Project ID NS-MH2023_08

ThemeNS-MH

Co Supervisor 1A IoPPN/Psychological MedicineWebsite

Co Supervisor 1B IoPPN/Neuroimaging, No CAG (cross-cutting Theme)Website

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

Anorexia nervosa (AN) is a disabling disorder typically beginning in adolescence. ~30% of patients respond poorly to psychotherapies, resulting in enduring illness, and the potential to impair development. We have pioneered non-invasive brain stimulation treatments in adults with AN and have funding for a sham-controlled double-blind feasibility RCT of 20 sessions of intermittent theta-burst-stimulation (iTBS) to the dorsolateral prefrontal cortex (DLPFC) in young people with persistent AN. Similar protocols are used in depression and are safe. The study will include neuroimaging and neurocognitive assessments before and after iTBS treatment.

Brain-based models of AN centre around the cognition-emotion interface and this translational study fits within these models. Specifically, it is hypothesised that iTBS promotes neuroplasticity resulting in changes in the relationship between the DLPFC and amygdala.

The student will be part of a vibrant Eating Disorders group. They will learn about eating disorders, associated clinical/neurocognitive studies, neuromodulation and neuroimaging. They will be taught project specific skills (e.g. assessment of eating disorders, iTBS protocols, analysis of clinical/neurocognitive tasks, utilise neuroimaging, and learn how to analyse different types of neuroimaging data (from both new and existing data).

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 studies of eating disorders. Year 2: They will participate in data acquisition related to the ongoing RCT. Year 3: Data analysis, paper writing, thesis completion.

One representative publication from each co-supervisor:

Dalton, B., Lewis, Y.D. Bartholdy, S., Kekic, M.,J. McClelland, J., Campbell, I.C. and Schmidt, U. (2021) Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment in Severe, Enduring Anorexia Nervosa: An Open Longer-term Follow-up” Nervosa: An Open Longer-term Follow-up. Eur Eating Disord Rev., 28,, 6, 773-781 doi:10.1002/erv.2766

Dalton B, Maloney E, Rennalls SJ, Bartholdy S, Kekic M, McClelland J, Campbell IC, Schmidt U, O’Daly OG. 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 Jul 9;9(1):84.