Abstract
Binge eating disorder (BED) is associated with deficient response inhibition. Malfunctioning response inhibition is linked to hypoactivation of the dorsolateral prefrontal cortex (dlPFC), where excitability could be increased by anodal transcranial direct current stimulation (tDCS). Response inhibition can be assessed using an antisaccade task which requires supressing a dominant response (i.e. saccade) towards a newly appearing picture in the visual field. We performed a double-blind, randomised, placebo-controlled proof-of-concept-study in which we combined a food-modified antisaccade task with tDCS in people with BED. We expected task learning and modulatory tDCS effects. Sixteen people were allocated to a 1 mA condition, 15 people to a 2 mA condition. Each participant underwent the food-modified antisaccade task at three measurement points: baseline without stimulation, anodal verum and sham stimulation at the right dlPFC in a crossover design. The error rate and the latencies of correct antisaccades decreased over time. No tDCS effect on the error rate could be observed. Compared to sham stimulation, 2 mA tDCS decreased the latencies of correct antisaccades, whereas 1 mA tDCS increased it. Self-reported binge eating episodes were reduced in the 2 mA condition, while there was no change in the 1 mA condition. Participants demonstrated increased response inhibition capacities by a task learning effect concerning the error rate and latencies of correct antisaccades over time as well as a nonlinear tDCS effect represented by ameliorated latencies in the 2 mA and impaired latencies in the 1 mA condition. The reduction of binge eating episodes might indicate a transfer effect to everyday life. Given that the reduction in binge eating was observed before tDCS administration, this effect could not be the result of neuromodulation. Randomized clinical trials are needed to fully understand this reduction, and to explore the efficacy of a combined antisaccade and tDCS training for BED.
Highlights
Since 2013, binge eating disorder (BED) is a distinct eating disorder diagnosis in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DMS-V)
In a modified antisaccade task with food vs. neutral control stimuli, it has been shown that participants with BED had more problems in inhibiting saccades towards food stimuli compared to matched normal weight and individuals with obesity who did not have an eating disorder [13]
In this double-blind, randomised, placebo-controlled proof of concept study, we investigated learning effects on a food-modified antisaccade task addressing response inhibition, and the effects of anodal 1 mA and 2 mA transcranial direct current stimulation (tDCS) to the right dorsolateral prefrontal cortex (dlPFC) in a sample with BED
Summary
Since 2013, binge eating disorder (BED) is a distinct eating disorder diagnosis in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DMS-V). An experienced loss of control is reported. An executive function to overcome or correct impulsive behaviour in favour of another reaction is cognitive control [9, 10]. In a modified antisaccade task with food vs neutral control stimuli, it has been shown that participants with BED had more problems in inhibiting saccades towards food stimuli compared to matched normal weight and individuals with obesity who did not have an eating disorder [13]. First attempts to use this response inhibition paradigm as a training programme for patients with BED in three sessions using only food stimuli delivered promising results that such a training might support patients to reduce binge eating episodes [14]
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