Psychotherapy and Psychosomatics

Giel K.E.a,b· Schag K.a,b· Max S.M.a,b,d· Martus P.c· Zipfel S.a,b· Fallgatter A.J.d· Plewnia C.d

Author affiliations

aDepartment of Psychosomatic Medicine und Psychotherapy, Medical University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
bCenter of Excellence for Eating Disorders, Tübingen, Germany
cInstitute for Clinical Epidemiology and Applied Biostatistics, Medical Faculty, Eberhard Karls University Tübingen, Tübingen, Germany
dDepartment of Psychiatry and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany

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Article / Publication Details

First-Page Preview

Received: September 20, 2022
Accepted: January 05, 2023
Published online: March 08, 2023

Number of Print Pages: 12
Number of Figures: 4
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

Abstract

Introduction: Binge eating disorder (BED) is characterized by recurrent binge eating (BE) episodes with loss of control. Inhibitory control impairments, including alterations in dorsolateral prefrontal cortex (dlPFC) functioning, have been described for BED. A targeted modulation of inhibitory control circuits by the combination of inhibitory control training and transcranial brain stimulation could be promising. Objective: The aim of the study was to demonstrate feasibility and clinical effects of a transcranial direct current stimulation (tDCS)-enhanced inhibitory control training to reduce BE episodes and to generate an empirical basis for a confirmatory trial. Methods: We performed a monocentric clinical phase II double-blind randomized trial with two parallel arms. Forty-one adult outpatients with full-syndrome BED according to DSM-5 received six sessions of food-related inhibitory control training, randomly combined with 2 mA verum or sham tDCS of the right dlPFC. The main outcome was BE frequency within a 4-week interval after treatment termination (T8; primary) and at 12-week follow-up (T9; secondary) as compared to baseline. Results: BE frequency was reduced in the sham group from 15.5 to 5.9 (T8) and to 6.8 (T9); in the verum group, the reduction was 18.6 to 4.4 (T8) resp. 3.8 (T9). Poisson regression with the study arm as the factor and baseline BE frequency as the covariate revealed a p value of 0.34 for T8 and 0.026 for T9. Sham and real tDCS differed at T9 in BE frequency. Conclusions: Inhibitory control training enhanced by tDCS is safe in patients with BED and results in a substantial and sustainable reduction in BE frequency which unfolds over several weeks post-treatment. These results constitute the empirical basis for a confirmatory trial.

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References American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Assoc; 2013. World Health Organization. ICD-11: international classification of diseases (11th revision). Berlin, Germany: World Health Organization; 2019. Giel KE, Bulik CM, Fernandez-Aranda F, Hay P, Keski-Rahkonen A, Schag K, et al. Binge eating disorder. Nat Rev Dis Primers. 2022;8(1):16. Santomauro DF, Melen S, Mitchison D, Vos T, Whiteford H, Ferrari AJ. The hidden burden of eating disorders: an extension of estimates from the global burden of disease study 2019. Lancet Psychiatry. 2021;8(4):320–8. Hilbert A, Petroff D, Herpertz S, Pietrowsky R, Tuschen-Caffier B, Vocks S, et al. Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder. J Consult Clin Psychol. 2019;87(1):91–105. Kessler RM, Hutson PH, Herman BK, Potenza MN. The neurobiological basis of binge-eating disorder. Neurosci Biobehav Rev. 2016;63:223–38. Waltmann M, Herzog N, Horstmann A, Deserno L. Loss of control over eating: a systematic review of task based research into impulsive and compulsive processes in binge eating. Neurosci Biobehav Rev. 2021;129:330–50. Giel KE, Teufel M, Junne F, Zipfel S, Schag K. Food-related impulsivity in obesity and binge eating disorder-a systematic update of the evidence. Nutrients. 2017;9(11):1170. Cole MW, Schneider W. The cognitive control network: integrated cortical regions with dissociable functions. Neuroimage. 2007;37(1):343–60. von Bastian CC, Belleville S, Udale RC, Reinhartz A, Essounni M, Strobach T. Mechanisms underlying training-induced cognitive change. Nat Rev Psychol. 2022;1:30–41. Jones A, Di Lemma LCG, Robinson E, Christiansen P, Nolan S, Tudur-Smith C, et al. Inhibitory control training for appetitive behaviour change: a meta-analytic investigation of mechanisms of action and moderators of effectiveness. Appetite. 2016;97:16–28. İnce B, Schlatter J, Max S, Plewnia C, Zipfel S, Giel KE, et al. Can we change binge eating behaviour by interventions addressing food-related impulsivity? a systematic review. J Eat Disord. 2021;9(1):38. Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol. 2000;527 Pt 3(Pt 3):633–9. Ahn S, Frohlich F. Pinging the brain with transcranial magnetic stimulation reveals cortical reactivity in time and space. Brain Stimul. 2021;14(2):304–15. Kuo MF, Chen PS, Nitsche MA. The application of tDCS for the treatment of psychiatric diseases. Int Rev Psychiatry. 2017;29(2):146–67. Chase HW, Boudewyn MA, Carter CS, Phillips ML. Transcranial direct current stimulation: a roadmap for research, from mechanism of action to clinical implementation. Mol Psychiatry. 2020;25(2):397–407. Schroeder PA, Schwippel T, Wolz I, Svaldi J. Meta-analysis of the effects of transcranial direct current stimulation on inhibitory control. Brain Stimul. 2020;13(5):1159–67. Dalton B, Bartholdy S, Campbell IC, Schmidt U. Neurostimulation in clinical and sub-clinical eating disorders: a systematic update of the literature. Curr Neuropharmacol. 2018;16(8):1174–92. Bikson M, Name A, Rahman A. Origins of specificity during tDCS: anatomical, activity-selective, and input-bias mechanisms. Front Hum Neurosci. 2013;7:688. Cramer SC, Sur M, Dobkin BH, O’Brien C, Sanger TD, Trojanowski JQ, et al. Harnessing neuroplasticity for clinical applications. Brain. 2011;134(Pt 6):1591–609. Dedoncker J, Baeken C, De Raedt R, Vanderhasselt MA. Combined transcranial direct current stimulation and psychological interventions: state of the art and promising perspectives for clinical psychology. Biol Psychol. 2021;158:107991. Giel KE, Speer E, Schag K, Leehr EJ, Zipfel S. Effects of a food-specific inhibition training in individuals with binge eating disorder-findings from a randomized controlled proof-of-concept study. Eat Weight Disord. 2017;22(2):345–51. Max SM, Plewnia C, Zipfel S, Giel KE, Schag K. Combined antisaccade task and transcranial direct current stimulation to increase response inhibition in binge eating disorder. Eur Arch Psychiatry Clin Neurosci. 2021;271(1):17–28. Weller S, Nitsche MA, Plewnia C. Enhancing cognitive control training with transcranial direct current stimulation: a systematic parameter study. Brain Stimul. 2020;13(5):1358–69. Sommer A, Plewnia C. Depression treatment by tDCS-enhanced cognitive control training: a test of two stimulation intensities. Brain Stimul. 2021;14(4):987–9. Hutton SB, Ettinger U. The antisaccade task as a research tool in psychopathology: a critical review. Psychophysiology. 2006;43(3):302–13. Jasper H. The ten-twenty electrode system of the International Federation. Electroencephalogr Clin Neurophysiol. 1958;10:370–5. Nasseri P, Nitsche MA, Ekhtiari H. A framework for categorizing electrode montages in transcranial direct current stimulation. Front Hum Neurosci. 2015;9:54. Hilbert A, Tuschen-Caffier B. Eating disorder examniation. Tübingen: dgvt-Verlag; 2016. Giel KE, Schag K, Martus P, Max SM, Plewnia C. Ameliorating cognitive control in patients with binge eating disorder by electrical brain stimulation: study protocol of the randomized controlled ACCElect pilot trial. J Eat Disord. 2022;10(1):26. Pudel V, Westenhöfer J. Fragebogen zum essverhalten (FEV): handanweisung. Göttingen: Verlag für Psychologie Hogrefe; 1989. Beesdo-Baum K, Zaudig M, Wittchen H. Strukturiertes Klinisches Interview für DSM-5®-Störungen: klinische Version Göttingen. Göttingen: Hogrefe; 2019. Hautzinger M, Keller F, Kühner C, editors. BDI-II. Beck depressions inventar revision: manual. Frankfurt: Harcourt Test Services; 2006. Psychiatric Research Unit. WCCfMH: WHO-5 well-being index. Hillerød, Denmark: Frederiksborg General Hospital; 1998. Meule A, Vögele C, Kübler A. Psychometrische evaluation der deutschen barratt impulsiveness scale: kurzversion (BIS-15). Diagnostica. 2011;57(3):126–33. Schmidt RE, Gay P, d’Acremont M, Van der Linden M. A German adaptation of the UPPS impulsive behavior scale: psychometric properties and factor structure. Swiss J Psychol. 2008;67(2):107–12. 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(10):e030023. Burgess EE, Sylvester MD, Morse KE, Amthor FR, Mrug S, Lokken KL, et al. Effects of transcranial direct current stimulation (tDCS) on binge eating disorder. Int J Eat Disord. 2016;49(10):930–6. Berner LA, Sysko R, Rebello TJ, Roberto CA, Pike KM. Patient descriptions of loss of control and eating episode size interact to influence expert diagnosis of ICD-11 binge-eating disorder. J Eat Disord. 2020;8(1):71. Leehr EJ, Krohmer K, Schag K, Dresler T, Zipfel S, Giel KE. Emotion regulation model in binge eating disorder and obesity: a systematic review. Neurosci Biobehav Rev. 2015;49:125–34. Neacsiu AD, Beynel L, Powers JP, Szabo ST, Appelbaum LG, Lisanby SH, et al. Enhancing cognitive restructuring with concurrent repetitive transcranial magnetic stimulation: a transdiagnostic randomized controlled trial. Psychother Psychosom. 2022;91(2):94–106. Segrave RA, Arnold S, Hoy K, Fitzgerald PB. Concurrent cognitive control training augments the antidepressant efficacy of tDCS: a pilot study. Brain Stimul. 2014;7(2):325–31. Silva RMFD, Brunoni AR, Goerigk S, Batistuzzo MC, Costa DLDC, Diniz JB, et al. Efficacy and safety of transcranial direct current stimulation as an add-on treatment for obsessive-compulsive disorder: a randomized, sham-controlled trial. Neuropsychopharmacology. 2021;46(5):1028–34. Schag K, Rennhak SK, Leehr EJ, Skoda EM, Becker S, Bethge W, et al. IMPULS: impulsivity-focused group intervention to reduce binge eating episodes in patients with binge eating disorder–a randomised controlled trial. Psychother Psychosom. 2019;88(3):141–53. LaFata EM, Gearhardt AN. Ultra-processed food addiction: an epidemic? Psychother Psychosom. 2022;91(6):363–72. Article / Publication Details

First-Page Preview

Received: September 20, 2022
Accepted: January 05, 2023
Published online: March 08, 2023

Number of Print Pages: 12
Number of Figures: 4
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

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