Psychiatric profile and quality of life of subjects with excess weight treated with transcranial direct current stimulation combined with a hypocaloric diet

ABSTRACT

Background: Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) may reduce appetite and caloric intake and may be able to play a role as an adjunct treatment for obesity. Stimulation of this brain area is also used for the treatment of depression, which shares a common pathophysiology with obesity. As a result, the effect of tDCS on mental health and its impact on the quality of life of subjects with excess weight needs to be addressed.

Objective: To assess the effect of daily tDCS of the right DLPFC on mood, daytime sleepiness, anxiety and quality of life in subjects with excess weight on a hypocaloric diet.

Methods: We randomly assigned 28 subjects to receive 20 sessions of active or sham tDCS over the right DLPFC for 20 consecutive weekdays. The severity of depressive and anxiety symptoms was assessed by the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory-State (STAI-S). Sleepiness was measured by a daytime sleepiness questionnaire (DSQ), and quality of life was measured by the 36-Item Short Form Health Survey (SF-36).

Results: There were no significant changes in BDI, STAI-S and DSQ scores between groups, even after adjustments for the use of antidepressant medications and changes in body weight. There were also no significant changes in different subscales of the SF-36 quality of life questionnaire between groups.

Conclusion: Repetitive tDCS on the right DLPFC is not associated with impairment in mental health or quality of life in overweight and obese subjects.

KEYWORDS:

• TDCS
• depressive symptoms
• anxiety
• quality of life
• excess weight
• sleepiness
• DLPFC
• adverse effects

Acknowledgements

The authors acknowledge Professor Steven E. Kahn from the Department of Metabolism, Endocrinology and Nutrition of the University of Washington and Professor Mirela Jobim de Azevedo (in memoriam) from the Department of Internal Medicine of Universidade Federal do Rio Grande do Sul, who made important contributions to the design of this protocol. Hospital de Clínicas de Porto Alegre Research Fund (FIPE) provided financial support.

Contributors

CA, RCF and FG planned the study; GRN and CA collected the data; GRN, CA and FG analysed the data; GRN, CA, EB, PS and FG interpreted the data; GRN, CA and FG wrote the article; GRN made the figures; all authors read and approved the manuscript before submission. GRN and CA share first author status.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval

The study was approved by the local ethics committee (CAAE 42996915.0.0000.5327).

Additional information

Funding

This trial was supported by grants from the Hospital de Clínicas de Porto Alegre Research Fund [FIPE 15-0119], which did not have any role in the study design, data collection or writing of the manuscript.

Notes on contributors

Gabriella Richter Natividade

Gabriella Richter Natividade is an undergraduate student in the School of Medicine at Universidade Federal do Rio Grande do Sul, Brazil and is a doctorate student in the Postgraduate Program in Medical Science: Endocrinology in the same school.

Carina de Araujo

Carina de Araujo is a dietician and doctorate student in the Postgraduate Program in Medical Science: Endocrinology from Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.

Raquel Crespo Fitz

Raquel Crespo Fitz is a dietician with a master degree in Medical Science: Endocrinology from Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.

Elisa Brietzke

Elisa Brietzke is a psychiatrist and professor in the Department of Psychiatry, Queen's University School of Medicine, Kingston, Ontario, Canada.

Pedro Schestatsky

Pedro Schestatsky is professor of the Department of Internal Medicine at the school of Medicine of Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Fernando Gerchman

Fernando Gerchman is an Endocrinologist of the Division of Endocrinology and Metabolism of Hospital de Clínicas de Porto Alegre and professor of the Department of Internal Medicine and of the Postgraduate Course in Medical Science: Endocrinology of Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.