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

Manoela N da Jornada; Luciana C Antunes; Camila Alves; Iraci L S Torres; Felipe Fregni; Paulo R S Sanches; Danton P Silva Jr; Wolnei Caumo

doi:10.1016/j.brs.2024.02.001

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

Brain Stimul. 2024 Mar-Apr;17(2):152-162. doi: 10.1016/j.brs.2024.02.001. Epub 2024 Feb 8.

Authors

Manoela N da Jornada¹, Luciana C Antunes², Camila Alves¹, Iraci L S Torres³, Felipe Fregni⁴, Paulo R S Sanches⁵, Danton P Silva Jr⁵, Wolnei Caumo⁶

Affiliations

¹ Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
² Health Science Center, Nutrition Department, Clinical Nutrition Division, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
³ Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain Pharmacology and Neuromodulation, Preclinical Investigations, Experimental Research Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
⁴ Laboratory of Neuromodulation and Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Boston, MA, USA.
⁵ Laboratory of Biomedical Engineer at HCPA, Porto ALegre, Brazil.
⁶ Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil; Laboratory of Neuromodulation and Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Boston, MA, USA; Pain and Palliative Care Service at HCPA, Brazil; Department of Surgery, School of Medicine, UFRGS, Porto Alegre, Brazil. Electronic address: wcaumo@hcpa.edu.br.

PMID: 38336340
DOI: 10.1016/j.brs.2024.02.001

Abstract

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-min tDCS sessions daily with 2 mA 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.

Keywords: Fibromyalgia; Home-based tDCS; Overweight/obesity; Randomized clinical trial.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Dorsolateral Prefrontal Cortex / physiology
Feeding Behavior* / physiology
Female
Fibromyalgia* / therapy
Humans
Male
Middle Aged
Motor Cortex / physiology
Motor Cortex / physiopathology
Transcranial Direct Current Stimulation* / methods
Treatment Outcome