transcranial magnetic stimulation (tms) in obesity

Conditions: Obesity; Food Craving; Appetite and General Nutritional Disorders

Summary: obesity is a metabolic disease that has reached epidemic proportions. insofar no long-term effective drug treatment was developed for obesity. lyfe style modulation and bariatric surgery are the only interventions with a limited rate of success. obesity is due to several factors, mainly linked to a neurophysiological mechanism of "food addiction". the use of repetitive deep transcranial magnetic stimulation (dtms) was proposed to reduce appetite and food craving in obese subjects, leading eventually to a weight reduction. dtms was already tested successfully in other forms of addiction (smoking, alcohol, cocaine) and the usefulness of dtms in the treatment of food addiction, and therefore in obesity, was hypothesized. end-points of this research will be: 1) effect on food craving; 2) acute and chronic effects on blood level of hormones acting on the appetite regulation; 3) chronic effects on body weight. the demonstration that a safe, non-invasive and repeatable methodology can treat obesity reducing food craving and modulating appetite/satiety hormones secretion will constitute a cornerstone in translational medicine of metabolic diseases.


Eligibility criteria:
inclusion criteria: 1. age: 22-65 years 2. if the patient is taking medications, it must take on a stable dose for at least a month 3. obesity: ≤ 30 bmi ≤ 45 4. ability to follow verbal or written instructions. exclusion criteria: 1. axis-i and ii psychiatric disorders according to dsm criteria 5 (such as major depression, bipolar disorder, or attention deficit disorder) 2. iq score \< 85 3. organic brain disorders: history of stroke, brain major surgery or head trauma 4. pregnancy or lactation, absence of medically approved contraceptive methods in females of childbearing potential 5. serious or poorly controlled diseases (hepatic, renal or hearth failure, atrial fibrillation or other heart rhythm disorders) 6. h yperglycemia - fasting glucose level \> 170 mg/dl 7. urine drug screen positive for amphetamines, barbiturates, cannabinoids, cocaine metabolites, opiates and phencyclidine 8. positivity to blood alcohol test 9. metal in any part of the head, except for dental fillings 10. implanted infusion pumps 11. intracardiac devices (pacemakers, heart valves ...) 12. history of diseases whose exacerbation could be fatal (e.g. cardiovascular disease, increased intracranial pressure) 13. history of epilepsy or a family history of epilepsy among first-degree relatives 14. medications associated with lowered seizure threshold (such as antidepressants, anxiolytics...) 15. treatment with anti-obesity medications or other medications influencing body weight within 3 month prior to screening visit 16. starting a weight loss plan at any time during data collection for the subject 17. patients affected by galactosemia, priapism and terminal illness 18. patients on fluid restriction for siadh or other conditions 19. contraindications to perform the magnetic resonance imaging (mri).

Keywords: transcranial magnetic stimulation obesity food craving appetite/satiety hormones fmri intestinal microbiota physical activity