Impact of multiple-session home-based transcranial direct current stimulation (M-HB-tDCS) on eating behavior in fibromyalgia: A factorial randomized clinical trial.

BACKGROUND

Multiple-session home-based self-applied transcranial direct current stimulation (M-HB-self-applied-tDCS) has previously been found to effectively reduce chronic pain and enhance cognitive function. However, the effectiveness of this method for disordered eating behavior still needs to be studied.

OBJECTIVE

This study aimed to assess whether 20 sessions of M-HB-self-applied-tDCS, administered over four weeks to either the left dorsolateral prefrontal cortex (L-DLPFC) or primary motor cortex (M1), could improve various aspects of eating behavior, anthropometric measures, and adherence.

METHODS

We randomly assigned 102 fibromyalgia patients between the ages of 30 and 65 to one of four tDCS groups: L-DLPFC (anodal-(a)-tDCS, n = 34; sham-(s)-tDCS, n = 17) or M1 (a-tDCS, n = 34; s-tDCS, n = 17). Patients self-administered 20-minute tDCS sessions daily with 2mA under remote supervision following in-person training.

RESULTS

Generalized linear models revealed significant effects of M-HB-self-applied-tDCS compared to s-tDCS on uncontrolled eating (UE) (Wald χ2 = 5.62; df = 1; P = 0.018; effect size, ES = 0.55), and food craving (Wald χ2 = 5.62; df = 1; P = 0.018; ES = 0.57). Regarding fibromyalgia symptoms, we found a differentiated impact of a-tDCS on M1 compared to DLPFC in reducing food cravings. Additionally, M-HB-a-tDCS significantly reduced emotional eating and waist size. In contrast, M1 stimulation was more effective in improving fibromyalgia symptoms. The global adherence rate was high, at 88.94%.

CONCLUSION

These findings demonstrate that M-HB-self-applied-tDCS is a suitable approach for reducing uncontrolled and emotional eating, with greater efficacy in L-DLPFC. Furthermore, these results revealed the influence of fibromyalgia symptoms on M-HB-self-applied-tDCS's, with M1 being particularly effective in mitigating food cravings and reducing fibromyalgia symptoms.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors involved in this study disclose the following potential conflicts of interest: Dr. Caumo, affiliated with the National Council for Scientific and Technological Development (CNPq), Brazil, and Dr. Silva Torres reported receiving grants from the National Council for Scientific and Technological Development, as well as from the Foundation de Amparo à Pesquisa do Estado do Rio Grande do Sul. Dr. Sanches also received grants from the National Council for Scientific and Technological Development during the conduct of the study. It is noteworthy that the transcranial direct current stimulation (tDCS) device utilized in this research was developed and patented by Dr. Sanches, MSc Pereira, Dr. Silva Torres, and Dr. Caumo. These authors have received royalties from Quark Medical, as the patent (BR 20 2015 016450 0) was licensed to Quark Medical. MSc Pereira disclosed receiving grants from Financial Studies and Projects during the study. No other disclosures were reported by the authors.