The association between obesity and psychological distress has been widely demonstrated. Systematic reviews have highlighted the bidirectional nature of this relationship. Strategies aimed at improving dopamine function may be beneficial in the treatment of both obesity and the associated psychological symptoms. Deep Transcranial Magnetic Stimulation (dTMS) has been demonstrated capable of inducing satiety and body weight loss in obesity, through modulation of dopaminergic system. Aim of this study was to evaluate possible beneficial effects of a 5-week dTMS treatment on psychological conditions in obesity. A total of 33 obese patients (9 males, 24 females, age 48.1±10.6 years, BMI 36.9±4.7 Kg/m2) were randomized and completed the study: 13 obese subjects underwent a 5-week treatment with high-frequency (HF) dTMS (18 Hz), 10 were treated with low-frequency (LF) dTMS (1 Hz), and 10 were Sham-treated. Depressive symptoms [Zung Self-Rating Depression Scale (SDS), Beck Depression Inventory (BDI)], state [State-Trait Anxiety Inventory (STAI-1)] and trait anxiety (STAI-2), impulsiveness [Barratt Impulsiveness Scale (BIS)] were evaluated at baseline and at the end of 15 dTMS sessions. After 5 weeks, a significant weight loss was found in HF vs. LF and vs. sham (p=0.001). In the same group, a significant decrease in both Zung SDS (37.3±4.2 vs. 26.7±5.4, p=0.049 vs. baseline; p=0.036 vs. Sham) and BDI scores (4.8±4.1 vs. 2.6±2.5, p=0.019 vs. baseline) was found. In HF, state (37.1±7.9 vs. 32.4, p=0.024) and trait anxiety (35.6±10.5 vs. 30.1±7.8, p=0.016), and impulsiveness (55.6±9.3 vs. 51.6±8.4, p=0.021) scores significantly decreased compared to baseline. Weight loss over 5 weeks of dTMS treatment was associated with psychological benefit; the improvement of psychological conditions in obese subjects has been hypothesized to be due to a direct effect of HF dTMS, as well as a weight loss secondary result. The reduction of impulsivity could concur to a greater control of food craving in HF.
A. Ferrulli: None. C. Macrì: None. V. Dangelo: None. L. Luzi: Consultant; Self; McKinsey & Company. Research Support; Self; Allergan, Gelesis, SunStar Inc. Speaker's Bureau; Self; A. Menarini Diagnostics, AstraZeneca, Eli Lilly and Company, GlaxoSmithKline plc., Menarini Group, Novartis AG, Novo Nordisk Inc., Sunstar Foundation.
Italian Ministry of Health