2026 ECNP Congress

PS04-4066

Transcranial direct current stimulation in anorexia nervosa: a double-blind pilot trial assessing autistic traits, emotion regulation, and somatic outcomes

Klaudia Kister — W. Ziemichód, A. Makarewicz, Z. Rząd, N. Kajka, P. Szewczyk, H. Karakuła-Juchnowicz · Medical University of Lublin, I Department of Psychiatry- Psychotherapy and Early Intervention in Lublin, Lublin, Poland

2026 ECNP Congress

Background

Anorexia nervosa (AN) is a disorder with limited treatment effectiveness. Dysregulation of cognitive control networks has been observed in AN. It is estimated that approximately 4% to as many as 30–50% of individuals with AN exhibit elevated autistic traits or meet criteria for autism spectrum disorder (ASD). These traits include cognitive rigidity, difficulties in social communication, and restricted and repetitive patterns of behavior[1], reflecting a broader neuropsychological profile observed in AN.The partial overlap of neurobiological mechanisms suggests a potentially sharedbasis for the observed cognitive and socio-emotional difficulties. Despite a growing body of research, the nature of the relationship between AN and ASD remains unclear [2]. It is not known whether autistic traits represent a stable neurodevelopmental dimension of functioning or are secondary to the course of malnutrition. We hypothesized that tDCS targeting the DLPFC would reduce autistic traits and improve emotion regulation, thereby supporting nutritional rehabilitation [3]. The primary aim of this 3-week randomized controlled trial (RCT) was to evaluate the effects of transcranial direct current stimulation (tDCS) on autistic traits, emotion regulation, and progress in nutritional rehabilitation in patients with AN .

Methods

In this single-center, randomized, double-blind, placebo-controlled pilot study, 22 adolescent girls aged 12–20 years with AN were randomized to active tDCS (n = 9) or sham stimulation (n = 13). The intervention consisted of 30 sessions delivered over three consecutive weeks (two sessions daily on weekdays; 2 mA, 20 min per session, anodal stimulation over the left dorsolateral prefrontal cortex). Outcomes were assessed at baseline, post-intervention, and at 2-month follow-up using the Autism Spectrum Quotient, the Difficulties in Emotion Regulation Scale (DERS-16), and body mass index. The trial was registered at ClinicalTrials.gov (NCT05814458).

Results

No statistically significant differences were observed between the active and sham groups in changes in AQ or DERS-16 scores across time points (baseline, post-intervention, and 2-month follow-up) (p>0.05). Body mass index increased over time in both groups. Although mean BMI was higher in the sham group at baseline and post-intervention, greater weight gain from baseline to follow-up was observed in the active tDCS group compared to the sham group.

Conclusions

This preliminary study shows that three weeks of tDCS targeting the dorsolateral prefrontal cortex did not significantly affect autistic traits or emotion regulation in adolescents with anorexia nervosa. However, greater weight gain observed in the active stimulation group suggests a potential role of tDCS as an adjunct to nutritional rehabilitation. These findings indicate that autistic traits and emotion regulation difficulties in AN may be less responsive to short-term neuromodulation. hese findings highlight the need for further research into whether tDCS may support recovery in AN through mechanisms other than the direct reduction of autistic traits and emotion regulation difficulties. Further studies with larger samples, longer follow-up, and stratification by autistic trait severity are needed to clarify the therapeutic potential of tDCS in this population. T

References

  1. Kirkovski M, Papavasiliou G, Speranza BE, et al. Autism spectrum disorder and anorexia nervosa: Investigating the behavioural and neurocognitive overlap. Psychiatry Res. 2025 Feb;344:116285.
  2. Westwood H, Tchanturia K. Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review. Curr Psychiatry Rep. 2017 Jul;19(7):41.
  3. McDonald, Caity E., Susan L. Rossell, et al. The comorbidity of eating disorders in bipolar disorder and associated clinical correlates characterised by emotion dysregulation and impulsivity: A systematic review. Journal of Affective Disorders 259 (2019): 228-243.