike Schmidt

An investigation of neural and cognitive mechanisms underpinning neuromodulation treatment in young people with persistent anorexia nervosa.

Anorexia nervosa (AN) typically begins in adolescence. ~ 30% of patients respond poorly to psychotherapies, resulting in enduring illness. Brain-based models of AN propose that a core problem relates to the cognitive control of emotional processes: accordingly, most treatments (including talking therapies) seek to alter cognitive functioning/ emotion regulation. However, treatment success is ~50%, i.e. there is a need for improvement. The continuing development of brain based interventions provides a way forward.

For many years, we have conducted non-invasive brain stimulation treatments in AN: evidence is indicative of their therapeutic benefit. Protocols are safe, well tolerated and similar to those used in depression. The mode of action of these procedures is unclear but our broad hypothesis is that neuromodulation promotes neuroplastic changes i.e. it enables changes to occur at the cognition-emotion interface. There are a range of clinical/procedural issues associated with this emerging field e.g. whether the procedures are best as standalone or adjunct therapies, duration of treatment effects etc. There are also academic questions related to the establishment of associated structural and functional brain changes.

The student will be part of the Centre for Research in Eating and Weight Disorders and the Centre for Neuroimaging. They will learn about eating disorders, neuromodulation and associated clinical/neurocognitive studies and functional and structural neuroimaging. They will be taught project specific skills (assessment of eating disorders, neuromodulation protocols, the conduct and analysis of neuroimaging protocols and clinical/neurocognitive tasks).

A training needs analysis will be conducted with the student. The student will attend transferrable skills training (as required). Objectives: Year 1: The student will familiarise themselves with the project and write a systematic review e.g. on neuro-imaging outcomes in neuromodulation in eating disorders. Year 2: They will participate in data acquisition related to the ongoing RCT. Year 3: Data analysis, paper writing, thesis completion.

Representative Publications

Test-retest reliability of time-varying patterns of brain activity across single band and multiband resting-state functional magnetic resonance imaging in healthy older adults. Cahart MS, Dell’Acqua F, Giampietro V, Cabral J, Timmers M, Streffer J, Einstein S, Zelaya F, Williams SCR, O’Daly O. Front Hum Neurosci. 2022 Nov 10;16:980280. doi: 10.3389/fnhum.2022.980280.

A pilot study exploring the effect of repetitive transcranial magnetic stimulation (rTMS) treatment on cerebral blood flow and its relation to clinical outcomes in severe enduring anorexia nervosa. Dalton B, Maloney E, Rennalls SJ, Bartholdy S, Kekic M, McClelland J, Campbell IC, Schmidt U, O’Daly OG. J Eat Disord. 2021 Jul 9;9(1):84. doi: 10.1186/s40337-021-00420-w.

Neural Correlates of Failed Inhibitory Control as an Early Marker of Disordered Eating in Adolescents. Bartholdy S, O’Daly OG, Campbell IC, Banaschewski T, Barker G, Bokde ALW, Bromberg U, Büchel C, Quinlan EB, Desrivières S, Flor H, Frouin V, Garavan H, Gowland P, Heinz A, Ittermann B, Martinot JL, Paillère Martinot ML, Nees F, Orfanos DP, Poustka L, Hohmann S, Fröhner JH, Smolka MN, Walter H, Whelan R, Schumann G, Schmidt U; IMAGEN Consortium. Biol Psychiatry. 2019 Jun 1;85(11):956-965. doi: 10.1016/j.biopsych.2019.01.027.

Gallop L, Westwood SJ, Lewis Y, Campbell IC, Schmidt U. Effects of transcranial direct current stimulation in children and young people with psychiatric disorders: a systematic review. Eur Child Adolesc Psychiatry. 2023 Feb 11. doi: 10.1007/s00787-023-02157-0. Epub ahead of print. PMID: 36764973.

Flynn M, Campbell I, Schmidt U. Does concurrent self-administered transcranial direct current stimulation and attention bias modification training improve symptoms of binge eating disorder? Protocol for the TANDEM feasibility randomized controlled trial. Front Psychiatry. 2022 Aug 3;13:949246. doi: 10.3389/fpsyt.2022.949246. PMID: 35990072; PMCID: PMC9382293.

Dalton B, Maloney E, Rennalls SJ, et al. A pilot study exploring the effect of repetitive transcranial magnetic stimulation (rTMS) treatment on cerebral blood flow and its relation to clinical outcomes in severe enduring anorexia nervosa. J Eat Disord. 2021;9(1):84.