Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T11:27:28.070Z Has data issue: false hasContentIssue false
  • English
  • Français

Repetitive transcranial magnetic stimulation reduces cortisol concentrations in bulimic disorders

Published online by Cambridge University Press:  07 October 2010

A. M. Claudino ,
F. Van den Eynde ,
D. Stahl ,
T. Dew ,
M. Andiappan ,
J. Kalthoff ,
U. Schmidt  and
I. C. Campbell
A. M. Claudino*
Affiliation:
Institute of Psychiatry, King's College London, London, UK Department of Psychiatry, Federal University of São Paulo, Brazil
F. Van den Eynde
Affiliation:
Institute of Psychiatry, King's College London, London, UK
D. Stahl
Affiliation:
Institute of Psychiatry, King's College London, London, UK
T. Dew
Affiliation:
Department of Chemical Pathology, King's College NHS Trust, London, UK
M. Andiappan
Affiliation:
Institute of Psychiatry, King's College London, London, UK
J. Kalthoff
Affiliation:
Institute of Psychiatry, King's College London, London, UK
U. Schmidt
Affiliation:
Institute of Psychiatry, King's College London, London, UK
I. C. Campbell
Affiliation:
Institute of Psychiatry, King's College London, London, UK
*
*Address for correspondence: A. M. Claudino, M.D., Ph.D., Institute of Psychiatry, Section of Eating Disorders, PO59, De Crespigny Park, London SE5 8AF, UK. (Email: angelica.claudino@kcl.ac.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

In people with bulimic eating disorders, exposure to high-calorie foods can result in increases in food craving, raised subjective stress and salivary cortisol concentrations. This cue-induced food craving can be reduced by repetitive transcranial magnetic stimulation (rTMS). We investigated whether rTMS has a similar effect on salivary cortisol concentrations, a measure of hypothalamic–pituitary–adrenal axis (HPAA) activity.

Method

We enrolled twenty-two female participants who took part in a double-blind randomized sham-controlled trial on the effects of rTMS on food craving. Per group, eleven participants were randomized to the real or sham rTMS condition. The intervention consisted of one session of high-frequency rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC). Salivary cortisol concentrations were assessed at four time points throughout the 90-min trial. To investigate differences in post-rTMS concentrations between the real and sham rTMS groups, a random-effects model including the pre-rTMS cortisol concentrations as covariates was used.

Results

Salivary cortisol concentrations following real rTMS were significantly lower compared with those following sham rTMS. In this sample, there was also a trend for real rTMS to reduce food craving more than sham rTMS.

Conclusions

These results suggest that rTMS applied to the left DLPFC alters HPAA activity in people with a bulimic disorder.

Keywords

Binge eatingcravingeating disordershypothalamic–pituitary–adrenal axisrepetitive transcranial magnetic stimulationsalivary cortisol
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 6 , June 2011 , pp. 1329 - 1336
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adam, TC, Epel, ES (2007). Stress, eating and the reward system. Physiology and Behavior 91, 449–458.CrossRefGoogle ScholarPubMed
Baeken, C, De Raedt, R, Leyman, L, Schiettecatte, J, Kaufman, L, Poppe, K, Vanderhasselt, MA, Anckaert, E, Bossuyt, A (2009 a). The impact of one HF-rTMS session on mood and salivary cortisol in treatment resistant unipolar melancholic depressed patients. Journal of Affective Disorders 113, 100–108.CrossRefGoogle ScholarPubMed
Baeken, C, De Raedt, R, Leyman, L, Schiettecatte, J, Poppe, K, Kaufman, L, Haes, M, Vanderhasselt, MA, Anckaert, E, D'Haenen, H (2009 b). The impact of one session of HF-rTMS on salivary cortisol in healthy female subjects. World Journal of Biological Psychiatry 10, 586–590.CrossRefGoogle ScholarPubMed
Barrot, M, Marinelli, M, Abrous, DN, Rouge-Pont, F, Le Moal, M, Piazza, PV (2000). The dopaminergic hyper-responsiveness of the shell of the nucleus accumbens is hormone-dependent. European Journal of Neuroscience 12, 973–979.CrossRefGoogle ScholarPubMed
Buchmann, AF, Laucht, M, Schmid, B, Wiedemann, K, Mann, K, Zimmermann, US (2010). Cigarette craving increases after a psychosocial stress test and is related to cortisol stress response but not to dependence scores in daily smokers. Journal of Psychopharmacology 24, 247–255.CrossRefGoogle Scholar
Cho, SS, Strafella, AP (2009). rTMS of the left dorsolateral prefrontal cortex modulates dopamine release in the ipsilateral anterior cingulate cortex and orbitofrontal cortex. PLoS One 4, e6725.CrossRefGoogle ScholarPubMed
Epel, E, Lapidus, R, McEwen, B, Brownell, K (2001). Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior. Psychoneuroendocrinology 26, 37–49.CrossRefGoogle ScholarPubMed
Evers, S, Hengst, K, Pecuch, PW (2001). The impact of repetitive transcranial magnetic stimulation on pituitary hormone levels and cortisol in healthy subjects. Journal of Affective Disorders 66, 83–88.CrossRefGoogle ScholarPubMed
Garde, AH, Hansen, AM (2005). Long-term stability of salivary cortisol. Scandinavian Journal of Clinical and Laboratory Investigation 65, 433–436.CrossRefGoogle ScholarPubMed
George, MS, Wassermann, EM, Williams, WA, Steppel, J, Pascual-Leone, A, Basser, P, Hallett, M, Post, RM (1996). Changes in mood and hormone levels after rapid-rate transcranial magnetic stimulation (rTMS) of the prefrontal cortex. Journal of Neuropsychiatry and Clinical Neurosciences 8, 172–180.Google ScholarPubMed
George, SA, Khan, S, Briggs, H, Abelson, JL (2010). CRH-stimulated cortisol release and food intake in healthy, non-obese adults. Psychoneuroendocrinology 35, 607–612.CrossRefGoogle ScholarPubMed
Giel, KE, Teufel, M, Friederich, HC, Hautzinger, M, Enck, P, Zipfel, S (2010). Processing of pictorial food stimuli in patients with eating disorders – a systematic review. International Journal of Eating Disorders. Published online: 2 February 2010. doi:10.1002/eat.2078.Google Scholar
Girdler, SS, Koo-Loeb, J, Pedersen, CA, Brown, HJ, Maixner, W (1998). Blood pressure-related hypoalgesia in bulimia nervosa. Psychosomatic Medicine 60, 736–743.CrossRefGoogle ScholarPubMed
Gluck, ME, Geliebter, A, Hung, J, Yahav, E (2004 a). Cortisol, hunger, and desire to binge eat following a cold stress test in obese women with binge eating disorder. Psychosomatic Medicine 66, 876–881.CrossRefGoogle ScholarPubMed
Gluck, ME, Geliebter, A, Lorence, M (2004 b). Cortisol stress response is positively correlated with central obesity in obese women with binge eating disorder (BED) before and after cognitive-behavioral treatment. Annals of the New York Academy of Sciences 1032, 202–207.CrossRefGoogle ScholarPubMed
Hedges, DW, Massari, C, Salyer, DL, Lund, TD, Hellewell, JL, Johnson, AC, Lephart, ED (2003). Duration of transcranial magnetic stimulation effects on the neuroendocrine stress response and coping behavior of adult male rats. Progress in Neuro-Psychopharmacology and Biological Psychiatry 27, 633–638.CrossRefGoogle ScholarPubMed
Hellhammer, DH, Wust, S, Kudielka, BM (2009). Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology 34, 163–171.CrossRefGoogle ScholarPubMed
Ji, RR, Schlaepfer, TE, Aizenman, CD, Epstein, CM, Qiu, D, Huang, JC, Rupp, F (1998). Repetitive transcranial magnetic stimulation activates specific regions in rat brain. Proceedings of the National Academy of Sciences of the USA 95, 15635–15640.CrossRefGoogle ScholarPubMed
Keck, ME, Welt, T, Post, A, Muller, MB, Toschi, N, Wigger, A, Landgraf, R, Holsboer, F, Engelmann, M (2001). Neuroendocrine and behavioral effects of repetitive transcranial magnetic stimulation in a psychopathological animal model are suggestive of antidepressant-like effects. Neuropsychopharmacology 24, 337–349.CrossRefGoogle Scholar
Koo-Loeb, JH, Costello, N, Light, KC, Girdler, SS (2000). Women with eating disorder tendencies display altered cardiovascular, neuroendocrine, and psychosocial profiles. Psychosomatic Medicine 62, 539–548.CrossRefGoogle ScholarPubMed
Koo-Loeb, JH, Pedersen, C, Girdler, SS (1998). Blunted cardiovascular and catecholamine stress reactivity in women with bulimia nervosa. Psychiatry Research 80, 13–27.CrossRefGoogle ScholarPubMed
Koob, GF, Volkow, ND (2010). Neurocircuitry of addiction. Neuropsychopharmacology 35, 217–238.CrossRefGoogle ScholarPubMed
Kudielka, BM, Hellhammer, DH, Wust, S (2009). Why do we respond so differently? Reviewing determinants of human salivary cortisol responses to challenge. Psychoneuroendocrinology 34, 2–18.CrossRefGoogle ScholarPubMed
Laessle, RG, Schulz, S (2009). Stress-induced laboratory eating behavior in obese women with binge eating disorder. International Journal of Eating Disorders 42, 505–510.CrossRefGoogle ScholarPubMed
Lattimore, P, Caswell, N (2004). Differential effects of active and passive stress on food intake in restrained and unrestrained eaters. Appetite 42, 167–173.CrossRefGoogle ScholarPubMed
Lester, NA, Keel, PK, Lipson, SF (2003). Symptom fluctuation in bulimia nervosa: relation to menstrual-cycle phase and cortisol levels. Psychological Medicine 33, 51–60.CrossRefGoogle ScholarPubMed
Lo Sauro, C, Ravaldi, C, Cabras, PL, Faravelli, C, Ricca, V (2008). Stress, hypothalamic–pituitary–adrenal axis and eating disorders. Neuropsychobiology 57, 95–115.CrossRefGoogle ScholarPubMed
Lowe, MR, Kral, TV (2006). Stress-induced eating in restrained eaters may not be caused by stress or restraint. Appetite 46, 16–21.CrossRefGoogle ScholarPubMed
Ludescher, B, Leitlein, G, Schaefer, JE, Vanhoeffen, S, Baar, S, Machann, J, Claussen, CD, Schick, F, Eschweiler, GW, Ludescher, B, Leitlein, G, Schaefer, J-E, Vanhoeffen, S, Baar, S, Machann, J, Claussen, CD, Schick, F, Eschweiler, GW (2009). Changes of body composition in bulimia nervosa: increased visceral fat and adrenal gland size. Psychosomatic Medicine 71, 93–97.CrossRefGoogle ScholarPubMed
Lustyk, MK, Olson, KC, Gerrish, WG, Holder, A, Widman, L (2010). Psychophysiological and neuroendocrine responses to laboratory stressors in women: implications of menstrual cycle phase and stressor type. Biological Psychology 83, 84–92.CrossRefGoogle ScholarPubMed
Mathes, WF, Brownley, KA, Mo, X, Bulik, CM (2009). The biology of binge eating. Appetite 52, 545–553.CrossRefGoogle ScholarPubMed
Neudeck, P, Florin, I, Tuschen-Caffier, B (2001). Food exposure in patients with bulimia nervosa. Psychotherapy and Psychosomatics 70, 193–200.CrossRefGoogle ScholarPubMed
Newman, E, O'Connor, DB, Conner, M (2007). Daily hassles and eating behaviour: the role of cortisol reactivity status. Psychoneuroendocrinology 32, 125–132.CrossRefGoogle ScholarPubMed
Nieuwenhuizen, AG, Rutters, F (2008). The hypothalamic–pituitary–adrenal–axis in the regulation of energy balance. Physiology and Behavior 94, 169–177.CrossRefGoogle ScholarPubMed
Piazza, PV, Le Moal, ML (1996). Pathophysiological basis of vulnerability to drug abuse: role of an interaction between stress, glucocorticoids, and dopaminergic neurons. Annual Review of Pharmacology and Toxicology 36, 359–378.CrossRefGoogle ScholarPubMed
Pirke, KM, Platte, P, Laessle, R, Seidl, M, Fichter, MM (1992). The effect of a mental challenge test of plasma norepinephrine and cortisol in bulimia nervosa and in controls. Biological Psychiatry 32, 202–206.CrossRefGoogle ScholarPubMed
Pogarell, O, Koch, W, Popperl, G, Tatsch, K, Jakob, F, Mulert, C, Grossheinrich, N, Rupprecht, R, Moller, HJ, Hegerl, U, Padberg, F (2007). Acute prefrontal rTMS increases striatal dopamine to a similar degree as d-amphetamine. Psychiatry Research 156, 251–255.CrossRefGoogle ScholarPubMed
Post, A, Keck, ME (2001). Transcranial magnetic stimulation as a therapeutic tool in psychiatry: what do we know about the neurobiological mechanisms? Journal of Psychiatric Research 35, 193–215.CrossRefGoogle ScholarPubMed
Pridmore, S (1999). Rapid transcranial magnetic stimulation and normalization of the dexamethasone suppression test. Psychiatry and Clinical Neurosciences 53, 33–37.CrossRefGoogle ScholarPubMed
Reuter, M, Hennig, J (2003). Cortisol as an indicator of dopaminergic effects on nicotine craving. Human Psychopharmacology 18, 437–446.CrossRefGoogle ScholarPubMed
Reuter, M, Netter, P, Rogausch, A, Sander, P, Kaltschmidt, M, Dorr, A, Hennig, J (2002). The role of cortisol suppression on craving for and satisfaction from nicotine in high and low impulsive subjects. Human Psychopharmacology 17, 213–224.CrossRefGoogle ScholarPubMed
Roberts, C, Troop, N, Connan, F, Treasure, J, Campbell, IC (2007). The effects of stress on body weight: biological and psychological predictors of change in BMI. Obesity (Silver Spring) 15, 3045–3055.CrossRefGoogle ScholarPubMed
Rojo, L, Conesa, L, Bermudez, O, Livianos, L (2006). Influence of stress in the onset of eating disorders: data from a two-stage epidemiologic controlled study. Psychosomatic Medicine 68, 628–635.CrossRefGoogle ScholarPubMed
Rutters, F, Nieuwenhuizen, AG, Lemmens, SG, Born, JM, Westerterp-Plantenga, MS (2009). Acute stress-related changes in eating in the absence of hunger. Obesity (Silver Spring) 17, 72–77.CrossRefGoogle ScholarPubMed
Sinha, R (2008). Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Sciences 1141, 105–130.CrossRefGoogle ScholarPubMed
Uher, R, Yoganathan, D, Mogg, A, Eranti, SV, Treasure, J, Campbell, IC, McLoughlin, DM, Schmidt, U (2005). Effect of left prefrontal repetitive transcranial magnetic stimulation on food craving. Biological Psychiatry 58, 840–842.CrossRefGoogle ScholarPubMed
Van den Eynde, F, Claudino, AM, Mogg, A, Horrell, L, Stahl, D, Ribeiro, W, Uher, R, Campbell, I, Schmidt, U (2010). Repetitive transcranial magnetic stimulation reduces cue-induced food craving in bulimic disorders. Biological Psychiatry 67, 793–795.CrossRefGoogle ScholarPubMed
Wallis, DJ, Hetherington, MM (2009). Emotions and eating. Self-reported and experimentally induced changes in food intake under stress. Appetite 52, 355–362.CrossRefGoogle ScholarPubMed
Zwanzger, P, Baghai, TC, Padberg, F, Ella, R, Minov, C, Mikhaiel, P, Schule, C, Thoma, H, Rupprecht, R (2003). The combined dexamethasone–CRH test before and after repetitive transcranial magnetic stimulation (rTMS) in major depression. Psychoneuroendocrinology 28, 376–385.CrossRefGoogle ScholarPubMed