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The Effect of Hypocaloric Diet Associated With tDCS on Weight Loss and Metabolic Profile

6 de noviembre de 2017 actualizado por: Hospital de Clinicas de Porto Alegre

The Effect of Hypocaloric Diet Associated With tDCS on Weight Loss and Metabolic Profile: a Pilot, Double Blind, Randomized, Placebo-controlled Study

To compare four weeks of transcranial direct current stimulation (tDCS) versus placebo associated with a reduced caloric diet on weight loss, glycemic control and regulators of hunger and satiety in overweight or obese subjects with different degrees of glucose tolerance, submitted to hypocaloric diet.

Descripción general del estudio

Descripción detallada

In order to assess whether tDCS treatment associated with a reduced caloric diet can improve weight loss, overweight or obese subjects will be recruited by advertisement on the web page of Porto Alegre Clinical Hospital, local newspaper and television, or referred by a doctor or nutritionist, from external to HCPA services. After screening and selection, patients will undergo a clinical, laboratory and nutritional evaluation. There will be a standard assessment protocol that includes: a complete clinical evaluation and socioeconomic status, assessment of physical activity, questionnaires of quality of life, sleep, depression and anxiety and body composition assessment.

In the laboratory evaluation the biochemistry exams include an oral glucose tolerance test (OGGT 75g), a meal tolerance test (MTT), serum glucose, Cholesterol, HDL-cholesterol, triglycerides, glycated hemoglobin and glycated albumin. The resting metabolic rate will be determine by indirect calorimetry. Besides, a 100-mm visual-analog scales will be used to measure a self-reported ratings of appetite, hunger, satiety and food craving.

Patients will also be prescribed a low caloric diet and individual counseling from a dietician in order to reduce 3% of their initial weight over 4-week treatment. Moreover, they will do one tDCS session a day (active or sham stimulation as previous randomization) for 5 consecutive days, during these four weeks of treatment (20 sessions).

Transcranial direct current stimulation (tDCS) is a non-invasive method of brain stimulation in which a small current is applied to the scalp. This technique uses a weak safety current of 2 milliampere (mA) for 20 minutes which may increase (anodal tDCS) or decrease (cathodal tDCS) cortical excitability.

During all of tDCS sessions, a film with images of food that usually elicit craving will be presented and after the end of each session, visual analog scales will be applied to assess hunger, satiety and presence of food craving. Finally, attention and mood scales will be applied periodically in addition to a questionnaire of adverse effects and use of tDCS.

At the end of the 4-week diet and tDCS, all patients will be submitted to the same clinical, laboratory, nutrition and feeding behavior exams applied at baseline.

Finally, participants should come in 3 and 6 months after the end of the protocol for reassessment weight, body composition by bioelectrical impedance and answer questionnaires.

An interim analysis will be performed when 12 patients will be included.

Tipo de estudio

Intervencionista

Inscripción (Anticipado)

20

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • Rio Grande Do Sul
      • Porto Alegre, Rio Grande Do Sul, Brasil
        • Reclutamiento
        • Hospital de Clinicas de Porto Alegre
        • Contacto:
          • Fernando Gerchman, MD
          • Número de teléfono: +55 51 33598127
          • Correo electrónico: fgerchman@gmail.com
        • Contacto:

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

20 años a 50 años (Adulto)

Acepta Voluntarios Saludables

Sí

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  1. Women of childbearing potential who are using medically approved birth control methods (eg hormonal contraceptives, intra uterine device (IUDs), barrier contraception) and who agree to use the same methods of contraception throughout the course of the study.
  2. BMI 25 ≥ 35 Kg/m2 at screening
  3. Stable weight for at least 12 weeks prior to screening
  4. Able and willing to provide written informed consent and to comply with the requirements of the study protocol

Exclusion Criteria:

  1. Pregnant or intend to become pregnant during the study period or who are currently breastfeeding.
  2. Women in perimenopause / menopause, or postmenopausal status, or who have had early menopause (under 40 years) or have had a hysterectomy or oophorectomy.
  3. Diagnosis or history of diabetes Mellitus type 1, diabetes resulting from pancreatic injury or secondary forms of diabetes, such as, for example, Cushing's syndrome and acromegaly.

    3.1. Metabolic and acute complications of diabetes such as ketoacidosis and hyperosmolar coma within the past six months.

  4. Gastrointestinal disease clinically symptomatic including, among others, inflammatory bowel disease and/or malabsorption diseases.
  5. Have received nutritional counseling in the last six months by a nutritionist.
  6. History of severe depression or other serious psychiatric comorbidities.
  7. History of gastric bypass, antrectomy or small bowel resection.
  8. History of chronic pancreatitis or idiopathic acute pancreatitis
  9. Myocardial infarction (MI), coronary arteries bypass surgery, post-transplant cardiomyopathy or stroke in the last 6 months
  10. Any abnormality in clinical laboratory tests which might prevent safe participation in the study
  11. Diagnosed and / or treated tumor (except basal cell skin cancer, carcinoma in situ of the cervix or prostate cancer in situ) in the last five years.
  12. History of known hemoglobinopathy and chronic anemia.
  13. Donation of one unit (500 ml) of blood or more, significant blood loss equivalent to at least one unit of blood within the last 2 weeks or blood transfusion in the past 8 weeks.
  14. Treatment with any oral antidiabetic drugs and / or herbal preparations or medications that do not require a prescription and can affect glycemic control within 12 weeks prior to screening.
  15. Chronic treatment with oral or parenteral corticosteroids (> 7 consecutive days of treatment) within 4 weeks prior to screening.
  16. Treatment with weight loss agents (e.g., orlistat, sibutramine, topiramate, bupropion) in the last 12 weeks prior to screening.
  17. Treatment with mineral oil or fiber supplementation (e.g., Benefiber, Metamucil, among others).
  18. Treatment with lipid-lowering drugs which have not been kept on a stable dose for the past 8 weeks before screening.
  19. Treatment with thyroid replacement hormones which has not been kept on a stable dose for the past 12 weeks prior to screening.
  20. Use of drugs under investigation within 30 days or 5 half-lives (whichever is longer) before screening unless the guidelines of local health authorities require a longer period.
  21. Any of the following laboratory abnormalities identified in the screening by history and / or tests brought by the patient or that are part of this protocol, as described in section 4.3.4.6 of this project:

    21.1. Alanine aminotransferase (ALT) and / or Aspartate aminotransferase (AST) > 3 times the upper limit of normal 21.2. Glomerular filtration rate estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation ≤ 30 ml per min per 1,73 m2 21.3. Thyroid stimulating hormone (TSH) outside the normal range 21.4. Fasting triglycerides ≥ 400 mg / dL. 21.5. History of active substance abuse (including alcohol) within the past year

  22. Any condition or concomitant medical disorder, not provided for in other items which in the opinion of the investigator, probably:

    22.1. Interfere with the patient's ability to complete the entire study period or participate in all activities of the study 22.2. Require during the study, administration of a treatment that may affect the interpretation of efficacy and safety data

  23. Patients potentially unreliable and those considered by the investigator as unsuitable for the study

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Triple

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador activo: Active tDCS + Diet
The participants will receive active tDCS treatment every day for 5 days per week, a total of 20 sessions. They will also be prescribed a hypocaloric dietary during these 4-week treatment.
The anode electrode will be placed over F4 position and the cathode electrode over F3, right and left respectively (using EEG 10/20 system). The electric current will be ramped up until it reaches 2 milliampere (mA), and subjects will be stimulated for 20 min.
Otros nombres:
  • Activo
A hypocaloric dietary prescription and individual counseling from a dietician in order to reduce 3% of their initial weight over 4-week treatment.
Otros nombres:
  • Dieta
Comparador falso: Sham tDCS + Diet
The participants will receive sham tDCS treatment every day for 5 days per week, a total of 20 sessions. They will also be prescribed a hypocaloric dietary during these 4-week treatment.
A hypocaloric dietary prescription and individual counseling from a dietician in order to reduce 3% of their initial weight over 4-week treatment.
Otros nombres:
  • Dieta
The electrodes will be placed at the same positions as in active stimulation; however, the device will be turned off after 30 s of stimulation.
Otros nombres:
  • Placebo

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Weight loss
Periodo de tiempo: 4 weeks
3% weight loss
4 weeks

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Changes in hormone levels after 4 week treatment
Periodo de tiempo: baseline and 4 weeks
Changes in hormone levels of satiety, appetite and endocrine pancreas, such as insulin comparing baseline to end of intervention.
baseline and 4 weeks
Glycated Albumin
Periodo de tiempo: baseline and 4 weeks
Reduction in fasting glycated albumin compared to baseline
baseline and 4 weeks
Fasting Plasma Glucose
Periodo de tiempo: baseline and 4 weeks
Reduction in fasting plasma glucose from baseline
baseline and 4 weeks
Homeostatic Model Assessment (HOMA)
Periodo de tiempo: 4 weeks
Insulin sensitivity index (HOMA-S) and Beta-cell dysfunction (HOMA-beta)
4 weeks
Body Mass Index (BMI)
Periodo de tiempo: 4 weeks
Number of patients who achieved a BMI reduction unit
4 weeks
Intake of calories
Periodo de tiempo: 4 weeks
Reduction or maintenance of the prescribed intake of calories during the 4-week intervention, in kcal/day, using a 3 days of food record, with food weighing.
4 weeks
Weight, waist circumference and total body fat loss after 3 and 6 month of end of intervention
Periodo de tiempo: 3 and 6 month after end of intervention
weight and waist circumference loss
3 and 6 month after end of intervention

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Investigador principal: Fernando Gerchman, MD, Hospital de Clinicas de Porto Alegre

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de marzo de 2016

Finalización primaria (Anticipado)

1 de mayo de 2018

Finalización del estudio (Anticipado)

1 de agosto de 2018

Fechas de registro del estudio

Enviado por primera vez

11 de enero de 2016

Primero enviado que cumplió con los criterios de control de calidad

16 de febrero de 2016

Publicado por primera vez (Estimar)

17 de febrero de 2016

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

8 de noviembre de 2017

Última actualización enviada que cumplió con los criterios de control de calidad

6 de noviembre de 2017

Última verificación

1 de agosto de 2017

Más información

Términos relacionados con este estudio

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

INDECISO

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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