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Chmiel J, Kurpas D, Rybakowski F, Leszek J. The Effectiveness of Transcranial Direct Current Stimulation (tDCS) in Binge Eating Disorder (BED)-Review and Insight into the Mechanisms of Action. Nutrients 2024; 16:1521. [PMID: 38794759 PMCID: PMC11123682 DOI: 10.3390/nu16101521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/12/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Binge eating disorder (BED) is the most common eating disorder among those contributing to the development of obesity, and thus acts as a significant burden on the lives and health of patients. It is characterized by complex neurobiology, which includes changes in brain activity and neurotransmitter secretion. Existing treatments are moderately effective, and so the search for new therapies that are effective and safe is ongoing. AIM AND METHODS This review examines the use of transcranial direct current stimulation (tDCS) in the treatment of binge eating disorder. Searches were conducted on the PubMed/Medline, Research Gate, and Cochrane databases. RESULTS Six studies were found that matched the review topic. All of them used the anodal stimulation of the right dorsolateral prefrontal cortex (DLPFC) in BED patients. tDCS proved effective in reducing food cravings, the desire to binge eat, the number of binging episodes, and food intake. It also improved the outcomes of inhibitory control and the treatment of eating disorder psychopathology. The potential mechanisms of action of tDCS in BED are explained, limitations in current research are outlined, and recommendations for future research are provided. CONCLUSIONS Preliminary evidence suggests that the anodal application of tDCS to the right DLPFC reduces the symptoms of BED. However, caution should be exercised in the broader use of tDCS in this context due to the small number of studies performed and the small number of patients included. Future studies should incorporate neuroimaging and neurophysiological measurements to elucidate the potential mechanisms of action of tDCS in BED.
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Affiliation(s)
- James Chmiel
- Institute of Neurofeedback and tDCS Poland, 70-393 Szczecin, Poland
| | - Donata Kurpas
- Department of Family and Pediatric Nursing, Faculty of Health Sciences, Wrocław Medical University, 51-618 Wrocław, Poland
| | - Filip Rybakowski
- Department and Clinic of Psychiatry, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Jerzy Leszek
- Department and Clinic of Psychiatry, Wrocław Medical University, 54-235 Wrocław, Poland
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Tabasi M, Mostafavi SA, Oreyzi H, Mohammadi MR, Khaleghi A. The Effectiveness of Transcranial Direct Current Stimulation (tDCS) and Omega-3 on Food Craving, Executive Functions, Weight, and Depressive Symptoms in Patients with Depression and Overweight: A Randomized Controlled Trial. IRANIAN JOURNAL OF PSYCHIATRY 2024; 19:158-173. [PMID: 38686306 PMCID: PMC11055968 DOI: 10.18502/ijps.v19i2.15102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/31/2024] [Accepted: 02/14/2024] [Indexed: 05/02/2024]
Abstract
Objective: The most important hypothesis of this research was based on the fact that the mechanism of the effect of omega-3 on depression and obesity is formed through its accumulation in the dorsolateral prefrontal cortex (DLPFC), especially in women. Accordingly, we investigated the omega-3 intake and the concurrent stimulation of the DLPFC by tDCS and hypothesized that the synergy of these two treatments can increase the obtained effect size in patients with depression and overweight. Method : This research was a double-blind randomized controlled trial (RCT) with a factorial design consisting of four treatment and control groups. The participants were females with depression and overweight on an outpatient basis. They received 5 ml/day omega-3 syrup (545 mg DHA, 620 mg EPA) or placebo adjunct with 12 sessions sham/tDCS stimulation administered for 3 weeks with anode-left/cathode-right protocol in the prefrontal cortex (1.5 mA, 15 minutes' stimulation / 15-20 minutes' rest intervals/one visit per week, 4 stimulations per visit). Results: tDCS or omega-3 alone did not significantly improve the executive functions, depression, food cravings, and weight in the experimental groups compared to the control group (P > 0.05). However, tDCS adjunct with the omega-3 had a significant and positive effect on improving weight change (P = 0.011; df = 1; F = 1.27; Eta = 0.108) with a power of 0.73 compared to the control group. Furthermore, their interaction led to an improving trend in executive functions and a decreasing trend in food cravings which are clinically important. Conclusion: tDCS could strengthen the omega-3 mechanisms of effect through stimulating its accumulation site in the brain (i.e., the DLPFC) and the synergistic effects of these two treatments result in weight control as well as an improvement trend in the executive functions and food craving in women.
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Affiliation(s)
- Mahla Tabasi
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Psychology, University of Religions and Denominations, Qom, Iran
| | - Hamidreza Oreyzi
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Jeong JE, Kim JW. Efficacy of Transcranial Direct Current Stimulation for Controlling of Food Craving in Subjects With Overweight or Obesity: A Pilot Study. Psychiatry Investig 2024; 21:92-99. [PMID: 38200635 PMCID: PMC10822738 DOI: 10.30773/pi.2023.0255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/25/2023] [Accepted: 10/18/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE We aim to explore the effects of transcranial direct current stimulation (tDCS) on food craving improvement and changes in brain function associated with craving by conducting a total of 10 sessions of tDCS over a period of 2 weeks on overweight and obese subjects. METHODS A total of 15 patients who were overweight or obese (body mass index [BMI] ≥23 kg/m2) were included. Weight, BMI, neuropsychological variables, and food craving-related variables were assessed. We measured absolute and relative power in 19 channels and analyzed quantitative electroencephalography (qEEG) according to the following frequency ranges: delta (1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), beta (12-25 Hz), high beta (25-30 Hz), and gamma (30-80 Hz). RESULTS After the application of tDCS, there was no significant reduction observed in weight and BMI. However, all measures related to food and eating showed a decrease in the intensity of cravings, and there was also a significant reduction in depression, anxiety, and perceived stress. In qEEG analysis, an increase in theta waves was observed in the left frontal area (F7 and F3), an increase in alpha waves in the right parietal area (P4), and a decrease in beta waves in the frontal area (FP2) and occipital area (O1). CONCLUSION This study confirmed the beneficial effects of tDCS on food craving regulation in overweight or obese individuals and observed improved scores in psychological factors such as depression and anxiety. Furthermore, neurophysiological changes related to food craving were observed using qEEG.
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Affiliation(s)
- Jo-Eun Jeong
- Department of Psychiatry, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Jun Won Kim
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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Ha OR, Lim SL. The role of emotion in eating behavior and decisions. Front Psychol 2023; 14:1265074. [PMID: 38130967 PMCID: PMC10733500 DOI: 10.3389/fpsyg.2023.1265074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
The present paper aims to provide the latest perspectives and future directions on the association between emotions and eating behavior. We discussed individual differences in the impact of negative emotions on eating, emotional eating as disinhibited eating decisions with heightened reward values of and sensitivity to palatable foods in response to negative emotions and social isolation, in addition to emotional eating as maladaptive coping strategies under negative emotion and stress, hedonic (pleasure-oriented) eating decisions mediated by the brain reward system, and self-controlled (health-oriented) eating decisions mediated by the brain control system. Perspectives on future directions were addressed, including the development of early eating phenotypes in infancy, shared neural mechanisms mediated by the ventromedial prefrontal cortex and the dorsolateral prefrontal cortex in emotion and eating decision regulation, possible roles of interoception incorporating hunger and satiety signals, gut microbiome, the insula and the orbitofrontal cortex, and emotional processing capacities in hedonic eating and weight gain.
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Affiliation(s)
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri – Kansas City, Kansas City, MO, United States
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Alhindi YA, Khalifa N, Al-Khyatt W, Idris I. The use of non-invasive brain stimulation techniques to reduce body weight and food cravings: A systematic review and meta-analysis. Clin Obes 2023; 13:e12611. [PMID: 37577814 DOI: 10.1111/cob.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 06/27/2023] [Accepted: 07/09/2023] [Indexed: 08/15/2023]
Abstract
Several studies demonstrated non-invasive brain stimulation (NIBS) techniques such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) are safe and simple techniques that can reduce body weight, food cravings, and food consumption in patients with obesity. However, a systematic to evaluate the efficacy of active NIBS versus sham stimulation in reducing body weight and food cravings in patients with obesity is not available. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) using PubMed, Embase, MEDLINE, and Cochrane Central Register of Control Trial between January 1990 and February 2022. Mean differences (MDs) for continuous outcome variables with 95% confidence intervals (95% CIs) were used to examine the effects of NIBS on body weight and body mass index (BMI), whereas the hedges's g test was used to measure the effects on food craving. Nineteen RCTs involving 571 participants were included in this study. Active neurostimulation (TMS and tDCS) was significantly more likely than sham stimulation to reduce body weight (TMS: -3.29 kg, 95% CI [-5.32, -1.26]; I2 = 48%; p < .001; tDCS: -0.82 kg, 95% CI [-1.01, -0.62]; I2 = 0.0%; p = .00) and BMI (TMS: -0.74, 95% CI [-1.17, -0.31]; I2 = 0% p = .00; tDCS: MD = -0.55, 95% CI [-2.32, 1.21]; I2 = 0% p = .54) as well as food cravings (TMS: g = -0.91, 95% CI [-1.68, -0.14]; I2 = 88 p = .00; tDCS: g = -0.32, 95% CI [-0.62, -0.02]; p = .04). Compared with sham stimulation, our findings indicate that active NIBS can significantly help to reduce body weight and food cravings. Hence, these novel techniques may be used as primary or adjunct tools in treating patients with obesity.
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Affiliation(s)
- Yousef Abdullah Alhindi
- Clinical, Metabolic and Molecular Physiology, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital, Nottingham, UK
- East Midlands Bariatric Metabolic Institute, Royal Derby Hospital, Derby, UK
- Division of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Najat Khalifa
- Queen's University Department of Psychiatry, Kingston, Ontario, Canada
| | - Waleed Al-Khyatt
- East Midlands Bariatric Metabolic Institute, Royal Derby Hospital, Derby, UK
| | - Iskandar Idris
- Clinical, Metabolic and Molecular Physiology, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital, Nottingham, UK
- East Midlands Bariatric Metabolic Institute, Royal Derby Hospital, Derby, UK
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Beaumont JD, Dalton M, Davis D, Finlayson G, Nowicky A, Russell M, Barwood MJ. No effect of prefrontal transcranial direct current stimulation (tDCS) on food craving, food reward and subjective appetite in females displaying mild-to-moderate binge-type behaviour. Appetite 2023; 189:106997. [PMID: 37574640 DOI: 10.1016/j.appet.2023.106997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
Previous work suggests there may be an effect of transcranial direct current stimulation (tDCS) on appetite control in people at risk of overconsumption, however findings are inconsistent. This study aimed to further understand the potential eating behaviour trait-dependent effect of tDCS, specifically in those with binge-type behaviour. Seventeen females (23 ± 7 years, 25.4 ± 3.8 kg m-2) with mild-to-moderate binge eating behaviour completed two sessions of double-blind, randomised and counterbalanced anodal and sham tDCS applied over the right dorsolateral prefrontal cortex at 2.0 mA for 20 min. Subjective appetite visual analogue scales (VAS), the Food Craving Questionnaire-State (FCQ-S), and Leeds Food Preference Questionnaire (LFPQ) were completed pre- and post-tDCS. Participants then consumed a fixed-energy meal, followed by the VAS, FCQ-S and LFPQ. No difference between pre- and post-tDCS scores were found across fullness (p = 0.275, BF10 = 0.040), prospective consumption (p = 0.127, BF10 = 0.063), desire to eat (p = 0.247, BF10 = 0.054) or FCQ-S measures (p = 0.918, BF10 = 0.040) when comparing active and sham protocols. Only explicit liking and wanting for high-fat sweet foods were significantly different between conditions, with increased scores following active tDCS. When controlling for baseline hunger, the significant differences were removed (p = 0.138 to 0.161, BF10 = 0.810 to 1.074). The present data does not support the eating behaviour trait dependency of tDCS in a specific cohort of female participants with mild-to-moderate binge eating scores, and results align with those from individuals with healthy trait scores. This suggests participants with sub-clinical binge eating behaviour do not respond to tDCS. Future work should further explore effects in clinical and sub-clinical populations displaying susceptibility to overconsumption and weight gain.
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Affiliation(s)
- Jordan D Beaumont
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK; Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield, S1 1WB, UK.
| | - Michelle Dalton
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Danielle Davis
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Graham Finlayson
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, LS2 9JU, UK
| | - Alexander Nowicky
- Centre for Cognitive Neuroscience, Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Mark Russell
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Martin J Barwood
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
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Schutter DJ, Smits F, Klaus J. Mind matters: A narrative review on affective state-dependency in non-invasive brain stimulation. Int J Clin Health Psychol 2023; 23:100378. [PMID: 36866122 PMCID: PMC9971283 DOI: 10.1016/j.ijchp.2023.100378] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
Variability in findings related to non-invasive brain stimulation (NIBS) have increasingly been described as a result of differences in neurophysiological state. Additionally, there is some evidence suggesting that individual differences in psychological states may correlate with the magnitude and directionality of effects of NIBS on the neural and behavioural level. In this narrative review, it is proposed that the assessment of baseline affective states can quantify non-reductive properties which are not readily accessible to neuroscientific methods. Particularly, affective-related states are theorized to correlate with physiological, behavioural and phenomenological effects of NIBS. While further systematic research is needed, baseline psychological states are suggested to provide a complementary cost-effective source of information for understanding variability in NIBS outcomes. Implementing measures of psychological state may potentially contribute to increasing the sensitivity and specificity of results in experimental and clinical NIBS studies.
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Affiliation(s)
- Dennis J.L.G. Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Fenne Smits
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Brain Research & Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, The Netherlands
| | - Jana Klaus
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
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de Klerk MT, Smeets PAM, la Fleur SE. Inhibitory control as a potential treatment target for obesity. Nutr Neurosci 2023; 26:429-444. [PMID: 35343884 DOI: 10.1080/1028415x.2022.2053406] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Strong reward responsiveness to food and insufficient inhibitory control are thought to be implicated in the development and maintenance of obesity. This narrative review addresses the role of inhibitory control in obesity and weight loss, and in how far inhibitory control is a promising target for weight loss interventions. METHODS PubMed, Web of Science, and Google Scholar were searched for papers up to May 2021. 41 papers were included. RESULTS Individuals with obesity have poorer food-specific inhibitory control, particularly when hungry, and less concurrent activation of inhibitory brain areas. Moreover, this was strongly predictive of future weight gain. More activation of inhibitory brain areas, on the other hand, was predictive of weight loss: individuals with successful weight loss initially show inhibitory brain activity comparable to that of normal weight individuals. When successful weight maintenance is achieved for at least 1 year, this inhibitory activity is further increased. Interventions targeting inhibitory control in obese individuals have divergent effects. Firstly, food-specific inhibitory control training is particularly effective for people with low inhibitory control and high BMI. Secondly, neuromodulation paradigms are rather heterogeneous: although rTMS to the left dorsolateral prefrontal cortex induced some weight-loss, multiple sessions of tDCS reduced food consumption (desire) and induced weight loss in two thirds of the papers. Thirdly, neurofeedback results in successful upregulation of brain activity and connectivity, but occasionally leads to increased food intake. In conclusion, inhibitory control is implicated in obesity. It can be targeted to promote weight loss although major weight losses have not been achieved.
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Affiliation(s)
- M T de Klerk
- Image Sciences Institute, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Neurobiology of Energy Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - P A M Smeets
- Image Sciences Institute, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - S E la Fleur
- Neurobiology of Energy Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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de Araujo C, Fitz RC, da Natividade GR, Osório AF, Merello PN, Mesquita LDA, Correia PE, Freitas PAC, Brietzke E, Gerchman F. Effects of transcranial direct current stimulation associated with hypocaloric diet on glucose homeostasis in obesity. Obesity (Silver Spring) 2022; 30:2414-2423. [PMID: 36415996 DOI: 10.1002/oby.23565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/29/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of this study was to test the effects of repetitive active transcranial direct current stimulation (tDCS) over the right dorsolateral prefrontal cortex (rDLPFC) associated with a hypocaloric diet on glucose homeostasis in people with excessive weight. METHODS Adults with overweight or obesity were selected in a randomized, double-blind pilot study to complete 4 weeks (20 sessions) of fixed-dose tDCS (2 mA, 20 minutes) delivered over the rDLPFC and associated with a standard hypocaloric diet. Participants were randomly assigned (1:1) and stratified by sex to the active tDCS group (active) or the sham tDCS group (sham). Changes in glucose homeostasis were assessed in a 4-hour liquid meal tolerance test, performed before and after the intervention. RESULTS Twenty-eight participants were randomized (79% with obesity; mean [SD] age 37.6 [5.8] years). After the intervention, fasting plasma glucose (mean [95% CI], -7.8 mg/dL [-14.0 to -1.6]) and insulin levels (-7.7 μIU/mL [-13.9 to -1.6]) decreased in the active compared with the sham. Similarly, the Matsuda insulin sensitivity index increase in the active (4.7 pmol-1 × mmol-1 [1.6 to 7.8]) compared with the sham (0.6 pmol-1 × mmol-1 [-1.4 to 3.2]). CONCLUSIONS Repetitive, active tDCS over the rDLPFC could be a promising noninvasive technique to improve glucose homeostasis in individuals with overweight or obesity on a low-calorie diet, highlighting the importance of investigating this intervention modality in individuals with type 2 diabetes mellitus.
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Affiliation(s)
- Carina de Araujo
- Graduate Program in Medical Sciences: Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Raquel C Fitz
- Graduate Program in Medical Sciences: Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Gabriella R da Natividade
- Graduate Program in Medical Sciences: Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Amanda F Osório
- Graduate Program in Medical Sciences: Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Paula N Merello
- Graduate Program in Medical Sciences: Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Leonardo de A Mesquita
- Graduate Program in Medical Sciences: Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Poliana E Correia
- Graduate Program in Medical Sciences: Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Priscila A C Freitas
- Laboratory Diagnosis Division, Clinical Biochemistry Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Elisa Brietzke
- Department of Psychiatry, Queens University School of Medicine, Kingston, Ontario, Canada
| | - Fernando Gerchman
- Graduate Program in Medical Sciences: Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Ester T, Kullmann S. Neurobiological regulation of eating behavior: Evidence based on non-invasive brain stimulation. Rev Endocr Metab Disord 2022; 23:753-772. [PMID: 34862944 PMCID: PMC9307556 DOI: 10.1007/s11154-021-09697-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 12/28/2022]
Abstract
The prefrontal cortex is appreciated as a key neurobiological player in human eating behavior. A special focus is herein dedicated to the dorsolateral prefrontal cortex (DLPFC), which is critically involved in executive function such as cognitive control over eating. Persons with obesity display hypoactivity in this brain area, which is linked to overconsumption and food craving. Contrary to that, higher activity in the DLPFC is associated with successful weight-loss and weight-maintenance. Transcranial direct current stimulation (tDCS) is a non-invasive neurostimulation tool used to enhance self-control and inhibitory control. The number of studies using tDCS to influence eating behavior rapidly increased in the last years. However, the effectiveness of tDCS is still unclear, as studies show mixed results and individual differences were shown to be an important factor in the effectiveness of non-invasive brain stimulation. Here, we describe the current state of research of human studies using tDCS to influence food intake, food craving, subjective feeling of hunger and body weight. Excitatory stimulation of the right DLPFC seems most promising to reduce food cravings to highly palatable food, while other studies provide evidence that stimulating the left DLPFC shows promising effects on weight loss and weight maintenance, especially in multisession approaches. Overall, the reported findings are heterogeneous pointing to large interindividual differences in tDCS responsiveness.
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Affiliation(s)
- Theresa Ester
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.
- German Center of Diabetes Research (DZD), Tübingen, Germany.
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.
- German Center of Diabetes Research (DZD), Tübingen, Germany.
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Ebehard Karls University Tübingen, Tübingen, Germany.
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Change in craving and frequency of consuming palatable foods for non-homeostatic motives after a gut-cued eating intervention. Eat Behav 2022; 46:101656. [PMID: 35944376 DOI: 10.1016/j.eatbeh.2022.101656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Little is known regarding consumption of palatable foods (PFs) for non-homeostatic reasons after weight-loss interventions and if baseline or change in frequency of this kind of eating can predict weight-loss outcomes. Little is also known of the relationship between PF eating for non-homeostatic motives and PF craving. Addressing these gaps is important because cravings and habitual consumption of PFs in the absence of homeostatic need contribute to obesity. METHODS N = 30 adults with a mean 34.8 BMI completed a seven-response choice version of the PEMS (PEMS-7) before and after Gut-Cued Eating (GCE), an intervention that did not ban PFs but instructed them to eat only when stomach-hungry and stop eating before feeling too full. Photos of PFs were also rated pre- and post-GCE. RESULTS Frequency of eating PFs for social, reward enhancement, and coping, but not conformity motives, decreased after GCE. The decreases predicted amount of weight loss independent of initial weight and demographics. PF craving also decreased and, while correlated with decreasing PF intake, it did not predict weight loss. DISCUSSION The study is preliminary because GCE was uncontrolled. However, results warrant a controlled investigation. That craving and frequency of consuming PFs for non-homeostatic motives declined with an intervention that did not ban PFs suggests a method that may voluntarily decrease one's intake of PFs. This should facilitate weight-loss and healthy-weight maintenance. Finally, decreased eating for non-homeostatic motives suggests that individuals were no longer using PFs to cope, socialize, and enhance reward, a change with benefits beyond weight loss.
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Mattes RD, Rowe SB, Ohlhorst SD, Brown AW, Hoffman DJ, Liska DJ, Feskens EJM, Dhillon J, Tucker KL, Epstein LH, Neufeld LM, Kelley M, Fukagawa NK, Sunde RA, Zeisel SH, Basile AJ, Borth LE, Jackson E. Valuing the Diversity of Research Methods to Advance Nutrition Science. Adv Nutr 2022; 13:1324-1393. [PMID: 35802522 PMCID: PMC9340992 DOI: 10.1093/advances/nmac043] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/08/2022] [Indexed: 12/13/2022] Open
Abstract
The ASN Board of Directors appointed the Nutrition Research Task Force to develop a report on scientific methods used in nutrition science to advance discovery, interpretation, and application of knowledge in the field. The genesis of this report was growing concern about the tone of discourse among nutrition professionals and the implications of acrimony on the productive study and translation of nutrition science. Too often, honest differences of opinion are cast as conflicts instead of areas of needed collaboration. Recognition of the value (and limitations) of contributions from well-executed nutrition science derived from the various approaches used in the discipline, as well as appreciation of how their layering will yield the strongest evidence base, will provide a basis for greater productivity and impact. Greater collaborative efforts within the field of nutrition science will require an understanding that each method or approach has a place and function that should be valued and used together to create the nutrition evidence base. Precision nutrition was identified as an important emerging nutrition topic by the preponderance of task force members, and this theme was adopted for the report because it lent itself to integration of many approaches in nutrition science. Although the primary audience for this report is nutrition researchers and other nutrition professionals, a secondary aim is to develop a document useful for the various audiences that translate nutrition research, including journalists, clinicians, and policymakers. The intent is to promote accurate, transparent, verifiable evidence-based communication about nutrition science. This will facilitate reasoned interpretation and application of emerging findings and, thereby, improve understanding and trust in nutrition science and appropriate characterization, development, and adoption of recommendations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Leonard H Epstein
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | | | - Michael Kelley
- Michael Kelley Nutrition Science Consulting, Wauwatosa, WI, USA
| | - Naomi K Fukagawa
- USDA Beltsville Human Nutrition Research Center, Beltsville, MD, USA
| | | | - Steven H Zeisel
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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13
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Effective Transcranial Direct Current Stimulation Parameters for the Modulation of Eating Behavior: A Systematic Literature Review and Meta-Analysis. Psychosom Med 2022; 84:646-657. [PMID: 35412517 DOI: 10.1097/psy.0000000000001074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to consider the effect of differing transcranial direct current stimulation (tDCS) parameters on eating-related measures and how issues with experimental design (e.g., inadequate blinding) or parameters variation may drive equivocal effects. METHODS Literature searches were conducted across MEDLINE, PsycINFO, Scopus, and Science Direct. Studies using conventional sham-controlled tDCS to modify eating-related measures in adult human participants were included. A total of 1135 articles were identified and screened by two independent authors. Study quality was assessed using the Risk of Bias tool. Random-effects meta-analyses were performed, with subgroup analyses to determine differences between parameter sets. RESULTS We identified 28 eligible studies; 7 showed low risk of bias, with the remaining studies showing bias arising from issues implementing or reporting blinding protocols. Large variation in applied parameters was found, including montage, current intensity and density, participant and researcher blinding, and the use of online or offline tasks. The application of differing parameters seemed to alter the effects of tDCS on eating-related measures, particularly for current density ( g = -0.25 to 0.31), and when comparing single-session ( g = -0.08 to 0.01) versus multisession protocols ( g = -0.34 to -0.29). Some parameters result in null effects. CONCLUSIONS The absence of tDCS-mediated change in eating-related measures may be driven by variation in applied parameters. Consistent application of parameters that seem to be effective for modulating eating behavior is important for identifying the potential impact of tDCS. Using the findings of this review, we propose a series of parameters that researchers should apply in their work.
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Beaumont JD, Smith NC, Starr D, Davis D, Dalton M, Nowicky A, Russell M, Barwood MJ. Modulating eating behavior with transcranial direct current stimulation (tDCS): A systematic literature review on the impact of eating behavior traits. Obes Rev 2022; 23:e13364. [PMID: 34786811 DOI: 10.1111/obr.13364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 12/25/2022]
Abstract
Transcranial direct current stimulation (tDCS) is becoming an increasingly popular technique for altering eating behaviors. Recent research suggests a possible eating behavior trait-dependent effect of tDCS. However, studies recruit participant populations with heterogeneous trait characteristics, including "healthy" individuals who do not present with eating behavior traits suggesting susceptibility to overconsumption. The present review considers the effects of tDCS across eating-related measures and explores whether a trait-dependent effect is evident across the literature. A literature search identified 28 articles using sham-controlled tDCS to modify eating-related measures. Random effects meta-analyses were performed, with subgroup analyses to identify differences between "healthy" and trait groups. Trivial overall effects (g = -0.12 to 0.09) of active versus sham tDCS were found. Subgroup analyses showed a more consistent effect for trait groups, with small and moderate effect size (g = -1.03 to 0.60), suggesting tDCS is dependent on participants' eating behavior traits. Larger effect sizes were found for those displaying traits associated with study outcomes (e.g., heightened food cravings). "Healthy" individuals appear to be unresponsive to stimulation. Based on this meta data, future work should recruit those with eating behavior trait susceptibilities to overconsumption, focusing on those who present with traits associated with the outcome of interest.
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Affiliation(s)
- Jordan D Beaumont
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - Natalie C Smith
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - David Starr
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - Danielle Davis
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - Michelle Dalton
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - Alexander Nowicky
- Centre for Cognitive Neuroscience, Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Mark Russell
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - Martin J Barwood
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
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15
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Stevens CE, Lausen MA, Wagstaff LE, McRae TR, Pittman BR, Amthor FR, Boggiano MM. Effect of transcranial direct current stimulation (tDCS) on food craving and eating when using a control method that minimizes guessing of the real vs. control condition. Eat Weight Disord 2021; 26:1669-1674. [PMID: 32748372 DOI: 10.1007/s40519-020-00970-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/24/2020] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Validation of transcranial direct current stimulation (tDCS) to treat obesity is hampered by evidence that participants can distinguish real from the traditional-control condition. Correctly guessing the real condition precludes knowing if it is neuromodulation or expectation that suppresses food craving and eating. Therefore, this study tested the putative efficacy of tDCS to the dorsolateral prefrontal cortex (DLPFC) to reduce food craving and eating when an alternative control condition was used that would be difficult to distinguish from the real condition. METHODS N = 28 adults with a 26-50 BMI range received a typical 20-min 2 mA current session of tDCS targeting the DLPFC as the real condition and a same duration/current tDCS session targeting the sensorimotor cortex (SMC), a region not expected to affect appetite, as the control. Food image craving ratings, in-lab food consumption, and momentary ratings of physical sensations were measured. RESULTS DLPFC failed to reduce food craving and consumption compared to SMC stimulation. When interviewed, 71% of participants were unable to guess real from control conditions. Those who guessed DLPFC tDCS as real attributed their guess to increased number and frequency of sensations. However, their sensation ratings during tDCS did not differ between conditions. CONCLUSIONS The results question if tDCS suppresses craving and eating at all, or if the DLPFC is the best target to do so. The results also indicate that alternate-site constant stimulation as the control method may strengthen the scientific evaluation of tDCS to treat obesity. LEVEL OF EVIDENCE Level I, experimental study.
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Affiliation(s)
- Carl E Stevens
- Department of Psychology, The University of Alabama at Birmingham, 415 Campbell Hall, 1300 University Blvd., Birmingham, AL, 35294-1170, USA
| | - Marissa A Lausen
- Department of Psychology, The University of Alabama at Birmingham, 415 Campbell Hall, 1300 University Blvd., Birmingham, AL, 35294-1170, USA
| | - Laura E Wagstaff
- Department of Psychology, The University of Alabama at Birmingham, 415 Campbell Hall, 1300 University Blvd., Birmingham, AL, 35294-1170, USA
| | - Tommy R McRae
- Department of Psychology, The University of Alabama at Birmingham, 415 Campbell Hall, 1300 University Blvd., Birmingham, AL, 35294-1170, USA
| | - Bethany R Pittman
- Department of Psychology, The University of Alabama at Birmingham, 415 Campbell Hall, 1300 University Blvd., Birmingham, AL, 35294-1170, USA
| | - Franklin R Amthor
- Department of Psychology, The University of Alabama at Birmingham, 415 Campbell Hall, 1300 University Blvd., Birmingham, AL, 35294-1170, USA
| | - Mary M Boggiano
- Department of Psychology, The University of Alabama at Birmingham, 415 Campbell Hall, 1300 University Blvd., Birmingham, AL, 35294-1170, USA.
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16
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Rösch SA, Schmidt R, Lührs M, Ehlis AC, Hesse S, Hilbert A. Evidence of fNIRS-Based Prefrontal Cortex Hypoactivity in Obesity and Binge-Eating Disorder. Brain Sci 2020; 11:brainsci11010019. [PMID: 33375315 PMCID: PMC7823505 DOI: 10.3390/brainsci11010019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 12/18/2022] Open
Abstract
Obesity (OB) and associated binge-eating disorder (BED) show increased impulsivity and emotional dysregulation. Albeit well-established in neuropsychiatric research, functional near-infrared spectroscopy (fNIRS) has rarely been used to study OB and BED. Here, we investigated fNIRS-based food-specific brain signalling, its association with impulsivity and emotional dysregulation, and the temporal variability in individuals with OB with and without BED compared to an age- and sex-stratified normal weight (NW) group. Prefrontal cortex (PFC) responses were recorded in individuals with OB (n = 15), OB + BED (n = 13), and NW (n = 12) in a passive viewing and a response inhibition task. Impulsivity and emotional dysregulation were self-reported; anthropometrics were objectively measured. The OB and NW groups were measured twice 7 days apart. Relative to the NW group, the OB and OB + BED groups showed PFC hyporesponsivity across tasks, whereas there were few significant differences between the OB and OB + BED groups. Greater levels of impulsivity were significantly associated with stronger PFC responses, while more emotional dysregulation was significantly associated with lower PFC responses. Temporal differences were found in the left orbitofrontal cortex responses, yet in opposite directions in the OB and NW groups. This study demonstrated diminished fNIRS-based PFC responses across OB phenotypes relative to a NW group. The association between impulsivity, emotional dysregulation, and PFC hypoactivity supports the assumption that BED constitutes a specific OB phenotype.
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Affiliation(s)
- Sarah A. Rösch
- Integrated Research and Treatment Center Adiposity Diseases, Behavioural Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstrasse 10, 04103 Leipzig, Germany; (R.S.); (A.H.)
- International Max Planck Research School NeuroCom, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstrasse 1a, 04103 Leipzig, Germany
- Correspondence: ; Tel.: +49-341-97-15372
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Behavioural Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstrasse 10, 04103 Leipzig, Germany; (R.S.); (A.H.)
| | - Michael Lührs
- Brain Innovation B.V., Oxfordlaan 55, 6229 EV Maastricht, The Netherlands;
- Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV Maastricht, The Netherlands
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstrasse 14, 72076 Tübingen, Germany;
| | - Swen Hesse
- Department of Nuclear Medicine, University of Leipzig Medical Center, Liebigstrasse 18, 04103 Leipzig, Germany;
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioural Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstrasse 10, 04103 Leipzig, Germany; (R.S.); (A.H.)
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17
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de Araujo C, Fitz RC, Natividade GR, Osório AF, Merello PN, Schöffel AC, Brietzke E, Azevedo MJD, Schestatsky P, Gerchman F. The effect of transcranial direct current stimulation along with a hypocaloric diet on weight loss in excessive weight people: A pilot randomized clinical trial. Clin Nutr ESPEN 2020; 40:68-76. [DOI: 10.1016/j.clnesp.2020.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 11/26/2022]
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18
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Beaumont JD, Davis D, Dalton M, Nowicky A, Russell M, Barwood MJ. The effect of transcranial direct current stimulation (tDCS) on food craving, reward and appetite in a healthy population. Appetite 2020; 157:105004. [PMID: 33068669 DOI: 10.1016/j.appet.2020.105004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/22/2020] [Accepted: 10/09/2020] [Indexed: 11/15/2022]
Abstract
The ability to control hedonic appetite is associated with executive functioning, originating in the prefrontal cortex (PFC). These rewarding components of food can override homeostatic mechanisms, potentiating obesogenic behaviours. Indeed, those susceptible to overconsumption appear to have PFC hypo-activation. Transcranial direct current stimulation (tDCS) over the dorsolateral PFC (DLPFC) has been shown to reduce food craving and consumption, potentially via attenuating this reward response. We examined the effects of stimulation on food reward and craving using a healthy-weight cohort. This study is amongst the first to explore the effects of tDCS on explicit and implicit components of reward for different food categories. Twenty-one healthy-weight participants (24 ± 7 years, 22.8 ± 2.3 kg m-2) completed two sessions involving double-blind, randomised and counterbalanced anodal or sham tDCS over the right DLPFC, at 2 mA for 20 min. Food craving (Food Craving Questionnaire-State), reward (Leeds Food Preference Questionnaire), and subjective appetite (100 mm visual analogue scales) were measured pre- and post-tDCS. Eating behaviour trait susceptibility was assessed using the Three Factor Eating Questionnaire-Short Form, Control of Eating Questionnaire, and Food Craving Questionnaire-Trait-reduced. Stimulation did not alter food craving, reward or appetite in healthy-weight participants who displayed low susceptibility to overconsumption, with low trait craving, good craving control, and low uncontrolled eating and emotional eating behaviour. Implicit and explicit reward were reliable measures of hedonic appetite, suggesting these are robust targets for future tDCS research. These findings suggest that applying tDCS over the DLPFC does not change food reward response in individuals not at risk for overconsumption, and future work should focus on those at risk of overconsumption who may be more responsive to the effects of tDCS on hedonic appetite.
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Affiliation(s)
- Jordan D Beaumont
- School of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK.
| | - Danielle Davis
- School of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Michelle Dalton
- School of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Alexander Nowicky
- Centre for Cognitive Neuroscience, Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Mark Russell
- School of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Martin J Barwood
- School of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
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19
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Chen J, Qin J, He Q, Zou Z. A Meta-Analysis of Transcranial Direct Current Stimulation on Substance and Food Craving: What Effect Do Modulators Have? Front Psychiatry 2020; 11:598. [PMID: 32670118 PMCID: PMC7332543 DOI: 10.3389/fpsyt.2020.00598] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/09/2020] [Indexed: 12/22/2022] Open
Abstract
Substance addiction and food addiction are significant social problems worldwide. In previous studies of substance addiction, transcranial direct current stimulation (tDCS) has been used to influence craving of substance or food. However, the reported effects are not always consistent due to inconsistent experimental settings. The way modulators influence the effect of tDCS on substance addiction is worth exploring. This meta-analysis was conducted to estimate the effect size of tDCS on substance and food craving and to investigate the influence of potential modulators. We systemically identified and reviewed studies on substance/food craving using tDCS that were published between January 2008 to January 2020. A total of 32 eligible studies were identified. Hedges' g was computed as an indicator of the effect of tDCS and some potential moderators (substance type, stimulation sites, current intensities, number of sessions, duration of stimulation, and study design) were examined using subgroup analysis. Random effects analysis revealed a total medium effect size [Hedges' g = 0.536, 95% confidence interval (CI): 0.389-0.683, after adjusting Hedges' g = 0.416, 95% CI: 0.262-0.570] preferring active over sham stimulation to reduce craving. A significant difference was observed between the number of sessions (repeated stimulation was better than single stimulation). The duration of stimulation may have a positive influence on the effects of tDCS. No other significant differences were found in other subgroups analysis. In conclusion, our results provided evidence that tDCS can be an effective way to reduce craving of substance or food, and longer multiple stimulus durations in all can more effectively reduce craving; however, the influences of modulators still need be to be examined in depth in future.
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Affiliation(s)
| | | | | | - Zhiling Zou
- Faculty of Psychology, Southwest University, Chongqing, China
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20
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Ray MK, Zachmann AE, Caudill CV, Boggiano MM. Relationship between trait suggestibility and eating-related behaviors in overweight and obesity. Eat Behav 2020; 37:101380. [PMID: 32193130 PMCID: PMC7246141 DOI: 10.1016/j.eatbeh.2020.101380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/21/2020] [Accepted: 02/29/2020] [Indexed: 12/20/2022]
Abstract
Differences in trait suggestibility among those with obesity may help explain differential responses to weight-loss interventions. Ubiquitous advertising of unhealthy foods, weight-loss products that are not evidence-based, and myths regarding weight loss could be particularly sabotaging in individuals with high levels of suggestibility, with or at risk of developing obesity. This study explored relationships between suggestibility, body mass index (BMI), and self-reported eating-related behaviors that vary among those with obesity. A sample of ethnically diverse adults (N = 73) with a BMI ≥25 completed the Short Suggestibility Scale (SSS), Palatable Eating Motives Scale (PEMS), Binge Eating Scale (BES), Dutch Eating Behavior Questionnaire-Restraint (DEBQ-R), and Barratt Impulsiveness Scale (BIS). Impulsiveness was controlled in analyses due to its strong association with suggestibility. Analyses revealed that BMI was not related to SSS scores, consistent with studies using hypnotic-suggestibility scales. However, SSS scores were positively associated with eating caloric food more frequently for Reward, Social, and Conformity motives, and with greater actual dieting behavior, and binge eating. Suggestibility was not related to eating for Coping motives or effort to diet. If supported by future replications, knowledge of these associations could potentially help inform and tailor weight-loss interventions to protect those that may be most susceptible to adopting invalid messages and products.
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Affiliation(s)
- Mary Katherine Ray
- Department of Psychology, The University of Alabama at Birmingham, 415 Campbell Hall, Birmingham, AL 35294-1170, USA.
| | - Ashley E. Zachmann
- Department of Psychology, 415 Campbell Hall, The University of Alabama at Birmingham, Birmingham, Alabama 35294-1170, USA
| | - Caroline V. Caudill
- Department of Psychology, 415 Campbell Hall, The University of Alabama at Birmingham, Birmingham, Alabama 35294-1170, USA
| | - Mary M. Boggiano
- Department of Psychology, 415 Campbell Hall, The University of Alabama at Birmingham, Birmingham, Alabama 35294-1170, USA
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21
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Gordon G, Brockmeyer T, Schmidt U, Campbell IC. Combining cognitive bias modification training (CBM) and transcranial direct current stimulation (tDCS) to treat binge eating disorder: study protocol of a randomised controlled feasibility trial. BMJ Open 2019; 9:e030023. [PMID: 31640997 PMCID: PMC6830595 DOI: 10.1136/bmjopen-2019-030023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Binge eating disorder (BED) is a common mental disorder, closely associated with obesity. Existing treatments are only moderately effective with high relapse rates, necessitating novel interventions. This paper describes the rationale for, and protocol of, a feasibility randomised controlled trial (RCT), evaluating the combination of transcranial direct current stimulation (tDCS) and a computerised cognitive training, namely approach bias modification training (ABM), in patients with BED who are overweight or obese. The aim of this trial is to obtain information that will guide decision-making and protocol development in relation to a future large-scale RCT of combined tDCS+ABM treatment in this group of patients, and also to assess the preliminary efficacy of this intervention. METHODS AND ANALYSIS 66 participants with Diagnostic and Statistical Manual-5 diagnosis of BED and a body mass index (BMI) of ≥25 kg/m2 will be randomly allocated to one of three groups: ABM+real tDCS; ABM+sham tDCS or a wait-list control group. Participants in both intervention groups will receive six sessions of ABM+real/sham tDCS over 3 weeks; engaging in the ABM task while simultaneously receiving bilateral tDCS to the dorsolateral prefrontal cortex. ABM is based on an implicit learning paradigm in which participants are trained to enact an avoidance behaviour in response to visual food cues. Assessments will be conducted at baseline, post-treatment (3 weeks) and follow-up (7 weeks post-randomisation). Feasibility outcomes assess recruitment and retention rates, acceptability of random allocation, blinding success (allocation concealment), completion of treatment sessions and research assessments. Other outcomes include eating disorder psychopathology and related neurocognitive outcomes (ie, delay of gratification and inhibitory control), BMI, other psychopathology (ie, mood), approach bias towards food and surrogate endpoints (ie, food cue reactivity, trait food craving and food intake). ETHICS AND DISSEMINATION This study has been approved by the North West-Liverpool East Research Ethics Committee. Results will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN35717198.
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Affiliation(s)
- Gemma Gordon
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Timo Brockmeyer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Gottingen, Goettingen, Niedersachsen, Germany
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Iain C Campbell
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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22
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Food Addiction: Implications for the Diagnosis and Treatment of Overeating. Nutrients 2019; 11:nu11092086. [PMID: 31487791 PMCID: PMC6770567 DOI: 10.3390/nu11092086] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/14/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
Abstract
With the obesity epidemic being largely attributed to overeating, much research has been aimed at understanding the psychological causes of overeating and using this knowledge to develop targeted interventions. Here, we review this literature under a model of food addiction and present evidence according to the fifth edition of the Diagnostic and Statistical Manual (DSM-5) criteria for substance use disorders. We review several innovative treatments related to a food addiction model ranging from cognitive intervention tasks to neuromodulation techniques. We conclude that there is evidence to suggest that, for some individuals, food can induce addictive-type behaviours similar to those seen with other addictive substances. However, with several DSM-5 criteria having limited application to overeating, the term ‘food addiction’ is likely to apply only in a minority of cases. Nevertheless, research investigating the underlying psychological causes of overeating within the context of food addiction has led to some novel and potentially effective interventions. Understanding the similarities and differences between the addictive characteristics of food and illicit substances should prove fruitful in further developing these interventions.
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23
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Fassini PG, Das SK, Suen VMM, Magerowski G, Marchini JS, da Silva Junior WA, Changyu S, Alonso-Alonso M. Appetite effects of prefrontal stimulation depend on COMT Val158Met polymorphism: A randomized clinical trial. Appetite 2019; 140:142-150. [PMID: 31095973 DOI: 10.1016/j.appet.2019.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/22/2019] [Accepted: 05/12/2019] [Indexed: 12/13/2022]
Abstract
The regulation of appetite is supported by dopamine-modulated brain circuits. Recent studies have shown that transcranial direct current stimulation (tDCS) aimed at increasing the excitability of the dorsolateral prefrontal cortex can reduce appetite, but the underlying mechanisms remain unknown, and response variability is large. The aim of this study was to determine whether individual differences in Catechol-O-methyl transferase (COMT) Val158Met polymorphism can influence tDCS effects on appetite. Thirty-eight adult women with obesity, classified as carriers or non-carriers of the Met allele, underwent a randomized, double-blind, sham-controlled tDCS intervention involving three phases: Phase I, target engagement (immediate effects of tDCS on working memory performance), Phase II, tDCS only (10 sessions, two weeks), and Phase III, tDCS + hypocaloric diet: (6 sessions, two weeks, 30% energy intake reduction, inpatient). Data were analyzed using linear mixed-effects models and mixed ANCOVA. Appetite was evaluated using visual analogue scales. We found that Met-carriers receiving active tDCS were the only participants who experienced a significant reduction of appetite over time. Conversely, Met non-carriers maintained high levels of appetite during the intervention; this effect was driven by a delayed paradoxical rise in appetite after stimulation. Working memory task performance at phase I correlated with subsequent appetite change in a COMT-dependent manner: speed improvements during the task predicted appetite increase in Met carriers and appetite reduction in Met non-carriers. Our findings suggest that genotype differences impacting dopamine levels influence prefrontal tDCS effects on appetite. This source of variability should be considered in the design of future studies.
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Affiliation(s)
- Priscila Giacomo Fassini
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States
| | - Sai Krupa Das
- Energy Metabolism Laboratory, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111-1524, United States
| | - Vivian Marques Miguel Suen
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900. Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Greta Magerowski
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States
| | - Júlio Sérgio Marchini
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900. Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Wilson Araújo da Silva Junior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900. Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Shen Changyu
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States
| | - Miguel Alonso-Alonso
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States.
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Osimo SA, Korb S, Aiello M. Obesity, subliminal perception and inhibition: Neuromodulation of the prefrontal cortex. Behav Res Ther 2019; 119:103408. [DOI: 10.1016/j.brat.2019.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/03/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
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The effect of expectation on transcranial direct current stimulation (tDCS) to suppress food craving and eating in individuals with overweight and obesity. Appetite 2019; 136:1-7. [PMID: 30611756 DOI: 10.1016/j.appet.2018.12.044] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/29/2018] [Accepted: 12/29/2018] [Indexed: 12/15/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a neuromodulation technique with potential to treat eating disorders and obesity. As for any potential treatment, it is important to assess the degree to which expectation effects contribute to its reported efficacy. This study assessed the effect of tDCS on amount of food craving and eating while tightly controlling treatment expectation. N = 74 adults with overweight or obesity were informed of the known effects of tDCS to suppress craving and eating. Once electrodes were on the head, half of the participants were told they were receiving real, and the other half sham tDCS. Within these groups, approximately half actually received real and the other half sham tDCS. Stimulation parameters used were those previously found to reduce craving and eating, including in our lab: 2 mA, anode right/cathode left targeting the dorsolateral prefrontal cortex for 20 min (real), or only for the first and last minute (sham). Analyses controlled for demographics, hunger, trait impulsiveness, eating motives, dieting, binge eating, suggestibility, and baseline craving and eating. Participants told they were receiving real tDCS craved and ate less than participants told they were receiving sham tDCS (both p < 0.01), regardless of tDCS condition administered. There was no main effect of real vs. sham tDCS on craving or eating or an interaction between tDCS condition and expectation. The scientific validation of tDCS as a treatment for eating-related conditions hinges on controlling for the powerful effects of expectation. This can include the type of information provided on consent forms and participants' ability to guess real from sham conditions.
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Sedgmond J, Lawrence NS, Verbruggen F, Morrison S, Chambers CD, Adams RC. Prefrontal brain stimulation during food-related inhibition training: effects on food craving, food consumption and inhibitory control. ROYAL SOCIETY OPEN SCIENCE 2019; 6:181186. [PMID: 30800367 PMCID: PMC6366210 DOI: 10.1098/rsos.181186] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/30/2018] [Indexed: 06/09/2023]
Abstract
Modulation of dorsolateral prefrontal cortex (DLPFC) activity using non-invasive brain stimulation has been shown to reduce food craving as well as food consumption. Using a preregistered design, we examined whether bilateral transcranial direct current stimulation (tDCS) of the DLPFC could reduce food craving and consumption in healthy participants when administered alongside the cognitive target of inhibitory control training. Participants (N = 172) received either active or sham tDCS (2 mA; anode F4, cathode F3) while completing a food-related Go/No-Go task. State food craving, ad-lib food consumption and response inhibition were evaluated. Compared with sham stimulation, we found no evidence for an effect of active tDCS on any of these outcome measures in a predominantly female sample. Our findings raise doubts about the effectiveness of single-session tDCS on food craving and consumption. Consideration of individual differences, improvements in tDCS protocols and multi-session testing are discussed.
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Affiliation(s)
- Jemma Sedgmond
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff CF24 4HQ, UK
| | - Natalia S. Lawrence
- School of Psychology, University of Exeter, Washington Singer Building, Exeter EX4 4QG, UK
| | - Frederick Verbruggen
- School of Psychology, University of Exeter, Washington Singer Building, Exeter EX4 4QG, UK
- Department of Experimental Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Sinead Morrison
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff CF24 4HQ, UK
| | - Christopher D. Chambers
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff CF24 4HQ, UK
| | - Rachel C. Adams
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff CF24 4HQ, UK
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27
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Sreeraj VS, Masali M, Shivakumar V, Bose A, Venkatasubramanian G. Clinical Utility of Add-On Transcranial Direct Current Stimulation for Binge Eating Disorder with Obesity in Schizophrenia. Indian J Psychol Med 2018; 40:487-490. [PMID: 30275626 PMCID: PMC6149297 DOI: 10.4103/ijpsym.ijpsym_551_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Over the recent years, there has been an increasing application of noninvasive brain stimulation techniques such as transcranial direct-current stimulation (tDCS) to modify eating behaviors in healthy population and persons with eating disorders. tDCS is a noninvasive, neuromodulatory intervention which is well-tolerated and safe. In this case report, we describe the successful application of add-on tDCS in a patient with schizophrenia to reduce the craving for food that in turn, helped in reversing the weight gain.
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Affiliation(s)
- Vanteemar S Sreeraj
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Manjunath Masali
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Venkataram Shivakumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Anushree Bose
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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28
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Abstract
The study of addiction and impulsion control disorders has shown that behaviors of seeking and consumption of addictive substances are subserved by neurobiological alterations specifically related to brain networks for reward, stress, and executive control, representing the brain's adaptation to the continued use of an addictive substance. In parallel, studies using neuromodulation techniques such as transcranial direct current stimulation (tDCS) have demonstrated promising effects in modulating cognitive and motor functions. This review aims to describe the neurobiology of addiction and some of the most relevant cognitive models of addictive behavior and to clarify how tDCS application modulates the intake and craving for several addictive substances, such as food, alcohol, nicotine, cocaine, crack, methamphetamine, and cannabis. We also discuss the positive and null outcomes of the use of this neuromodulatory technique in the treatment of addiction disorders resulting from the use of these substances. The reviewed findings lead us to conclude that tDCS interventions hold several promising clinical avenues in addiction and impulsive control. However, methodological investigations are necessary for undercover optimal parameters before implementing its clinical application.
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29
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Spetter MS. Current state of the use of neuroimaging techniques to understand and alter appetite control in humans. Curr Opin Clin Nutr Metab Care 2018; 21:329-335. [PMID: 29927764 DOI: 10.1097/mco.0000000000000493] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW It is in the brain where the decision is made what and how much to eat. In the last decades neuroimaging research has contributed extensively to new knowledge about appetite control by revealing the underlying brain processes. Interestingly, there is the fast growing idea of using these methods to develop new treatments for obesity and eating disorders. In this review, we summarize the findings of the importance of the use of neuropharmacology and neuroimaging techniques in understanding and modifying appetite control. RECENT FINDINGS Appetite control is a complex interplay between homeostatic, hedonic, and cognitive processes. Administration of the neuropeptides insulin and oxytocin curb food intake and alter brain responses in reward and cognitive control areas. Additionally, these areas can be targeted for neuromodulation or neurofeedback to reduce food cravings and increase self-control to alter food intake. SUMMARY The recent findings reveal the potential of intranasal administration of hormones or modifying appetite control brain networks to reduce food consumption in volunteers with overweight and obesity or individuals with an eating disorder. Although long-term clinical studies are still needed.
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Affiliation(s)
- Maartje S Spetter
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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30
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Hall PA, Lowe CJ. Cravings, currents and cadavers: What is the magnitude of tDCS effects on food craving outcomes? Nutr Neurosci 2018; 23:490-493. [PMID: 30153775 DOI: 10.1080/1028415x.2018.1513678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Peter A Hall
- School of Public Health & Health Systems, University of Waterloo, Canada
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31
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Strang CE, Ray MK, Boggiano MM, Amthor FR. Effects of tDCS-like electrical stimulation on retinal ganglion cells. Eye Brain 2018; 10:65-78. [PMID: 30214335 PMCID: PMC6118271 DOI: 10.2147/eb.s163914] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose Transcranial direct current stimulation (tDCS) has been studied in humans for its effects on enhancement of learning, amelioration of psychiatric disorders, and modification of other behaviors for over 50 years. Typical treatments involve injecting 2 mA current through scalp electrodes for 20 minutes, sometimes repeated weekly for two to five sessions. Little is known about the direct effects of tDCS at the neural circuit or the cellular level. This study assessed the effects of tDCS-like currents on the central nervous system by recording effects on retinal ganglion cell responsiveness using the rabbit retina eyecup preparation. Materials and methods We examined changes in firing to On and Off light stimuli during and after brief applications of a range of currents and polarity and in different classes of ganglion cells. Results The responses of Sustained cells were consistently suppressed during the first round of current application, but responses could be enhanced after subsequent rounds of stimulation. The observed first round suppression was independent of current polarity, amplitude, or number of trials. However, the light responses of Transient cells were more likely to be enhanced by negative currents and unaffected or suppressed by first round positive currents. Short-duration currents, that is, minutes, as low as 2.5 µA produced a remarkable persistency of firing changes, for up to 1.5 hours, after cessation of current. Conclusion The results are consistent with postulated tDCS alteration of central nervous system function, which outlast the tDCS session and provide evidence for the isolated retina as a useful model to understand tDCS actions at the neuronal level.
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Affiliation(s)
- Christianne E Strang
- Department of Psychology, The University of Alabama at Birmingham, Birmingham, AL, USA,
| | - Mary Katherine Ray
- Department of Psychology, The University of Alabama at Birmingham, Birmingham, AL, USA,
| | - Mary M Boggiano
- Department of Psychology, The University of Alabama at Birmingham, Birmingham, AL, USA,
| | - Franklin R Amthor
- Department of Psychology, The University of Alabama at Birmingham, Birmingham, AL, USA,
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Araujo CD, Fitz RC, Nogara DA, Schestatsky P, Gerchman F. Effect of transcranial direct current stimulation associated with hypocaloric diet on weight loss and metabolic profile in overweight or obesity: study protocol for a double-blind, randomized controlled clinical trial. Trials 2018; 19:386. [PMID: 30012180 PMCID: PMC6048812 DOI: 10.1186/s13063-018-2776-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dietary interventions have limited success in promoting sustainable weight loss; new treatments allowing better compliance with hypocaloric diets should be developed. The aim of this trial is to describe the effects of a protocol combining repetitive active transcranial direct current stimulation (tDCS) with a hypocaloric diet on weight loss and food consumption in overweight or obese adults. METHODS/DESIGN Overweight or obese adults between 20 and 50 years of age with stable weight over the last 4 months will be selected for a 4-week randomized clinical trial of fixed-dose tDCS (20 sessions; 5 consecutive weekdays/wk, 2 mA, 20 minutes) over the right dorsolateral prefrontal cortex associated with a weight loss diet. The subjects will be randomly assigned in a 1:1 ratio and stratified by sex to active tDCS + diet or sham tDCS + diet. The study will be conducted at the Endocrine and Metabolism Unit of the Hospital de Clínicas de Porto Alegre, Brazil. The primary outcome is weight loss. Energy and macronutrient consumption, as well as adherence to the diet, will be assessed using 3-day weighed dietary records. Changes in blood glucose and plasma insulin will be assessed, and participants will complete self-report questionnaires to assess changes in mood and food behavior. All analyses will be done on a per-protocol and intention-to-treat basis. DISCUSSION This study explores the potential role of tDCS as an adjunctive treatment with a hypocaloric diet for obesity management. TRIAL REGISTRATION ClinicalTrials.gov , NCT02683902 . Registered on 11 January 2016.
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Affiliation(s)
- Carina de Araujo
- Postgraduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul Brazil
- Endocrine Division, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Anexo, 4° andar, Porto Alegre, Rio Grande do Sul CEP: 90035-003 Brazil
| | - Raquel Crespo Fitz
- Postgraduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul Brazil
| | - Daniela Albugeri Nogara
- Postgraduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul Brazil
- Medicine Graduate Course, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil
| | - Pedro Schestatsky
- Neurology Service, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul Brazil
| | - Fernando Gerchman
- Endocrine Division, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Anexo, 4° andar, Porto Alegre, Rio Grande do Sul CEP: 90035-003 Brazil
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Mostafavi SA, Khaleghi A, Mohammadi MR, Akhondzadeh S. Is transcranial direct current stimulation an effective modality in reducing food craving? A systematic review and meta-analysis. Nutr Neurosci 2018; 23:55-67. [PMID: 29734883 DOI: 10.1080/1028415x.2018.1470371] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Non-invasive electrical stimulation of the brain has recently been extensively investigated to regulate food craving. However, the existing literature is controversial and there are some important questions which need to be addressed about clinical and technical factors contributing to efficacy of this method. A systematic search was performed in reliable scientific databases, and 15 eligible studies were identified. The pooled standardized mean differences for the effects of transcranial direct current stimulation (tDCS) on Visual Analogue Scale, energy intake and food craving questionnaire were -0.78 [-1.12, -0.44], -0.91 [-1.38, -0.44], -0.54 [-0.85, -0.24], respectively. Subgroup analysis showed that the most important factors associated with the impact of tDCS on food craving were the population under study, current intensity of stimulation, and number of stimulation sessions. The findings of this study support a significant impact of neuromodulation of dorsolateral prefrontal cortex (DLPFC) on energy intake and food craving using tDCS. It is recommended that multisession bilateral stimulation of the DLPFC with the current intensity of 2 mA be used to reduce food craving.
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Affiliation(s)
- Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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34
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Lee DJ, Elias GJB, Lozano AM. Neuromodulation for the treatment of eating disorders and obesity. Ther Adv Psychopharmacol 2018; 8:73-92. [PMID: 29399320 PMCID: PMC5788100 DOI: 10.1177/2045125317743435] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/24/2017] [Indexed: 12/25/2022] Open
Abstract
Eating disorders and obesity adversely affect individuals both medically and psychologically, leading to reduced life expectancy and poor quality of life. While there exist a number of treatments for anorexia, morbid obesity and bulimia, many patients do not respond favorably to current behavioral, medical or bariatric surgical management. Neuromodulation has been postulated as a potential treatment for eating disorders and obesity. In particular, deep brain stimulation and transcranial non-invasive brain stimulation have been studied for these indications across a variety of brain targets. Here, we review the neurobiology behind eating and eating disorders as well as the current status of preclinical and clinical neuromodulation trials for eating disorders and obesity.
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Affiliation(s)
- Darrin J Lee
- Division of Neurosurgery, Toronto Western Hospital, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Gavin J B Elias
- Division of Neurosurgery, Toronto Western Hospital, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Toronto Western Hospital, Department of Surgery, University of Toronto, 399 Bathurst St., West Wing 4-431, Toronto, ON M5T 2S8, Canada
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35
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Ziomber A, Rokita E, Kaszuba-Zwoinska J, Romańska I, Michaluk J, Antkiewicz-Michaluk L. Repeated Transcranial Direct Current Stimulation Induces Behavioral, Metabolic and Neurochemical Effects in Rats on High-Calorie Diet. Front Behav Neurosci 2018; 11:262. [PMID: 29379423 PMCID: PMC5775234 DOI: 10.3389/fnbeh.2017.00262] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 12/29/2017] [Indexed: 11/13/2022] Open
Abstract
Due to its high prevalence, obesity is considered an epidemic, which stimulated research on non-invasive methods to reduce excess body fat. Transcranial direct current stimulation (tDCS) is a non-invasive technique used to modulate the activity of cerebral cortex, which has already found increasing interest in medicine as a promising methodology. The aim of this study was to analyze the impact of tDCS on feeding behavior, metabolic abnormalities and neurotransmitters in certain brain areas involved in appetite control of obese rats. The male Wistar rats were divided into five subgroups depending on consumed diet effect (lean, obese) and tDCS type (anodal, cathodal, sham, and no stimulation). Two 10-min daily sessions of tDCS for 8 consecutive days of the study were applied. Rats subjected to active tDCS (anodal right or cathodal left of the prefrontal cortex) had reduced appetite and showed lesser body weight gain than the animals subjected to sham procedure or those receiving no stimulation at all. Furthermore, tDCS contributed to reduction of epididymal fat pads and to a decrease in blood concentration of leptin. Neurochemical examination revealed that tDCS modulated serotonin pathways of the reward-related brain areas and contributed to a significant decrease in the density of D2 but not D1 dopamine receptors in the dorsal striatum, recorded 5 h after the last stimulation. No significant effect of tDCS on dopamine and it's metabolites in examined brain regions was observed. It seems that the hypothalamus was not affected by tDCS application as no changes in measured neurotransmitters were detected at any examined time point. However, these results do not exclude the possibility of the delayed response of the monoamines in the examined brain areas to tDCS application. Altogether, these findings imply that repeated tDCS of the prefrontal cortex may change feeding behavior of obese rats. Either right anodal or left cathodal tDCS were sufficient to decrease food intake, to reduce body adiposity and to normalize other metabolic anomalies. These beneficial effects can be at least partially explained by changes in serotoninergic and in lesser extent dopaminergic system activity within some brain areas belonging to reward system.
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Affiliation(s)
- Agata Ziomber
- Chair of Pathophysiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Eugeniusz Rokita
- Chair of Physiology, Department of Biophysics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jolanta Kaszuba-Zwoinska
- Chair of Pathophysiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Irena Romańska
- Department of Neurochemistry, Institute of Pharmacology Polish Academy of Sciences, Krakow, Poland
| | - Jerzy Michaluk
- Department of Neurochemistry, Institute of Pharmacology Polish Academy of Sciences, Krakow, Poland
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