Evidence map›Paper›PMID 42226264›Full record

ReviewAnnals of general psychiatry2026

Efficacy and safety of repetitive transcranial magnetic stimulation in anorexia and bulimia nervosa: a systematic review and meta-analysis.

Dalia Kamal Ewis, Haneen Sabet, Yousef Hawas, Wajeeh Hassan, Moaz Elsayed Abouelmagd, Arwa Jader, Dina Essam Abo-Elnour, Abdallah Abbas, Mohamed E G Elsayed, Carlos Schönfeldt-Lecuona and 1 more

Abstract readReview
In one paragraph

Review in Annals of general psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Dalia Kamal Ewis *Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.
Haneen Sabet *Faculty of Medicine, South Valley University, Qena, Egypt.
Yousef HawasFaculty of Medicine, Tanta University, Gharbeya, Egypt.
Wajeeh HassanAllama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan.
Moaz Elsayed AbouelmagdFaculty of Medicine, Cairo University, Cairo, Egypt.
Arwa JaderNeurosurgery Department, Kufa University, Kufa, Iraq.
Dina Essam Abo-ElnourFaculty of Medicine, Zagazig University, Zagazig, Egypt.
Abdallah AbbasFaculty of Medicine, Al-Azhar University, Damietta, Egypt.
Mohamed E G ElsayedDepartment of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany.
Carlos Schönfeldt-LecuonaDepartment of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany. carlos.schoenfeldt@uni-ulm.de.
Ahmed M RaslanDepartment of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis systematic review and meta-analysis aimed to evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) in patients with anorexia nervosa (AN) and bulimia nervosa (BN), focusing on its impact on psychological, psychopathological, neurocognitive, and behavioral outcomes.

methodsA comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane CENTRAL from inception to May 2025. Eligible studies included clinical trials involving adult patients with AN or BN treated with rTMS. Data were pooled using fixed or random-effects models depending on heterogeneity. Mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated. Risk of bias was assessed using Cochrane RoB 2.0 and NIH tools.

resultsThirteen studies were included, yielding a total of n = 195 active rTMS treatments and n = 132 sham treatments. Compared to sham, rTMS did not significantly improve BMI in AN patients (MD: 0.19; 95% CI: -0.50, 0.88; P = 0.59). A significant moderate reduction in eating disorder severity was found in single-arm analysis (31 patients, SMD: -0.50, 95% CI [-0.90, -0.10], p = 0.01). Depression improved with rTMS over sham (105 patients, SMD: -0.41, 95% CI [-0.81, -0.02], p = 0.04), while anxiety, binge frequency, and vomiting frequency did not. Urge to eat increased in AN (30 patients, MD: 1.20, 95% CI [0.20, 2.21], p = 0.02) and decreased in BN (25 patients, MD: -10.25, 95% CI [-15.88, -4.62], p = 0.0004). No serious adverse events were reported.

conclusionsrTMS shows potential in improving eating disorder severity and depressive symptoms in AN, with disorder-specific modulation of food-related urges. Its effects on BMI and behavioral symptoms remain inconclusive. rTMS was well tolerated.

Indexed as

Anorexia nervosaBulimia nervosaEating disordersRepetitive transcranial magnetic stimulationrTMSTMSTranscranial magnetic stimulation

Identifiers

PMID42226264
PMCPMC13224673

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.