Anna Ferrulli1, Concetta Macrì1, Ileana Terruzzi2, Federico Ambrogi3, Valentina Milani4, Michela Adamo1, Livio Luzi5,6. 1. Endocrinology and Metabolism Division and Metabolism Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy. 2. Laboratory of Nutrigenomics, Metabolism and Cell Differentiation, Diabetes Research Institute, San Raffaele Hospital, Milan, Italy. 3. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 4. Scientific Directorate, IRCCS Policlinico San Donato, Milan, Italy. 5. Endocrinology and Metabolism Division and Metabolism Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy. livio.luzi@unimi.it. 6. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. livio.luzi@unimi.it.
Abstract
PURPOSE: In obesity, metabolic and voluntary factors regulate appetite, and a dysregulation of the reward pathway was demonstrated in all addiction disorders. Deep transcranial magnetic stimulation (dTMS) is already used to modulate cerebral dopamine activation in neuro-psychiatric diseases. We presently assess the acute effect of high frequency (HF) and low frequency (LF) dTMS on the modulation of the main neuropeptides and neurotransmitters involved in the reward pathway in obese subjects. METHODS: This study was designed as a double-blind, sham-controlled, randomized clinical trial. Thirty-three obese patients (9 males, 24 females, age 48.1 ± 10.6, BMI36.4 ± 4.7) were enrolled in the study. All patients were studied during a single dTMS session and blood aliquots were drawn before and after a single dTMS session. Metabolic and neuro-endocrine parameters were evaluated before and after: (1) 18Hz dTMS (HF, 13 patients); (2) 1 Hz dTMS (LF, 10 patients); (3) Sham treatment (Sham, 10 patients). RESULTS: No statistically significant variations in metabolic parameters, systolic and diastolic blood pressure, and heart rate were shown acutely. HF showed a significant increase of β-endorphin compared to other groups (p = 0.048); a significant increase of ghrelin in LF (p = 0.041) was also demonstrated. CONCLUSIONS: A single session of HF dTMS treatment determines in obese subjects an acute increase of β-endorphin level, indicating an activation of the reward pathway. The present findings constitute proof of principle for a potential application of this methodology in obesity treatment.
RCT Entities:
PURPOSE: In obesity, metabolic and voluntary factors regulate appetite, and a dysregulation of the reward pathway was demonstrated in all addiction disorders. Deep transcranial magnetic stimulation (dTMS) is already used to modulate cerebral dopamine activation in neuro-psychiatric diseases. We presently assess the acute effect of high frequency (HF) and low frequency (LF) dTMS on the modulation of the main neuropeptides and neurotransmitters involved in the reward pathway in obese subjects. METHODS: This study was designed as a double-blind, sham-controlled, randomized clinical trial. Thirty-three obesepatients (9 males, 24 females, age 48.1 ± 10.6, BMI 36.4 ± 4.7) were enrolled in the study. All patients were studied during a single dTMS session and blood aliquots were drawn before and after a single dTMS session. Metabolic and neuro-endocrine parameters were evaluated before and after: (1) 18 Hz dTMS (HF, 13 patients); (2) 1 Hz dTMS (LF, 10 patients); (3) Sham treatment (Sham, 10 patients). RESULTS: No statistically significant variations in metabolic parameters, systolic and diastolic blood pressure, and heart rate were shown acutely. HF showed a significant increase of β-endorphin compared to other groups (p = 0.048); a significant increase of ghrelin in LF (p = 0.041) was also demonstrated. CONCLUSIONS: A single session of HF dTMS treatment determines in obese subjects an acute increase of β-endorphin level, indicating an activation of the reward pathway. The present findings constitute proof of principle for a potential application of this methodology in obesity treatment.
Entities:
Keywords:
Food craving; Ghrelin; Obesity; Transcranial magnetic stimulation; β-endorphin
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