Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Republic of Korea.
Diabetes Obes Metab. 2019 Aug;21(8):1956-1966. doi: 10.1111/dom.13763. Epub 2019 Jun 10.
We conducted a 4-week randomized, sham-controlled, single-blind, parallel-group trial to examine the effect of repetitive transcranial magnetic stimulation (rTMS) delivered to the left dorsolateral prefrontal cortex (DLPFC) on functional brain connectivity and body weight in adults with obesity.
Of the 45 volunteers with obesity, aged between 18 and 70 years (body mass index [BMI] ≥25 kg/m according to the obesity criterion for an Asian population), 36 participants (54.1 ± 11.0 years, BMI 30.2 ± 3.5 kg/m , 77.8% female) completed the 4 weeks of follow-up, undergoing two resting state fMRI scans (20 in the real stimulation group and 16 in the sham stimulation group). A total of eight sessions of high-frequency rTMS targeting the left DLPFC were provided over a period of 4 weeks (5-second trains with 25-second inter-train intervals, 10 Hz, 110% motor threshold; 2000 pulses over 20 minutes).
Participants in the real stimulation group showed significantly greater weight loss from baseline following the eight session of rTMS (-2.53 ± 2.41 kg vs 0.38 ± 1.13 kg, P < 0.01). For intrinsic brain connectivity comparisons, the between-ness centrality values within the right frontoparietal network tended to increase with rTMS, and a significant interaction effect was identified for time (pre vs post) × rTMS (real vs sham) in the right frontoparietal network (P = 0.031, FDR corrected).
We observed that rTMS selectively increased resting state functional connectivity within the right frontoparietal network. Our findings suggest that high-frequency rTMS to the left DLPFC might strengthen the frontoparietal network that orchestrates top-down inhibitory control to reduce food intake.
我们进行了一项为期 4 周的随机、假刺激对照、单盲、平行组试验，以检验左背外侧前额叶皮层（DLPFC）重复经颅磁刺激（rTMS）对肥胖成年人的功能性脑连接和体重的影响。
在 45 名年龄在 18 至 70 岁之间（根据亚洲人群肥胖标准，身体质量指数[BMI]≥25kg/m²）的肥胖志愿者中，有 36 名参与者（54.1±11.0 岁，BMI 30.2±3.5kg/m²，77.8%为女性）完成了 4 周的随访，进行了两次静息状态功能磁共振成像（fMRI）扫描（真实刺激组 20 次，假刺激组 16 次）。在 4 周的时间内，共进行了 8 次针对左 DLPFC 的高频 rTMS 治疗（5 秒的刺激，间隔 25 秒，10Hz，110%运动阈值；20 分钟内 2000 个脉冲）。
与 rTMS 治疗前相比，真实刺激组在 8 次 rTMS 治疗后体重明显减轻（-2.53±2.41kg 与 0.38±1.13kg，P<0.01）。对于内在脑连接比较，右侧额顶网络的介数中心值随着 rTMS 的增加而趋于增加，并且在右侧额顶网络中，时间（治疗前与治疗后）与 rTMS（真实刺激与假刺激）之间存在显著的交互效应（P=0.031，FDR 校正）。
我们观察到 rTMS 选择性地增加了右侧额顶网络的静息状态功能连接。我们的研究结果表明，左 DLPFC 的高频 rTMS 可能增强了额顶网络，该网络协调自上而下的抑制控制以减少食物摄入。
