The neurobiological underpinnings of obesity point to brain asymmetry in cortical and deeper brain regions. Furthermore, chemical, structural and functional imbalance in cortical and sub-cortical brain regions alters reward processing, attentional control and self-regulation in food-addicted obese individuals. In this study the investigators use TMS with a special multichannel H-coil developed by their lab to safely stimulate cortical and deeper brain regions in obese humans. The investigators aim to produce interhemispheric neuroplasticity (INP) using a paired associative stimulation (PAS) protocol over the DLPFC, to restore neurobiological functioning, alleviate food addiction symptoms, and promote weight loss.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
A 3-week long treatment (15 days). Treatment session consist of 300 rapidly occurring pairs of pulses over the dorsolateral prefrontal cortex (at a frequency of 10 Hz and intensity of 110% of individual's motor threshold), with a 5-seconds interval, for a duration of 1800 seconds in total.
SorokaUMC
Beersheba, Israel
RECRUITINGChange in weight
Unit of measure: BMI in kg/m\^2 (weight in kilograms, height in meters)
Time frame: Change in weight between baseline versus the end of the treatment (day 15) and follow-up (a month after day 15)
Performance on a food Stroop test
Unit of measure: reaction time (in milliseconds)
Time frame: Change in performance between baseline versus the end of the treatment (day 15) and follow-up (a month after day 15)
Food addiction symptoms
Yale Food Addiction Scale (YFAS)
Time frame: Change between baseline versus the end of the treatment (day 15) and follow-up (a month after day 15)
Safety and tolerability of a PAS protocol using the multi-channel deep TMS system, measured via the number of adverse events (AE)
Measured via the number of adverse events
Time frame: Throughout the study period, estimated as 2 years
Eating behavior (cognitive restraint, disinhibition, and hunger)
Three Factor Eating Questionnaire (TFEQ)
Time frame: Change between baseline versus the end of the treatment (day 15) and follow-up (a month after day 15)
Quality of life
Health Status Scale Short-form 36 (SF-36)
Time frame: Change between baseline and the end of the treatment (day 15) and follow-up (a month after day 15)
Implementation of INP
1\. Acute change in INP, assessed via changes in cortical excitability (measured via EEG and TCI) between pre- and post PAS administration. 2. Chronic change in INP assessed as change in cortical excitability between baseline versus the end of the treatment (day 15) and follow up (measured via EEG and TCI)
Time frame: Changes in cortical excitability between baseline versus following 15 days of treatment
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