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Repetitive transcranial magnetic stimulation reduces cortisol concentrations in bulimic disorders

Published online by Cambridge University Press:  07 October 2010

A. M. Claudino ,
F. Van den Eynde ,
D. Stahl ,
T. Dew ,
M. Andiappan ,
J. Kalthoff ,
U. Schmidt  and
I. C. Campbell
A. M. Claudino*
Affiliation:
Institute of Psychiatry, King's College London, London, UK Department of Psychiatry, Federal University of São Paulo, Brazil
F. Van den Eynde
Affiliation:
Institute of Psychiatry, King's College London, London, UK
D. Stahl
Affiliation:
Institute of Psychiatry, King's College London, London, UK
T. Dew
Affiliation:
Department of Chemical Pathology, King's College NHS Trust, London, UK
M. Andiappan
Affiliation:
Institute of Psychiatry, King's College London, London, UK
J. Kalthoff
Affiliation:
Institute of Psychiatry, King's College London, London, UK
U. Schmidt
Affiliation:
Institute of Psychiatry, King's College London, London, UK
I. C. Campbell
Affiliation:
Institute of Psychiatry, King's College London, London, UK
*
*Address for correspondence: A. M. Claudino, M.D., Ph.D., Institute of Psychiatry, Section of Eating Disorders, PO59, De Crespigny Park, London SE5 8AF, UK. (Email: angelica.claudino@kcl.ac.uk)
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Abstract

Background

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.

Method

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.

Results

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.

Conclusions

These results suggest that rTMS applied to the left DLPFC alters HPAA activity in people with a bulimic disorder.

Keywords

Binge eatingcravingeating disordershypothalamic–pituitary–adrenal axisrepetitive transcranial magnetic stimulationsalivary cortisol
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 6 , June 2011 , pp. 1329 - 1336
Copyright
Copyright © Cambridge University Press 2010

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