Enhancing the outcomes of bariatric surgery with inhibitory control training, electrical brain stimulation and psychosocial aftercare: a pilot study protocol.

IF 3.5 3区 医学 Q2 NUTRITION & DIETETICS
Sarah A Rösch, Lennart Wünsche, Carsten Thiele, Therese Reinstaller, Tino Zähle, Kathrin Schag, Katrin E Giel, Christian Plewnia, Johann Steiner, Florian Junne
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引用次数: 0

Abstract

Background: Notwithstanding the documented short- and long-term weight loss and remission of physical and mental diseases following bariatric surgery, a significant proportion of patients fail to respond (fully) to treatment in terms of physical and mental health improvement. Mounting evidence links food-specific impulsivity, prefrontal cortex (PFC) hypoactivity and disrupted hormone secretion in bariatric surgery candidates to poorer post-surgical health outcomes. Neuromodulatory treatments like transcranial direct current stimulation (tDCS) uniquely target these neurobehavioral impairments. We present a pilot study protocol offering tDCS combined with an inhibitory control training and a structured psychosocial intervention to patients after bariatric surgery.

Methods: A total of N = 20 patients are randomized to 6 sessions of verum or sham tDCS over the PFC, combined with an individualized food-specific inhibitory control training and a structured psychosocial intervention within 18 months after bariatric surgery (t0). Beyond acceptability, feasibility and satisfaction of the intervention, effects of verum versus sham tDCS on food-specific impulsivity and on secondary outcomes quality of life, general impulsivity and psychopathology, food-related cravings, eating disorder psychopathology, weight trajectory and endocrine markers are assessed 4 weeks (t1) and 3 months after the intervention (t2).

Discussion: Results will provide information on the potential of combining tDCS with an inhibitory control training and a structured psychosocial intervention to enhance physical and mental outcomes after bariatric surgery. The present study may guide the development of future research with regard to tDCS as a brain-based intervention and of future post-surgical clinical programs, paving the way for randomized-controlled trials in larger samples.

Trial registration: The trial was prospectively registered on July 8, 2024, under the registration number DRKS00034620 in the German Clinical Trials Register ( https://drks.de/search/de/trial/DRKS00034620 ).

通过抑制控制训练、脑电刺激和心理社会护理来提高减肥手术的效果:一项试点研究方案。
背景:尽管记录了减肥手术后短期和长期的体重减轻和身体和精神疾病的缓解,但很大一部分患者在身体和精神健康改善方面对治疗没有(完全)反应。越来越多的证据表明,减肥手术患者的食物特异性冲动、前额皮质(PFC)活性低下和激素分泌紊乱与术后健康状况较差有关。神经调节治疗,如经颅直流电刺激(tDCS)独特地针对这些神经行为障碍。我们提出了一项试点研究方案,为减肥手术后的患者提供tDCS结合抑制控制训练和结构化的社会心理干预。方法:在减肥手术后18个月内,共有N = 20名患者被随机分为6期的verum或假tDCS,并结合个体化食物特异性抑制控制训练和结构化心理社会干预。除了干预的可接受性、可行性和满意度外,在干预后4周(t1)和3个月(t2)评估verum和sham tDCS对食物特异性冲动性和次要结果的影响,包括生活质量、一般冲动性和精神病理学、食物相关的渴望、饮食失调精神病理学、体重轨迹和内分泌指标。讨论:结果将提供tDCS与抑制控制训练和结构化心理社会干预相结合的潜力信息,以提高减肥手术后的身体和心理结果。目前的研究可能会指导关于tDCS作为一种基于大脑的干预和未来的术后临床计划的未来研究的发展,为更大样本的随机对照试验铺平道路。试验注册:该试验已于2024年7月8日在德国临床试验注册中心(https://drks.de/search/de/trial/DRKS00034620)注册,注册号为DRKS00034620。
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来源期刊
Journal of Eating Disorders
Journal of Eating Disorders Neuroscience-Behavioral Neuroscience
CiteScore
5.30
自引率
17.10%
发文量
161
审稿时长
16 weeks
期刊介绍: Journal of Eating Disorders is the first open access, peer-reviewed journal publishing leading research in the science and clinical practice of eating disorders. It disseminates research that provides answers to the important issues and key challenges in the field of eating disorders and to facilitate translation of evidence into practice. The journal publishes research on all aspects of eating disorders namely their epidemiology, nature, determinants, neurobiology, prevention, treatment and outcomes. The scope includes, but is not limited to anorexia nervosa, bulimia nervosa, binge eating disorder and other eating disorders. Related areas such as important co-morbidities, obesity, body image, appetite, food and eating are also included. Articles about research methodology and assessment are welcomed where they advance the field of eating disorders.
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