Table 2.
Overview of the available ED-rTMS literature.
| Study | Subjects | Study design | Stimulation Site | rTMS Technique | Duty cycle (on/off s) | Total pulses/session | Stimulation Intensity | Number of sessions | Primary outcome | Findings |
|---|---|---|---|---|---|---|---|---|---|---|
| A | ||||||||||
| Uher et al., 2005 | n =28, F, FC | RCT | L-DLPFC, 5cm rule | 10 Hz | 5.55 s | 1000 | 110% MT | 1 | Cue-induced urge to eat | Food craving increased after sham stimulation |
| Barth et al., 2011 | n = 10, F, FC | RCT | L-PFC | 10 Hz | 10.20 s | 3000 | 100% RMT | 1 | Inhibition of cue-induced cravings | rTMS no better than sham |
| B | ||||||||||
| Van den Eynde et al., 2013 | n = 10, AN | RCT | L-DLPFC, 5 cm rule | 10 Hz rTMS | 5.55 s | 1000 | 110% MT | 1 | EDE-Q | Reduced levels of feeling full, fat, anxiety |
| C | ||||||||||
| Van den Eynde et al., 2010 | n = 38, bulimic-type ED | RCT | L-DLPFC, 5 cm rule | 10 Hz | 5.55 s | 1000 | 110% MT | 1 | Binge-eating episodes, urge to eat | Decreased urge to eat and binges 24 h post-stimulation |
| Claudino et al., 2011 | n = 22, bulimic-type ED | RCT | L-DLPFC | 10 Hz | 5.55 s | 1000 | 110% MT | 1 | Salivary cortisol concentration | Lower cortisol post-rTMS compared to sham |
| Walpoth et al., 2008 | n = 16, BN | RCT | L-DLPFC | 20 Hz | 10.60 s | 2000 | 120% MT | 15 sessions, daily | Binge/purge status | No significant difference between active and sham-rTMS |
| Hausmann et al., 2004 | n = 1, MDD-BN | Case report | L-DLPFC | 20 Hz | 10.60 s | 2000 | 80% MT | 10 sessions, daily | Binge/purge Diary | Remission of binge/purges, HDRS response |
| Downar et al., 2012 | n = 1, MDD-BN | Case report | B-DMPFC | 10 Hz | 5.10 s | 6000 | 120% RMT | 20 sessions, daily | Binge/purge status | Remission of binge/purges, HDRS response |
| Dunlop J. et al., 2015 | n = 28, bulimic-type ED | Open-label | B-DMPFC | 10 Hz | 5.10 s | 6000 | 120% RMT | 20–30 sessions, daily | Binge/purge status | 16 of 28 achieved >50% reduction of binges and purges 4-weeks post-rTMS |
A, rTMS studies related to food addiction and urges to eat; B and C, refer to rTMS studies related to AN and BN, respectively.
AN, anorexia nervosa; B-DMPFC, bilateral dorsomedial prefrontal cortex; BN, bulimia nervosa; ED, eating disorder; EDE-Q, eating disorder examination questionnaire; F, female; FC, food craving; HDRS, Hamilton Depression Rating Scale; L-DLPFC, left dorsolateral prefrontal cortex; L-PFC, left prefrontal cortex; MT, motor threshold; RCT, randomized control trial; RMT, resting motor threshold; rTMS, repetitive transcranial magnetic stimulation.