Abstract
Specific alterations in electroencephalography (EEG)-based brain activity have recently been linked to binge-eating disorder (BED), generating interest in treatment options targeting these neuronal processes. This randomized-controlled pilot study examined the effectiveness and feasibility of two EEG neurofeedback paradigms in the reduction of binge eating, eating disorder and general psychopathology, executive functioning, and EEG activity. Adults with BED and overweight (N = 39) were randomly assigned to either a food-specific EEG neurofeedback paradigm, aiming at reducing fronto-central beta activity and enhancing theta activity after viewing highly palatable food pictures, or a general EEG neurofeedback paradigm training the regulation of slow cortical potentials. In both conditions, the study design included a waiting period of 6 weeks, followed by 6 weeks EEG neurofeedback (10 sessions à 30 min) and a 3-month follow-up period. Both EEG neurofeedback paradigms significantly reduced objective binge-eating episodes, global eating disorder psychopathology, and food craving. Approximately one third of participants achieved abstinence from objective binge-eating episodes after treatment without any differences between treatments. These results were stable at 3-month follow-up. Among six measured executive functions, only decision making improved at posttreatment in both paradigms, and cognitive flexibility was significantly improved after food-specific neurofeedback only. Both EEG neurofeedback paradigms were equally successful in reducing relative beta and enhancing relative theta power over fronto-central regions. The results highlight EEG neurofeedback as a promising treatment option for individuals with BED. Future studies in larger samples are needed to determine efficacy and treatment mechanisms.
Highlights
Binge-eating disorder (BED) is characterized by recurrent episodes of binge eating, during which an objectively large amount of food is consumed, accompanied by a feeling of loss of control over eating, without regular compensatory measures to prevent weight gain
Based on observations that alpha/theta training was successful in the reduction of substance cravings in individuals with substance use disorders, Imperatori et al [8] investigated the effects of a 10-session alpha/theta EEG neurofeedback in a healthy sample (n = 25) to reduce food craving compared to a waiting list control group (n = 25)
It was shown that a 10-session food-specific and general EEG neurofeedback paradigm were effective in reducing the number of objective binge-eating episodes (OBEs), the key clinical feature of binge-eating disorder (BED), without one paradigm being superior to the other
Summary
Binge-eating disorder (BED) is characterized by recurrent episodes of binge eating, during which an objectively large amount of food is consumed, accompanied by a feeling of loss of control over eating, without regular compensatory measures to prevent weight gain Schmidt and Martin [9, 10] applied a 10-session EEG neurofeedback with the rational of reducing high beta activity (23 to 28 Hz) over frontal brain regions to n = 14 and n = 25 restrained eaters with overeating tendencies. In these studies, it was shown that EEG neurofeedback successfully reduced food craving and overeating episodes compared to waitlist control groups (n = 13 and n = 25) and an active mental imagery group (n = 25). This study demonstrated a reduction of food craving and an increase in resting-state EEG alpha activity after treatment, without effects on other frequency bands compared to waitlist controls
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