‘If we can get a positive signal from this study, I really think it’ll blow this field really wide open’, Monash University’s Dr Leo Chen

They had never had an eating disorder – until their brain injury. Their MRIs could revolutionise treatment for countless anorexia patients across the globe – starting here in Melbourne.

Anorexia is one of the deadliest mental illnesses, with researchers calling for better treatments.

Melbourne will be the first in the world to trial a new anorexia therapy after a handful of previously healthy patients from across the world developed symptoms post-brain injury.

Monash University’s Dr Leo Chen said anorexia had the “highest mortality rates” of all neuropsychiatric illnesses, yet “we don’t have any effective treatments”.

But a potential therapy has been in the works after researchers discovered similarities among several brain-injury patients, who had all unexpectedly developed symptoms of eating disorders.

Dr Chen, the trial’s lead investigator, said Harvard Medical School, Boston’s Brigham and Women’s Hospital, Monash University and Alfred Health researchers analysed 15 published cases of patients who suddenly developed anorexia symptoms.

“These are people who did not have problems with restrictive eating or food aversion or preoccupation with body image, but because of some brain damage, they developed anorexia behaviours,” he said.

“We noted where these areas of brain damage occurred, and mapped them to a brain network.”

They discovered a network consistently associated with anorexia, and believe other patients — who developed anorexia without suffering a brain injury — have some type of dysfunction in the same region.

Dr Chen said a coil placed on participant’s head will be used to deliver small pulses of energy into their brain in a non-invasive, painless 10-minute treatment session.

“We have identified a causal brain network for anorexia behaviours,” he said.

“We can see this network on each individual’s MRI scans and will use it to identify their

personalised stimulation target.

“It feels like a gentle tapping on the head.”

He said electromagnetic stimulation had never been trialled like this for anorexia until now, but had been used to treat depression for decades and aimed to “facilitate healthy brain cell firing” in the targeted network.

Monash University and Alfred Health have begun recruiting a small number of anorexia patients to undergo sessions over three weeks, followed by five months of “top-ups”.

While Dr Chen said they needed to be cautious and await the trial’s results, he was “quietly confident”.

“If we can get a positive signal from this study, I really think it’ll sort of blow this field really wide open,” he said.

“I think this can be a real game-changer.”

Dr Chen said it was “vital” we improve our understanding of anorexia, with Monash University’s Professor Jayashri Kulkarni also trialling oestrogen as a treatment.

“Most people who live with anorexia nervosa are young women, not all but most are … and they are 60 times more likely to die by suicide,” Dr Chen said.

“People are screaming out for more effective and tolerable treatments.

“A lot of people are suffering out there.”

He thanked the Li family and Blue Sky and Natwes Foundations for crucial funding.

https://www.monash.edu/medicine/her-centre/health/clinical-trials