Abstract
The aim of this perspective is to propose and discuss the integration of transcranial magnetic stimulation (TMS) over the dorsolateral prefrontal cortex with virtual reality (VR) food exposure for therapeutic interventions for food addiction. “Food addiction” is a dysfunctional eating pattern which is typically observed in eating disorders (ED) such as bulimia nervosa and binge eating disorder. Food addiction has been compared to substance use disorder due to the necessity of consuming a substance (food) and the presence of a dependence behavior. In recent years, VR has been applied in the treatment of ED because it triggers psychological and physiological responses through food exposure in place of real stimuli. Virtual reality-Cue exposure therapy has been proven as a valid technique for regulating anxiety and food craving in ED. More, TMS has been proven to modulate circuits and networks implicated in neuropsychiatric disorders and is effective in treating addiction such as nicotine craving and consumption and cocaine use disorder. The combination of a simulative technology and a neurostimulation would presumably provide better improvement compared to a single intervention because it implies the presence of both cognitive and neuropsychological techniques. The possible advantage of this approach will be discussed in the perspective.
Highlights
“Food addiction” is a dysfunctional eating pattern typically observed in eating disorders (ED) such as bulimia nervosa (BN) and binge eating disorder (BED; Meule and Gearhardt, 2014)
Participants will be randomly assigned to the experimental condition which consists of eight sessions of active repetitive TMS (rTMS) + virtual reality (VR)-CET (N = 20) or to the control condition (N = 20) consisting in 8 sessions of sham rTMS + VRCET
Active rTMS will be delivered over the left DLPCF because neuromodulation over this region has been associated with decreased food craving and ED symptoms and with increased dopaminergic activity
Summary
“Food addiction” is a dysfunctional eating pattern typically observed in eating disorders (ED) such as bulimia nervosa (BN) and binge eating disorder (BED; Meule and Gearhardt, 2014). It has been compared to substance use disorder (SUD) due to the necessity of consuming a substance (food) and the presence of a dependence behavior (Meule and Gearhardt, 2014). Virtual reality-based Cue exposure therapy (VR-CET) represents a valid technique for regulating anxiety and food craving in weight and EDs (Ferrer-garcia et al, 2017). The combination of a simulative technology and a neurostimulation would presumably provide better improvement compared to a single intervention, because it copes with both cognitive-emotional and brain mechanism underpinning EDs. The possible advantages of this approach will be discussed in this perspective. The idea that specific kind of foods may have an addiction potential and that overeating may be an addicted behavior has been discussed (Meule and Gearhardt, 2014)
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