Effects of transcranial continuous current stimulation (tDCS) associated with aerobic exercise in the treatment of food compulsion

A randomized clinical trial

Authors

  • Milena Artifon Federal University of Rio Grande do Sul, Brazil
  • Gabriel Mayer Tossi Federal University of Rio Grande do Sul, Brazil
  • Nathália Griebler Federal University of Rio Grande do Sul, Brazil
  • Pedro Schestatsky Federal University of Rio Grande do Sul, Brazil
  • Francesco Boeno Federal University of Rio Grande do Sul, Brazil
  • Cesar Moritz Federal University of Rio Grande do Sul, Brazil
  • Juliana Lopes Teodoro Federal University of Rio Grande do Sul, Brazil
  • Lucas Beraldo Federal University of Rio Grande do Sul, Brazil
  • Lauren Naomi Adachi Federal University of Rio Grande do Sul, Brazil
  • Álvaro Reischak de Oliveira Federal University of Rio Grande do Sul, Brazil
  • Caroline Pietta-Dias Federal University of Rio Grande do Sul, Brazil

DOI:

https://doi.org/10.14198/jhse.2024.192.01

Keywords:

Sport medicine, Health, Transcranial direct current stimulation, tDCS, Exercise, Binge eating

Abstract

Introduction: Binge eating disorder (BED) is closely associated with obesity, characterized by the repeated consumption of large amounts of food accompanied by a feeling of loss of control during the episode of binge eating. Existing treatments are moderately effective with high rates of recurrence; thus, physical exercise and neuromodulation techniques have emerged with positive potential associated with self-control in reward brain regions. Objective: To investigate whether 20 sessions of transcranial direct current (tDCS) stimulation alone or combined with aerobic exercise (AE) could reduce food consumption and the perception of hunger and satiety in adult individuals with BED. Methods: Adult individuals with BED were included in a randomized, double-blind study. Participants received 20 sessions according to random randomization (1) active tDCS, (2) placebo and AE tDCS or (3) active tDCS and AE, simultaneously with videos of foods that cause fissures, such as sweets and fast foods. tDCS was applied at 2mA / 20 min, with the anode over the right dorsolateral prefrontal cortex and the cathode over the contralateral supraorbital region (Soterix Medical®). The AE was performed on a treadmill after tDCS, at an intensity of 60-65% of HRmax, repeating the evaluations at the end. Primary outcomes included measures of food intake and perceptions of hunger, satiety and desire. Secondary outcomes were assessed through body composition, biochemical markers (lipid, glycaemic and leptin profile) and maximum oxygen consumption. Results: The tDCS group had lower values of triglycerides and lean mass compared to the other groups. However, in relation to food intake, hunger, satiety throughout the day, and uncontrollable desire to eat, there was no difference between the groups. Conclusions: tDCS alone was able to improve more clinical outcomes such as adipose mass and triglycerides. To our knowledge, to date this is the first study to demonstrate that the association of tDCS with aerobic exercise can improve the symptoms of binge eating in the investigated population. Test record: ReBEC identifier RBR-3d8fd2.

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References

Amianto, F., Ottone, L., Abbate Daga, G., & Fassino, S. (2015). Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5. BMC psychiatry, 15, 70. https://doi.org/10.1186/s12888-015-0445-6

Artifon, M., Schestatsky, P., Griebler, N., Tossi, G. M., Beraldo, L. M., & Pietta-Dias, C. (2020). Effects of transcranial direct current stimulation on the gut microbiome: A case report. Brain stimulation, 13(5), 1451-1452. https://doi.org/10.1016/j.brs.2020.07.019

Burrows T, Skinner J, McKenna R, Rollo M. Food Addiction, Binge Eating Disorder, and Obesity: Is There a Relationship? Behavioral sciences (Basel, Switzerland). 2017;7(3):54. Burrows, T., Skinner, J., McKenna, R., & Rollo, M. (2017). Food Addiction, Binge Eating Disorder, and Obesity: Is There a Relationship?. Behavioral sciences (Basel, Switzerland), 7(3), 54. https://doi.org/10.3390/bs7030054

Caudwell, P., Gibbons, C., Hopkins, M., King, N., Finlayson, G., & Blundell, J. (2013). No sex difference in body fat in response to supervised and measured exercise. Medicine and science in sports and exercise, 45(2), 351-358. https://doi.org/10.1249/MSS.0b013e31826ced79

Chen, S., Jackson, T., Dong, D., Zhang, X., & Chen, H. (2019). Exploring effects of single-session anodal tDCS over the inferior frontal gyrus on responses to food cues and food cravings among highly disinhibited restrained eaters: A preliminary study. Neuroscience letters, 706, 211-216. https://doi.org/10.1016/j.neulet.2019.05.035

Davidson, T. L., Kanoski, S. E., Chan, K., Clegg, D. J., Benoit, S. C., & Jarrard, L. E. (2010). Hippocampal lesions impair retention of discriminative responding based on energy state cues. Behavioral neuroscience, 124(1), 97-105. https://doi.org/10.1037/a0018402

Espirito Santo, H., & Daniel, F. (2015). Calculate and present effect sizes in scientific works (1): The limitations of p < 0.05 in the analysis of differences in means between two groups. Portuguese Journal of Behavioral and Social Research, 1(1), 3-16.

Evero, N., Hackett, L. C., Clark, R. D., Phelan, S., & Hagobian, T. A. (2012). Aerobic exercise reduces neuronal responses in food reward brain regions. Journal of applied physiology (Bethesda, Md. : 1985), 112(9), 1612-1619. https://doi.org/10.1152/japplphysiol.01365.2011

Fedewa, M. V., Hathaway, E. D., Ward-Ritacco, C. L., Williams, T. D., & Dobbs, W. C. (2018). The Effect of Chronic Exercise Training on Leptin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sports medicine (Auckland, N.Z.), 48(6), 1437-1450. https://doi.org/10.1007/s40279-018-0897-1is of Randomized Controlled Trials. Sports medicine (Auckland, NZ). 2018;48(6):1437-50. https://doi.org/10.1007/s40279-018-0897-1

Field, A. (2009). Discovering Statistics Using SPSS.

Fragala, M. S., Bi, C., Chaump, M., Kaufman, H. W., & Kroll, M. H. (2017). Associations of aerobic and strength exercise with clinical laboratory test values. PloS one, 12(10), e0180840. https://doi.org/10.1371/journal.pone.0180840

Fregni, F., Orsati, F., Pedrosa, W., Fecteau, S., Tome, F. A., Nitsche, M. A., Mecca, T., Macedo, E. C., Pascual-Leone, A., & Boggio, P. S. (2008). Transcranial direct current stimulation of the prefrontal cortex modulates the desire for specific foods. Appetite, 51(1), 34-41. https://doi.org/10.1016/j.appet.2007.09.016

García-Hermoso, A., Ramírez-Vélez, R., Ramírez-Campillo, R., Peterson, M. D., & Martínez-Vizcaíno, V. (2018). Concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity: a systematic review and meta-analysis. British journal of sports medicine, 52(3), 161-166. https://doi.org/10.1136/bjsports-2016-096605

Gluck, M. E., Alonso-Alonso, M., Piaggi, P., Weise, C. M., Jumpertz-von Schwartzenberg, R., Reinhardt, M., Wassermann, E. M., Venti, C. A., Votruba, S. B., & Krakoff, J. (2015). Neuromodulation targeted to the prefrontal cortex induces changes in energy intake and weight loss in obesity. Obesity (Silver Spring, Md.), 23(11), 2149-2156. https://doi.org/10.1002/oby.21313

Goeders N. E. (2002). Stress and cocaine addiction. The Journal of pharmacology and experimental therapeutics, 301(3), 785-789. https://doi.org/10.1124/jpet.301.3.785

Guelfi, K. J., Donges, C. E., & Duffield, R. (2013). Beneficial effects of 12 weeks of aerobic compared with resistance exercise training on perceived appetite in previously sedentary overweight and obese men. Metabolism: clinical and experimental, 62(2), 235-243. https://doi.org/10.1016/j.metabol.2012.08.002

Haskell W. L. (1984). The influence of exercise on the concentrations of triglyceride and cholesterol in human plasma. Exercise and sport sciences reviews, 12, 205-244. https://doi.org/10.1249/00003677-198401000-00009

Heinitz, S., Reinhardt, M., Piaggi, P., Weise, C. M., Diaz, E., Stinson, E. J., Venti, C., Votruba, S. B., Wassermann, E. M., Alonso-Alonso, M., Krakoff, J., & Gluck, M. E. (2017). Neuromodulation directed at the prefrontal cortex of subjects with obesity reduces snack food intake and hunger in a randomized trial. The American journal of clinical nutrition, 106(6), 1347-1357. https://doi.org/10.3945/ajcn.117.158089

Higuera-Hernández, M. F., Reyes-Cuapio, E., Gutiérrez-Mendoza, M., Rocha, N. B., Veras, A. B., Budde, H., Jesse, J., Zaldívar-Rae, J., Blanco-Centurión, C., Machado, S., & Murillo-Rodríguez, E. (2018). Fighting obesity: Non-pharmacological interventions. Clinical nutrition ESPEN, 25, 50-55. https://doi.org/10.1016/j.clnesp.2018.04.005

Howley, E. T., Bassett, D. R., Jr, & Welch, H. G. (1995). Criteria for maximal oxygen uptake: review and commentary. Medicine and science in sports and exercise, 27(9), 1292-1301. https://doi.org/10.1249/00005768-199509000-00009

Jáuregui-Lobera, I., & Martínez-Quiñones, J. V. (2018). Neuromodulation in eating disorders and obesity: a promising way of treatment?. Neuropsychiatric disease and treatment, 14, 2817-2835. https://doi.org/10.2147/NDT.S180231

Kerby, DS. (2014). The Simple Difference Formula: An Approach to Teaching Nonparametric Correlation. Comprehensive Psychology. 3:11.IT.3.1. https://doi.org/10.2466/11.IT.3.1

King, N. A., Caudwell, P. P., Hopkins, M., Stubbs, J. R., Naslund, E., & Blundell, J. E. (2009). Dual-process action of exercise on appetite control: increase in orexigenic drive but improvement in meal-induced satiety. The American journal of clinical nutrition, 90(4), 921-927. https://doi.org/10.3945/ajcn.2009.27706

Lang, N., Siebner, H. R., Ward, N. S., Lee, L., Nitsche, M. A., Paulus, W., Rothwell, J. C., Lemon, R. N., & Frackowiak, R. S. (2005). How does transcranial DC stimulation of the primary motor cortex alter regional neuronal activity in the human brain?. The European journal of neuroscience, 22(2), 495-504. https://doi.org/10.1111/j.1460-9568.2005.04233.x

Ljubisavljevic, M., Maxood, K., Bjekic, J., Oommen, J., & Nagelkerke, N. (2016). Long-Term Effects of Repeated Prefrontal Cortex Transcranial Direct Current Stimulation (tDCS) on Food Craving in Normal and Overweight Young Adults. Brain stimulation, 9(6), 826-833. https://doi.org/10.1016/j.brs.2016.07.002

Martin, S. S., Giugliano, R. P., Murphy, S. A., Wasserman, S. M., Stein, E. A., Ceška, R., López-Miranda, J., Georgiev, B., Lorenzatti, A. J., Tikkanen, M. J., Sever, P. S., Keech, A. C., Pedersen, T. R., & Sabatine, M. S. (2018). Comparison of Low-Density Lipoprotein Cholesterol Assessment by Martin/Hopkins Estimation, Friedewald Estimation, and Preparative Ultracentrifugation: Insights From the FOURIER Trial. JAMA cardiology, 3(8), 749-753. https://doi.org/10.1001/jamacardio.2018.1533

Martins, C., Kulseng, B., King, N. A., Holst, J. J., & Blundell, J. E. (2010). The effects of exercise-induced weight loss on appetite-related peptides and motivation to eat. The Journal of clinical endocrinology and metabolism, 95(4), 1609-1616. https://doi.org/10.1210/jc.2009-2082

Martins, C., Kulseng, B., Rehfeld, J. F., King, N. A., & Blundell, J. E. (2013). Effect of chronic exercise on appetite control in overweight and obese individuals. Medicine and science in sports and exercise, 45(5), 805-812. https://doi.org/10.1249/MSS.0b013e31827d1618

Martins, C., Truby, H., & Morgan, L. M. (2007). Short-term appetite control in response to a 6-week exercise programme in sedentary volunteers. The British journal of nutrition, 98(4), 834-842. https://doi.org/10.1017/S000711450774922X

Mathisen, T. F., Rosenvinge, J. H., Friborg, O., Vrabel, K., Bratland-Sanda, S., Pettersen, G., & Sundgot-Borgen, J. (2020). Is physical exercise and dietary therapy a feasible alternative to cognitive behavior therapy in treatment of eating disorders? A randomized controlled trial of two group therapies. The International journal of eating disorders, 53(4), 574-585. https://doi.org/10.1002/eat.23228

Montenegro, R. A., Okano, A. H., Cunha, F. A., Gurgel, J. L., Fontes, E. B., & Farinatti, P. T. (2012). Prefrontal cortex transcranial direct current stimulation associated with aerobic exercise change aspects of appetite sensation in overweight adults. Appetite, 58(1), 333-338. https://doi.org/10.1016/j.appet.2011.11.008

Morishima, T., Kurihara, T., Hamaoka, T., & Goto, K. (2014). Whole body, regional fat accumulation, and appetite-related hormonal response after hypoxic training. Clinical physiology and functional imaging, 34(2), 90-97. https://doi.org/10.1111/cpf.12069

Nitsche, M. A., Lampe, C., Antal, A., Liebetanz, D., Lang, N., Tergau, F., & Paulus, W. (2006). Dopaminergic modulation of long-lasting direct current-induced cortical excitability changes in the human motor cortex. The European journal of neuroscience, 23(6), 1651-1657. https://doi.org/10.1111/j.1460-9568.2006.04676.x

Peirce, J. M., & Alviña, K. (2019). The role of inflammation and the gut microbiome in depression and anxiety. Journal of neuroscience research, 97(10), 1223-1241. https://doi.org/10.1002/jnr.24476

Rodrigues-Krause, J., Farinha, J. B., Ramis, T. R., Macedo, R. C. O., Boeno, F. P., Dos Santos, G. C., Vargas, J., Jr, Lopez, P., Grazioli, R., Costa, R. R., Pinto, R. S., Krause, M., & Reischak-Oliveira, A. (2018). Effects of dancing compared to walking on cardiovascular risk and functional capacity of older women: A randomized controlled trial. Experimental gerontology, 114, 67-77. https://doi.org/10.1016/j.exger.2018.10.015

Rosenkilde, M., Reichkendler, M. H., Auerbach, P., Toräng, S., Gram, A. S., Ploug, T., Holst, J. J., Sjödin, A., & Stallknecht, B. (2013). Appetite regulation in overweight, sedentary men after different amounts of endurance exercise: a randomized controlled trial. Journal of applied physiology (Bethesda, Md. : 1985), 115(11), 1599-1609. https://doi.org/10.1152/japplphysiol.00680.2013

Ross, R., Blair, S. N., Arena, R., Church, T. S., Després, J. P., Franklin, B. A., Haskell, W. L., Kaminsky, L. A., Levine, B. D., Lavie, C. J., Myers, J., Niebauer, J., Sallis, R., Sawada, S. S., Sui, X., Wisløff, U., American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health, Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council on Cardiovascular and Stroke Nursing, … Stroke Council (2016). Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation, 134(24), e653-e699. https://doi.org/10.1161/CIR.0000000000000461

Sena, T. (2014). Diagnostic and Statistical Manual of Mental Disorders - DSM-5, statistics and human sciences: inflections on normalizations and regulations. International Interdisciplinary Journal INTERthesis; 11:96.

Siddiqui SV, Chatterjee U, Kumar D, Siddiqui A, Goyal N. Neuropsychology of prefrontal cortex. Indian J Psychiatry. 2008 Jul;50(3):202-8. https://doi.org/10.4103/0019-5545.43634

Sloan, R. P., Shapiro, P. A., McKinley, P. S., Bartels, M., Shimbo, D., Lauriola, V., Karmally, W., Pavlicova, M., Choi, C. J., Choo, T. H., Scodes, J. M., Flood, P., & Tracey, K. J. (2018). Aerobic Exercise Training and Inducible Inflammation: Results of a Randomized Controlled Trial in Healthy, Young Adults. Journal of the American Heart Association, 7(17), e010201. https://doi.org/10.1161/JAHA.118.010201

Solmi, M., Köhler, C. A., Stubbs, B., Koyanagi, A., Bortolato, B., Monaco, F., Vancampfort, D., Machado, M. O., Maes, M., Tzoulaki, I., Firth, J., Ioannidis, J. P. A., & Carvalho, A. F. (2018). Environmental risk factors and nonpharmacological and nonsurgical interventions for obesity: An umbrella review of meta-analyses of cohort studies and randomized controlled trials. European journal of clinical investigation, 48(12), e12982. https://doi.org/10.1111/eci.12982

Swift, D. L., McGee, J. E., Earnest, C. P., Carlisle, E., Nygard, M., & Johannsen, N. M. (2018). The Effects of Exercise and Physical Activity on Weight Loss and Maintenance. Progress in cardiovascular diseases, 61(2), 206-213. https://doi.org/10.1016/j.pcad.2018.07.014

Thousand Oaks, California (1991). Meta-Analytic Procedures for Social Research. Retrieved from [Accessed 12/09/2023]: https://methods.sagepub.com/book/meta-analytic-procedures-for-social-research

Ulbricht, L., Ripka, W., Beraldo, L. (2016). Quantitative data analysis. p. 165-203.

Wang, G. J., Volkow, N. D., Telang, F., Jayne, M., Ma, J., Rao, M., Zhu, W., Wong, C. T., Pappas, N. R., Geliebter, A., & Fowler, J. S. (2004). Exposure to appetitive food stimuli markedly activates the human brain. NeuroImage, 21(4), 1790-1797. https://doi.org/10.1016/j.neuroimage.2003.11.026

Wang, G. J., Yang, J., Volkow, N. D., Telang, F., Ma, Y., Zhu, W., Wong, C. T., Tomasi, D., Thanos, P. K., & Fowler, J. S. (2006). Gastric stimulation in obese subjects activates the hippocampus and other regions involved in brain reward circuitry. Proceedings of the National Academy of Sciences of the United States of America, 103(42), 15641-15645. https://doi.org/10.1073/pnas.0601977103

Wendt, HW (1972). Dealing with a common problem in Social science: A simplified rank-biserial coefficient of correlation based on the U statistic. European Journal of Social Psychology. 2(4):463-5. https://doi.org/10.1002/ejsp.2420020412

Wiegand A., Sommer A., Nieratschker V., & Plewnia C. (2019). Improvement of cognitive control and stabilization of affect by prefrontal transcranial direct current stimulation (tDCS). Scientific reports. 9(1):6797. https://doi.org/10.1038/s41598-019-43234-2

Effects of transcranial continuous current stimulation (tDCS) associated with aerobic exercise in the treatment of food compulsion: A randomized clinical trial

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2023-12-26

How to Cite

Artifon, M., Mayer Tossi, G., Griebler, N., Schestatsky, P., Boeno, F., Moritz, C., Lopes Teodoro, J., Beraldo, L., Naomi Adachi, L., Reischak de Oliveira, Álvaro, & Pietta-Dias, C. (2023). Effects of transcranial continuous current stimulation (tDCS) associated with aerobic exercise in the treatment of food compulsion: A randomized clinical trial. Journal of Human Sport and Exercise, 19(2), 436–450. https://doi.org/10.14198/jhse.2024.192.01

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Sport Medicine, Nutrition & Health