Institute of Psychiatry, King's College London, London, UK.
Psychol Med. 2011 Jun;41(6):1329-36. doi: 10.1017/S0033291710001881. Epub 2010 Oct 7.
In people with bulimic eating disorders, exposure to high-calorie foods can result in increases in food craving, raised subjective stress and salivary cortisol concentrations. This cue-induced food craving can be reduced by repetitive transcranial magnetic stimulation (rTMS). We investigated whether rTMS has a similar effect on salivary cortisol concentrations, a measure of hypothalamic-pituitary-adrenal axis (HPAA) activity.
We enrolled twenty-two female participants who took part in a double-blind randomized sham-controlled trial on the effects of rTMS on food craving. Per group, eleven participants were randomized to the real or sham rTMS condition. The intervention consisted of one session of high-frequency rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC). Salivary cortisol concentrations were assessed at four time points throughout the 90-min trial. To investigate differences in post-rTMS concentrations between the real and sham rTMS groups, a random-effects model including the pre-rTMS cortisol concentrations as covariates was used.
Salivary cortisol concentrations following real rTMS were significantly lower compared with those following sham rTMS. In this sample, there was also a trend for real rTMS to reduce food craving more than sham rTMS.
These results suggest that rTMS applied to the left DLPFC alters HPAA activity in people with a bulimic disorder.
在患有贪食症的人群中，暴露于高热量食物会导致食物渴望增加、主观压力升高和唾液皮质醇浓度升高。这种线索诱导的食物渴望可以通过重复经颅磁刺激（rTMS）来减少。我们研究了 rTMS 是否对唾液皮质醇浓度（反映下丘脑-垂体-肾上腺轴（HPAA）活动的指标）有类似的影响。
我们招募了 22 名女性参与者，他们参加了一项关于 rTMS 对食物渴望影响的双盲随机假对照试验。每组 11 名参与者被随机分配到真实或假 rTMS 条件。干预包括一次左背外侧前额叶皮质（DLPFC）的高频 rTMS。在 90 分钟的试验过程中，在四个时间点评估唾液皮质醇浓度。为了研究真实 rTMS 和假 rTMS 组之间 post-rTMS 皮质醇浓度的差异，使用了包括预 rTMS 皮质醇浓度作为协变量的随机效应模型。
与假 rTMS 相比，真实 rTMS 后唾液皮质醇浓度显著降低。在这个样本中，真实 rTMS 也有趋势比假 rTMS 更能减少食物渴望。
这些结果表明，应用于左 DLPFC 的 rTMS 改变了患有贪食症的人的 HPAA 活动。
