Does repetitive transcranial magnetic stimulation have positive effects on adults with eating disorders and/or excessive weight?

• Autor(a) principal: Batista, Pedro Garcia
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.6/8711
• topic: Cortex Pré-Frontal; Estimulação Magnética Transcraniana; Excesso de Peso; Neuromodulação; Perturbações Alimentares; Revisão Sistemática; Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina

Background Eating disorders (ED) are chronic illnesses with treatments of limited proven efficacy. Re-petitive transcranial magnetic stimulation (rTMS) has been investigated as a therapeutic tool for neuropsychiatric illnesses and is already certified for major depression disorder (MDD). There is evidence that when the left dorsolateral pre-frontal cortex (dlPFC) is targeted, the ED sympto-matology is improved. Objectives This article is a systematic review that intends to assess the validity of rTMS as a therapy for ED and food craving. Methods We conducted a literature search using the following search terms: rTMS, ED, anorexia, bulimia, binge-eating disorder and excessive weight. Articles published in English and indexed in the following databases were searched: Pubmed, Embase, hinari; inasp; eIFL; Cochrane Library; EBSCO; CINAHL; Current Contents; DARE; metacrawler; PsycINFO. Results All studies (5 in total) assessed the effects of rTMS on dlPFC. Van den Eynde et al. (1), showed that the real rTMS group with BN (n=17) had a significant reduction in cue-induced food craving (p=0.028). Walpoth and colleagues (2) studied 14 women with BN in whom the average number of binges per day did not declined significantly in the active group (n=7) relatively to placebo (p=0,211). Gay et al. (3) concluded that there were no significant improvements in binge-ing/purging symptoms in BN patients (p=0.96). Kim et al. (4) examined the effects of four rTMS sessions (n=57) in overweight patients, showing a significant weight loss in the intervention group (p=0.002). McClelland et al. (5) studied the effects of one session of rTMS and concluded that there was no significant reduction of core anorexia symptoms (p>0.05). Given the heterogeneity of par-ticipants/pathologies and results it was not possible to perform a meta-analysis. Conclusions Excitatory rTMS appears to have a positive effect in changing ED sympotms. More studies, especially RCT with large samples, are needed.