Abstract
Behavioural studies demonstrate alterations in cognitive functioning, particularly impaired response inhibition and increased attentional bias towards food in binge eating disorder (BED). This pilot study aimed to investigate the neurophysiological processing of a food-specific inhibition training combined with anodal transcranial direct current stimulation (tDCS) of the right dorsolateral prefrontal cortex (DLPFC) in 16 patients with BED (mean age = 38.6, mean BMI = 33.7 kg/m2). Patients performed a food-specific antisaccade task at baseline (T0) and in a cross-over design with verum vs. sham stimulation at T1 and T2. We investigated (i) event-related potentials (ERPs; N2, ERN and P3 amplitudes) while executing the task at baseline, (ii) whether baseline ERPs would predict task performance at T1 and T2 and (iii) associations between ERPs, eating disorder pathology and impulsivity at baseline. The mean amplitude of N2 was less pronounced in erroneous saccades (ES) than correct saccades (CS), whereas ERN and P3 mean amplitudes were more pronounced in ES. Moreover, the P3 mean amplitude of ES predicted the percentage of ES at both follow up-measurements irrespective of the applied stimulation (sham vs. verum). N2 in trials with correct saccades were negatively correlated with nonplanning trait impulsivity, while P3 in erroneous antisaccade trials was negatively correlated with food-related impulsivity. Overall, the findings of reduced ERN, enhanced P3 and N2 amplitude might be interpreted as difficulties in response inhibition towards food in individuals with BED. In particular, P3 predicts task outcome at follow-up and might represent a potential marker for inhibitory control processes.
Highlights
As the most recent eating disorder (ED) diagnostic category in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), binge eating disorder (BED) is characterised by recurrent binge eating episodes in which a person consumes a large amount of food in a discrete period of time
Concerning hypothesis 2, we looked at the association between EEG activity and performance in the food-modified antisaccade task, as well as the predictive value of EEG activity on task performance at follow-up appointments, a stepwise statistical procedure was used, due in part to the small sample size
Paired two-tailed t-tests revealed that the antisaccade task error rate (%) at T1 did not significantly differ from T0 (t(15) = 1.60, p = 0.131), nor did T1 significantly differ from T2 (t(14) = 0.82, p = 0.426)
Summary
As the most recent eating disorder (ED) diagnostic category in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), binge eating disorder (BED) is characterised by recurrent binge eating episodes in which a person consumes a large amount of food in a discrete period of time. Several reviews have demonstrated impaired response inhibition, executive planning, decision making, cognitive flexibility, as well as increased attentional biases and reward sensitivity to food related stimuli among individuals with BED (Kittel et al, 2015; Kessler et al, 2016; Giel et al, 2017b; Stojek et al, 2018). These concepts are all related to the personality trait impulsivity (Dawe and Loxton, 2004; Gullo et al, 2014; Sharma et al, 2014), and among patients with BED this is expressed through impulsive food-related behaviours (Giel et al, 2017b)
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