Immediate cognitive effects of repetitive Transcranial Magnetic Stimulation in eating disorders: A pilot study

  • F. Van den Eynde
  • A. M. Claudino
  • I. C. Campbell
  • U. Schmidt
Brief Report


OBJECTIVE: The aim of this study was to evaluate the effects of high frequency repetitive Transcranial Magnetic Stimulation (rTMS), delivered to the dorsolateral prefrontal cortex, on selective attention in people with a bulimic disorder. METHOD: Participants (N=33) were randomised to a single session of real or sham rTMS. They performed a Stroop colour word task before and after the rTMS intervention. Interference scores were calculated as the time difference between completing cards with congruent and incongruent stimuli. RESULTS: Analysis of covariance comparing the interference scores post-rTMS with the pre-rTMS scores as covariates showed no differences between the real and sham groups [F(1,32)=1.110; p=0.301]. DISCUSSION: While methodological issues warrant a cautious interpretation, these pilot data suggest that selective attention is unaffected by a single session of rTMS.

Key words

Eating disorders rTMS Stroop cognition bulimia nervosa EDNOS 


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  1. 1.
    Slotema CW, Blom JD, Hoek HW, et al. Should we expand the toolbox of psychiatric treatment methods to include Repetitive Transcranial Magnetic Stimulation (rTMS)? a meta-analysis of the efficacy of rTMS in psychiatric disorders. J Clin Psychiatry 2010; 71: 873–84.PubMedCrossRefGoogle Scholar
  2. 2.
    Schlaepfer TE, George MS, Mayberg H. WFSBP Guidelines on Brain Stimulation Treatments in Psychiatry. World J Biol Psychiatry 2010; 11: 2–18.PubMedCrossRefGoogle Scholar
  3. 3.
    Walpoth M, Hoertnagl C, Mangweth-Matzek B, et al. Repetitive transcranial magnetic stimulation in bulimia nervosa: preliminary results of a single-centre, randomised, double-blind, sham-controlled trial in female outpatients. Psychother Psychosom 2008; 77: 57–60.PubMedCrossRefGoogle Scholar
  4. 4.
    Van den Eynde F, Claudino AM, Mogg A, et al. Repetitive transcranial magnetic stimulation reduces cue-induced food craving in bulimic disorders. Biol Psychiatry 2010; 67: 793–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Claudino AM, Van den Eynde F, Stahl D, et al. Repetitive transcranial magnetic stimulation reduces cortisol levels in bulimic disorders. Psychol Med 2010; 7: 1–8.Google Scholar
  6. 6.
    Van den Eynde F, Claudino AM, Campbell I, et al. Cardiac safety of repetitive transcranial magnetic stimulation in bulimic eating disorders. Brain Stimulation 2011; 4: 112–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Uher R, Yoganathan D, Mogg A, et al. Effect of left prefrontal repetitive transcranial magnetic stimulation on food craving. Biol Psychiatry 2005; 58: 840–2.PubMedCrossRefGoogle Scholar
  8. 8.
    Guse B, Falkai P, Wobrock T. Cognitive effects of highfrequency repetitive transcranial magnetic stimulation: a systematic review. J Neural Transm 2010; 117: 105–22.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Banich MT, Milham MP, Jacobson BL, et al. Attentional selection and the processing of task-irrelevant information: insights from fMRI examinations of the Stroop task. Prog Brain Res 2001; 134: 459–70.PubMedCrossRefGoogle Scholar
  10. 10.
    Johansson L, Ghaderi A, Andersson G. Stroop interference for food- and body-related words: a metaanalysis. Eat Behav 2005; 6: 271–81.PubMedCrossRefGoogle Scholar
  11. 11.
    Carter FA, Bulik CM, McIntosh VV, et al. Changes on the stroop test following treatment: relation to word type, treatment condition, and treatment outcome among women with bulimia nervosa. Int J Eat Disord 2000; 28: 349–55.PubMedCrossRefGoogle Scholar
  12. 12.
    Van den Eynde F, Guillaume S, Broadbent H, et al. Neurocognition in bulimic eating disorders: a systematic review. Acta Psychiatr Scand, doi: 10.1111/j.1600- 0447.2011.01701.x., 2011.Google Scholar
  13. 13.
    Stroop JR. Studies of interference in serial verbal reactions. J Exp Psychol 1935; 18: 643–62.CrossRefGoogle Scholar
  14. 14.
    Davidson DJ, Zacks RT, Williams CC. Stroop interference, practice, and aging. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2003; 10: 85–98.PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Schroeter ML, Zysset S, Wahl M, et al. Prefrontal activation due to Stroop interference increases during development — an event-related fNIRS study. Neuroimage 2004; 23: 1317–25.PubMedCrossRefGoogle Scholar
  16. 16.
    Hadland KA, Rushworth MF, Passingham RE, et al. Interference with performance of a response selection task that has no working memory component: an rTMS comparison of the dorsolateral prefrontal and medial frontal cortex. J Cogn Neurosci 2001; 13: 1097–108.PubMedCrossRefGoogle Scholar
  17. 17.
    Rektorova I, Megova S, Bares M, et al. Cognitive functioning after repetitive transcranial magnetic stimulation in patients with cerebrovascular disease without dementia: a pilot study of seven patients. J Neurol Sci 2005; 229–230: 157–61.PubMedCrossRefGoogle Scholar
  18. 18.
    Martis B, Alam D, Dowd SM, et al. Neurocognitive effects of repetitive transcranial magnetic stimulation in severe major depression. Clin Neurophysiol 2003; 114: 1125–32.PubMedCrossRefGoogle Scholar
  19. 19.
    Hausmann A, Pascual-Leone A, Kemmler G, et al. No deterioration of cognitive performance in an aggressive unilateral and bilateral antidepressant rTMS addon trial. J Clin Psychiatry 2004; 65: 772–82.PubMedCrossRefGoogle Scholar
  20. 20.
    Wagner M, Rihs TA, Mosimann UP, et al. Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex affects divided attention immediately after cessation of stimulation. J Psychiatr Res 2006; 40: 315–21.PubMedCrossRefGoogle Scholar
  21. 21.
    Vanderhasselt MA, De Raedt R, Baeken C, et al. The influence of rTMS over the left dorsolateral prefrontal cortex on Stroop task performance. Exp Brain Res 2006; 169: 279–82.PubMedCrossRefGoogle Scholar
  22. 22.
    Mosimann UP, Schmitt W, Greenberg BD, et al. Repetitive transcranial magnetic stimulation: a putative add-on treatment for major depression in elderly patients. Psychiatry Res 2004; 126: 123–33.PubMedCrossRefGoogle Scholar
  23. 23.
    Moser DJ, Jorge RE, Manes F, et al. Improved executive functioning following repetitive transcranial magnetic stimulation. Neurology 2002; 58: 1288–90.PubMedCrossRefGoogle Scholar
  24. 24.
    Jorge RE, Robinson RG, Tateno A, et al. Repetitive transcranial magnetic stimulation as treatment of poststroke depression: a preliminary study. Biol Psychiatry 2004; 55: 398–405.PubMedCrossRefGoogle Scholar
  25. 25.
    Boggio PS, Fregni F, Bermpohl F, et al. Effect of repetitive TMS and fluoxetine on cognitive function in patients with Parkinson’s disease and concurrent depression. Mov Disord 2005; 20: 1178–84.PubMedCrossRefGoogle Scholar
  26. 26.
    Avery DH, Holtzheimer PE 3rd, Fawaz W, et al. A controlled study of repetitive transcranial magnetic stimulation in medication-resistant major depression. Biol Psychiatry 2006; 59: 187–94.PubMedCrossRefGoogle Scholar

Copyright information

© Editrice Kurtis2011 2011

Authors and Affiliations

  • F. Van den Eynde
    • 1
  • A. M. Claudino
    • 1
    • 2
  • I. C. Campbell
    • 1
  • U. Schmidt
    • 1
  1. 1.Institute of Psychiatry, Section of Eating DisordersKing’s College LondonLondonUK
  2. 2.Department of PsychiatryFederal University of São PauloBrazil

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