Elsevier

Biological Psychiatry

Volume 67, Issue 8, 15 April 2010, Pages 793-795
Biological Psychiatry

Brief Report
Repetitive Transcranial Magnetic Stimulation Reduces Cue-Induced Food Craving in Bulimic Disorders

https://doi.org/10.1016/j.biopsych.2009.11.023Get rights and content

Background

Craving or the “urge to consume” is a characteristic of bulimic eating disorders and addictions. Dysfunction of the dorsolateral prefrontal cortex (DLPFC) is associated with craving. We investigated whether stimulation of the DLPFC reduces food craving in people with a bulimic-type eating disorder.

Methods

Thirty-eight people with bulimic-type eating disorders were randomly allocated to receive one session of real or sham high-frequency repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC in a double-blind procedure. Outcome measures included self-reported food craving immediately after the stimulation session and frequency of bingeing over a 24-hour follow-up period.

Results

Compared with sham control, real rTMS was associated with decreased self-reported urge to eat and fewer binge-eating episodes over the 24 hours following stimulation.

Conclusions

High-frequency rTMS of the left DLPFC lowers cue-induced food cravings in people with a bulimic eating disorder and may reduce binge eating. These results provide a rationale for exploring rTMS as a treatment for bulimic eating disorders.

Section snippets

Methods and Materials

A power calculation indicated that 18 individuals per group were needed to detect an effect size of d = .85 reported in our previous study (13) with 80% power at one-sided α = .05. Therefore, 38 participants (5 male participants, 33 female participants), 18 to 60 years old with BN or Eating Disorder Not Otherwise Specified-bulimic type (EDNOS-BN, including Binge Eating Disorder) were recruited from the Eating Disorders outpatient department at the Maudsley Hospital, London, and by e-mail

Results

Table 1 shows the baseline characteristics of participants by group; no significant group differences were observed.

Thirty-seven participants completed the procedure. One participant, randomized to real rTMS, dropped out due to discomfort after 4 trains of rTMS. Five participants in each group reported side effects immediately after the rTMS session, i.e., a transient slight headache [χ2(1) = .907; p = .763]. Sixteen in each group reported that they would agree to take part in a treatment study

Discussion

We found that a single session of real rTMS reduces cue-induced food craving in people with bulimic disorders, extending our previous findings (13) to a clinical group. In addition, we observed a significant reduction in bingeing in the 24 hours after the real rTMS compared with the sham rTMS, providing a “proof of concept” for rTMS as a treatment for bulimic disorders. We did not find an immediate effect of rTMS on the urge to binge eat. This is probably due to binge eating being a complex

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Authors FVdE and AC contributed equally to this article.

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