Introduction: Binge eating disorder (BED) is characterized by recurrent binge eating (BE) episodes with loss of control. Inhibitory control impairments, including alterations in dorsolateral prefrontal cortex (dlPFC) functioning, have been described for BED. A targeted modulation of inhibitory control circuits by the combination of inhibitory control training and transcranial brain stimulation could be promising. Objective: The aim of the study was to demonstrate feasibility and clinical effects of a transcranial direct current stimulation (tDCS)-enhanced inhibitory control training to reduce BE episodes and to generate an empirical basis for a confirmatory trial. Methods: We performed a monocentric clinical phase II double-blind randomized trial with two parallel arms. Forty-one adult outpatients with full-syndrome BED according to DSM-5 received six sessions of food-related inhibitory control training, randomly combined with 2 mA verum or sham tDCS of the right dlPFC. The main outcome was BE frequency within a 4-week interval after treatment termination (T8; primary) and at 12-week follow-up (T9; secondary) as compared to baseline. Results: BE frequency was reduced in the sham group from 15.5 to 5.9 (T8) and to 6.8 (T9); in the verum group, the reduction was 18.6 to 4.4 (T8) resp. 3.8 (T9). Poisson regression with the study arm as the factor and baseline BE frequency as the covariate revealed a p value of 0.34 for T8 and 0.026 for T9. Sham and real tDCS differed at T9 in BE frequency. Conclusions: Inhibitory control training enhanced by tDCS is safe in patients with BED and results in a substantial and sustainable reduction in BE frequency which unfolds over several weeks post-treatment. These results constitute the empirical basis for a confirmatory trial.
Psychother Psychosom

中文翻译：

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通过经颅直流电刺激增强抑制控制训练以减少暴食事件：随机 II 期 ACCElect 试验的结果

简介：暴食症 (BED) 的特征是反复发作的暴食 (BE) 事件，并伴有失控。BED 已经描述了抑制性控制障碍，包括背外侧前额叶皮层 (dlPFC) 功能的改变。通过结合抑制控制训练和经颅脑刺激来有针对性地调节抑制控制回路可能是有希望的。目的：本研究的目的是证明经颅直流电刺激 (tDCS) 增强抑制控制训练减少 BE 发作的可行性和临床效果，并为验证性试验提供经验基础。方法：我们进行了一项具有两个平行臂的单中心临床 II 期双盲随机试验。根据 DSM-5，41 名患有全综合征 BED 的成年门诊患者接受了六次与食物相关的抑制控制训练，随机结合右侧 dlPFC 的 2 mA verum 或假 tDCS。主要结果是与基线相比，治疗终止后 4 周内（T8；主要）和 12 周随访（T9；次要）中的 BE 频率。结果：假手术组的 BE 频率从 15.5 降低到 5.9 (T8) 和 6.8 (T9)；在 verum 组中，分别减少了 18.6 至 4.4 (T8)。3.8（T9）。泊松回归以研究组为因子，基线 BE 频率作为协变量显示pT8 的值为 0.34，T9 的值为 0.026。假和真正的 tDCS 在 T9 的 BE 频率不同。结论：通过 tDCS 增强的抑制控制训练对 BED 患者是安全的，并且导致 BE 频率显着和可持续地降低，这在治疗后几周内展开。这些结果构成了验证性试验的经验基础。
心理医生