多疗程家庭经颅直流电刺激（M-HB-tDCS）对纤维肌痛患者进食行为的影响：一项析因随机临床试验。
Impact of multiple-session home-based transcranial direct current stimulation (M-HB-tDCS) on eating behavior in fibromyalgia: A factorial randomized clinical trial.
机构信息
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.
Health Science Center, Nutrition Department, Clinical Nutrition Division, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
出版信息
Brain Stimul. 2024 Mar-Apr;17(2):152-162. doi: 10.1016/j.brs.2024.02.001. Epub 2024 Feb 8.
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.
背景
多次家庭自我应用经颅直流电刺激（M-HB-self-applied-tDCS）已被证明可有效减轻慢性疼痛和增强认知功能。然而，这种方法对饮食障碍行为的有效性仍需要研究。
目的
本研究旨在评估在四周内对左侧背外侧前额叶皮层（L-DLPFC）或初级运动皮层（M1）进行 20 次 M-HB-self-applied-tDCS 是否可以改善各种方面的饮食行为、人体测量指标和依从性。
方法
我们将 102 名年龄在 30 岁至 65 岁之间的纤维肌痛患者随机分配到四个 tDCS 组之一：L-DLPFC（阳极-tDCS，n=34；假-tDCS，n=17）或 M1（阳极-tDCS，n=34；假-tDCS，n=17）。患者在接受现场培训后，每天在远程监督下自我管理 20 分钟的 tDCS 治疗。
结果
广义线性模型显示，与假-tDCS 相比，M-HB-self-applied-tDCS 对未受控制的饮食（UE）（Wald χ2=5.62；df=1；P=0.018；效应大小，ES=0.55）和食物渴望（Wald χ2=5.62；df=1；P=0.018；ES=0.57）有显著影响。关于纤维肌痛症状，我们发现与 DLPFC 相比，M1 的阳极-tDCS 对减轻食物渴望有不同的影响。此外，M-HB-阳极-tDCS 显著减少了情绪化饮食和腰围。相比之下，M1 刺激在改善纤维肌痛症状方面更为有效。整体依从率很高，为 88.94%。
结论
这些发现表明，M-HB-self-applied-tDCS 是一种减少未受控制和情绪化饮食的合适方法，在 L-DLPFC 中效果更好。此外，这些结果揭示了纤维肌痛症状对 M-HB-self-applied-tDCS 的影响，M1 特别有效，可以减轻食物渴望和减轻纤维肌痛症状。
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