Combined antisaccade task and transcranial direct current stimulation to increase response inhibition in binge eating disorder

Sebastian M Max, Christian Plewnia, Stephan Zipfel, Katrin E Giel, Kathrin Schag, Sebastian M Max, Christian Plewnia, Stephan Zipfel, Katrin E Giel, Kathrin Schag

Abstract

Binge eating disorder (BED) is associated with deficient response inhibition. Malfunctioning response inhibition is linked to hypoactivation of the dorsolateral prefrontal cortex (dlPFC), where excitability could be increased by anodal transcranial direct current stimulation (tDCS). Response inhibition can be assessed using an antisaccade task which requires supressing a dominant response (i.e. saccade) towards a newly appearing picture in the visual field. We performed a double-blind, randomised, placebo-controlled proof-of-concept-study in which we combined a food-modified antisaccade task with tDCS in people with BED. We expected task learning and modulatory tDCS effects. Sixteen people were allocated to a 1 mA condition, 15 people to a 2 mA condition. Each participant underwent the food-modified antisaccade task at three measurement points: baseline without stimulation, anodal verum and sham stimulation at the right dlPFC in a crossover design. The error rate and the latencies of correct antisaccades decreased over time. No tDCS effect on the error rate could be observed. Compared to sham stimulation, 2 mA tDCS decreased the latencies of correct antisaccades, whereas 1 mA tDCS increased it. Self-reported binge eating episodes were reduced in the 2 mA condition, while there was no change in the 1 mA condition. Participants demonstrated increased response inhibition capacities by a task learning effect concerning the error rate and latencies of correct antisaccades over time as well as a nonlinear tDCS effect represented by ameliorated latencies in the 2 mA and impaired latencies in the 1 mA condition. The reduction of binge eating episodes might indicate a transfer effect to everyday life. Given that the reduction in binge eating was observed before tDCS administration, this effect could not be the result of neuromodulation. Randomized clinical trials are needed to fully understand this reduction, and to explore the efficacy of a combined antisaccade and tDCS training for BED.

Keywords: Antisaccade; Binge eating disorder; Cognitive control; Impulsivity; Response inhibition; Transcranial direct current stimulation.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
An overview of the three sessions (T0, T1 and T2) and the assessed data. The allocation to the two stimulation conditions (verum and sham stimulation) was randomized, counterbalanced and double-blind
Fig. 2
Fig. 2
An exemplary trial course. The trial starts with a 1250 ms lasting fixation. After an ISI with 200 ms, a food picture was presented for 1000 ms. Thereafter, the next trial starts again with a fixation
Fig. 3
Fig. 3
The error rate (mean, standard error) at each study appointment (T0, T1 and T2). * p < .05
Fig. 4
Fig. 4
The error rate (mean, standard error) depending on condition (1 mA vs. 2 mA) and stimulation (verum vs. sham) * p < .05
Fig. 5
Fig. 5
The latencies of correct antisaccades (mean, standard error) at each study appointment (T0, T1 and T2) * p < .05
Fig. 6
Fig. 6
The latencies of correct antisaccades (mean, standard error) depending on condition (1 mA vs. 2 mA) and stimulation (verum vs. sham) * p < .05
Fig. 7
Fig. 7
Self-reported frequency of binge eating episodes in the last 7 days (mean, standard error) depending on condition (1 mA vs. 2 mA) and session (T0, T1 and T2) * p < .05

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