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经颅直流电刺激(tDCS)与ω-3对伴有超重的抑郁症患者食物渴望、执行功能、体重及抑郁症状的影响:一项随机对照试验

The Effectiveness of Transcranial Direct Current Stimulation (tDCS) and Omega-3 on Food Craving, Executive Functions, Weight, and Depressive Symptoms in Patients with Depression and Overweight: A Randomized Controlled Trial.

作者信息

Tabasi Mahla, Mostafavi Seyed-Ali, Oreyzi Hamidreza, Mohammadi Mohammad Reza, Khaleghi Ali

机构信息

Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.

Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Psychiatry. 2024 Feb;19(2):158-173. doi: 10.18502/ijps.v19i2.15102.

Abstract

The most important hypothesis of this research was based on the fact that the mechanism of the effect of omega-3 on depression and obesity is formed through its accumulation in the dorsolateral prefrontal cortex (DLPFC), especially in women. Accordingly, we investigated the omega-3 intake and the concurrent stimulation of the DLPFC by tDCS and hypothesized that the synergy of these two treatments can increase the obtained effect size in patients with depression and overweight. This research was a double-blind randomized controlled trial (RCT) with a factorial design consisting of four treatment and control groups. The participants were females with depression and overweight on an outpatient basis. They received 5 ml/day omega-3 syrup (545 mg DHA, 620 mg EPA) or placebo adjunct with 12 sessions sham/tDCS stimulation administered for 3 weeks with anode-left/cathode-right protocol in the prefrontal cortex (1.5 mA, 15 minutes' stimulation / 15-20 minutes' rest intervals/one visit per week, 4 stimulations per visit). tDCS or omega-3 alone did not significantly improve the executive functions, depression, food cravings, and weight in the experimental groups compared to the control group (P > 0.05). However, tDCS adjunct with the omega-3 had a significant and positive effect on improving weight change (P = 0.011; df = 1; F = 1.27; Eta = 0.108) with a power of 0.73 compared to the control group. Furthermore, their interaction led to an improving trend in executive functions and a decreasing trend in food cravings which are clinically important. tDCS could strengthen the omega-3 mechanisms of effect through stimulating its accumulation site in the brain (i.e., the DLPFC) and the synergistic effects of these two treatments result in weight control as well as an improvement trend in the executive functions and food craving in women.

摘要

本研究最重要的假设基于这样一个事实

ω-3对抑郁和肥胖的影响机制是通过其在背外侧前额叶皮质(DLPFC)的积累形成的,尤其是在女性中。因此,我们研究了ω-3的摄入量以及经颅直流电刺激(tDCS)对DLPFC的同步刺激,并假设这两种治疗方法的协同作用可以增加抑郁症和超重患者的效应量。 本研究是一项双盲随机对照试验(RCT),采用析因设计,包括四个治疗组和对照组。参与者为门诊抑郁症和超重女性。她们每天服用5毫升ω-3糖浆(545毫克DHA,620毫克EPA)或安慰剂,并辅以12次假刺激/tDCS刺激,采用前额叶皮质阳极-左/阴极-右方案,持续3周(1.5毫安,15分钟刺激/15 - 20分钟休息间隔/每周一次就诊,每次就诊4次刺激)。与对照组相比,单独使用tDCS或ω-3在实验组中并未显著改善执行功能、抑郁、食物渴望和体重(P>0.05)。然而,与对照组相比,tDCS联合ω-3对体重变化有显著的积极影响(P = 0.011;自由度 = 1;F = 1.27;Eta = 0.108),功效为0.73。此外,它们的相互作用导致执行功能有改善趋势,食物渴望有下降趋势,这在临床上具有重要意义。tDCS可以通过刺激其在大脑中的积累部位(即DLPFC)来增强ω-3的作用机制,这两种治疗方法的协同作用导致体重控制以及女性执行功能和食物渴望的改善趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50bc/11055968/b10a11d76851/IJPS-19-158-g001.jpg

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