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High frequency deep transcranial magnetic stimulation acutely increases β-endorphins in obese humans

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Abstract

Purpose

In obesity, metabolic and voluntary factors regulate appetite, and a dysregulation of the reward pathway was demonstrated in all addiction disorders. Deep transcranial magnetic stimulation (dTMS) is already used to modulate cerebral dopamine activation in neuro-psychiatric diseases. We presently assess the acute effect of high frequency (HF) and low frequency (LF) dTMS on the modulation of the main neuropeptides and neurotransmitters involved in the reward pathway in obese subjects.

Methods

This study was designed as a double-blind, sham-controlled, randomized clinical trial. Thirty-three obese patients (9 males, 24 females, age 48.1 ± 10.6, BMI 36.4 ± 4.7) were enrolled in the study. All patients were studied during a single dTMS session and blood aliquots were drawn before and after a single dTMS session. Metabolic and neuro-endocrine parameters were evaluated before and after: (1) 18 Hz dTMS (HF, 13 patients); (2) 1 Hz dTMS (LF, 10 patients); (3) Sham treatment (Sham, 10 patients).

Results

No statistically significant variations in metabolic parameters, systolic and diastolic blood pressure, and heart rate were shown acutely. HF showed a significant increase of β-endorphin compared to other groups (p = 0.048); a significant increase of ghrelin in LF (p = 0.041) was also demonstrated.

Conclusions

A single session of HF dTMS treatment determines in obese subjects an acute increase of β-endorphin level, indicating an activation of the reward pathway. The present findings constitute proof of principle for a potential application of this methodology in obesity treatment.

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Acknowledgements

This study was supported by the Italian Ministry of Health (RF-2011–02349303).

Funding

Prof. Livio Luzi was a recipient of a grant from the Italian Ministry of Health (RF-2011–02349303).

Author information

Authors and Affiliations

  1. Endocrinology and Metabolism Division and Metabolism Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy

    Anna Ferrulli, Concetta Macrì, Michela Adamo & Livio Luzi

  2. Laboratory of Nutrigenomics, Metabolism and Cell Differentiation, Diabetes Research Institute, San Raffaele Hospital, Milan, Italy

    Ileana Terruzzi

  3. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Federico Ambrogi

  4. Scientific Directorate, IRCCS Policlinico San Donato, Milan, Italy

    Valentina Milani

  5. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy

    Livio Luzi

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  1. Anna Ferrulli
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  7. Livio Luzi
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Contributions

LL and IT contributed to designing the research study. LL, AF, and CM conducted experiments; specifically, LL provided research conduct oversight; AF contributed to performing dTMS after a specific training, and to providing medical oversight; CM contributed to collecting blood samples. AF and MA contributed to acquiring data; FA and VM performed statistical analysis. AF, LL, MA, FA and VM contributed to writing the manuscript. As corresponding author, LL confirms that he had full access to all the data in the study and has final responsibility for the decision to submit for publication.

Corresponding author

Correspondence to Livio Luzi.

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The authors declare that they have no conflict of interest.

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Ferrulli, A., Macrì, C., Terruzzi, I. et al. High frequency deep transcranial magnetic stimulation acutely increases β-endorphins in obese humans. Endocrine 64, 67–74 (2019). https://doi.org/10.1007/s12020-018-1791-1

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  • DOI: https://doi.org/10.1007/s12020-018-1791-1

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