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Efficacy of Transcranial Magnetic Stimulation in Anorexia Nervosa: A Systematic Review and Meta-Analysis Publisher Pubmed



Bahadori AR1, 2 ; Javadnia P3 ; Bordbar S4 ; Zafari R5 ; Taherkhani T5 ; Davari A1, 6 ; Tafakhori A1 ; Shafiee S7 ; Ranji S1
Authors
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Authors Affiliations
  1. 1. Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3. Department of Neurosurgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Medical Colleges, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Mazandaran University of Medical Sciences, Sari, Iran

Source: Eating and Weight Disorders Published:2025


Abstract

Purpose: Transcranial magnetic stimulation (TMS) has emerged as a promising treatment for various neuropsychiatric conditions, including depression, obsessive–compulsive disorder, and Parkinson's disease. Recent research has focused on evaluating its effectiveness in treating patients with anorexia nervosa (AN). This systematic review and meta-analysis examined the impact of TMS on patients with AN and evaluated any potential adverse effects. Methods: We conducted search according to PRISMA guidelines and comprehensively analyzed data from multiple databases, including Pubmed, Scopus, Embase, Web of Science, and the Cochrane Library, up to September 13th. Statistical analysis utilized the Comprehensive Meta-analysis software version 3.0. Results: The systematic review encompassed 17 studies, with nine undergoing meta-analyses. The primary target for TMS was the dorsolateral prefrontal cortex, with two studies targeting the dorsomedial prefrontal cortex, one targeting the insula and one targeting the inferior parietal lobe. The findings revealed a significant increase in body mass index (BMI) following TMS (SMD: −0.025, 95% CI: −0.0505 to −0.005, P-value = 0.045). Additionally, the Eating Disorder Examination Questionnaire (EDE-Q) score was quantitatively reported in six studies, which permitted its inclusion in the meta-analysis. The analysis exhibited a significant decrease in EDE-Q score after TMS (SMD: 0.634, 95% CI: 0.349–0.919, P-value < 0.001). Subgroup analysis based on TMS session duration indicated that the effect size of TMS on EDE-Q score is more pronounced when the session duration exceeds 20 min. Conclusion: TMS represents an effective therapy for patients with AN, leading to improvements in both BMI and core symptoms of AN, with minor and transient side effects. Level of evidence: Level I, systematic reviews and meta-analyses. © The Author(s) 2025.