TY  - JOUR
AU  - Fagundo, Ana Beatriz
AU  - Via, Esther
AU  - Sánchez, Isabel
AU  - Jiménez-Murcia, Susana
AU  - Forcano, Laura
AU  - Soriano-Mas, Carles
AU  - Giner-Bartolomé, Cristina
AU  - Santamaría, Juan J
AU  - Ben-Moussa, Maher
AU  - Konstantas, Dimitri
AU  - Lam, Tony
AU  - Lucas, Mikkel
AU  - Nielsen, Jeppe
AU  - Lems, Peter
AU  - Cardoner, Narcís
AU  - Menchón, Jose M
AU  - de la Torre, Rafael
AU  - Fernandez-Aranda, Fernando
PY  - 2014
DA  - 2014/08/12
TI  - Physiological and Brain Activity After a Combined Cognitive Behavioral Treatment Plus Video Game Therapy for Emotional Regulation in Bulimia Nervosa: A Case Report
JO  - J Med Internet Res
SP  - e183
VL  - 16
IS  - 8
KW  - eating disorders
KW  - bulimia nervosa
KW  - emotional regulation
KW  - impulsivity
KW  - video game therapy
KW  - neuroimaging
KW  - fMRI
AB  - Background: PlayMancer is a video game designed to increase emotional regulation and reduce general impulsive behaviors, by training to decrease arousal and improve decision-making and planning. We have previously demonstrated the usefulness of PlayMancer in reducing impulsivity and improving emotional regulation in bulimia nervosa (BN) patients. However, whether these improvements are actually translated into brain changes remains unclear. Objective: The aim of this case study was to report on a 28-year-old Spanish woman with BN, and to examine changes in physiological variables and brain activity after a combined treatment of video game therapy (VGT) and cognitive behavioral therapy (CBT). Methods: Ten VGT sessions were carried out on a weekly basis. Anxiety, physiological, and impulsivity measurements were recorded. The patient was scanned in a 1.5-T magnetic resonance scanner, prior to and after the 10-week VGT/CBT combined treatment, using two paradigms: (1) an emotional face-matching task, and (2) a multi-source interference task (MSIT). Results: Upon completing the treatment, a decrease in average heart rate was observed. The functional magnetic resonance imaging (fMRI) results indicated a post-treatment reduction in reaction time along with high accuracy. The patient engaged areas typically active in healthy controls, although the cluster extension of the active areas decreased after the combined treatment. Conclusions: These results suggest a global improvement in emotional regulation and impulsivity control after the VGT therapy in BN, demonstrated by both physiological and neural changes. These promising results suggest that a combined treatment of CBT and VGT might lead to functional cerebral changes that ultimately translate into better cognitive and emotional performances. 
SN  - 1438-8871
UR  - http://www.jmir.org/2014/8/e183/
UR  - https://doi.org/10.2196/jmir.3243
UR  - http://www.ncbi.nlm.nih.gov/pubmed/25116416
DO  - 10.2196/jmir.3243
ID  - info:doi/10.2196/jmir.3243
ER  -