ObjectiveIndividuals with anorexia nervosa (AN) pursue low‐fat, low‐calorie diets even when in a state of emaciation. These maladaptive food choices may involve fronto‐limbic circuitry associated with cognitive control, habit, and reward. We assessed whether high‐frequency repetitive transcranial magnetic stimulation (rTMS) to the left dorsolateral prefrontal cortex (DLPFC) influenced food‐related choice behavior in patients with severe, enduring (SE)‐AN.MethodThirty‐four females with SE‐AN completed a Food Choice Task before and after 20 sessions of real or sham rTMS treatment and at a 4‐month follow‐up. During the task, participants rated high‐ and low‐fat food items for healthiness and tastiness and then made a series of choices between a neutral‐rated food and high‐ and low‐fat foods. Outcomes included the proportion of high‐fat and self‐controlled choices made. A comparison group of 30 healthy women completed the task at baseline only.ResultsBaseline data were consistent with previous findings: relative to healthy controls, SE‐AN participants showed a preference for low‐fat foods and exercised self‐control on a greater proportion of trials. There was no significant effect of rTMS treatment nor time on food choices related to fat content. However, among SE‐AN participants who received real rTMS, there was a decrease in self‐controlled food choices at post‐treatment, relative to baseline. Specifically, there was an increase in the selection of tasty‐unhealthy foods.DiscussionIn SE‐AN, rTMS may promote more flexibility in relation to food choice. This may result from neuroplastic changes in the DLPFC and/or in associated brain areas.

Background: Despite the growing number of studies on the use of non-invasive brain stimulation in people with schizophrenia, there is limited research on participant views of such treatment methods.Aim: Explore participant experiences and perceptions of transcranial direct current stimulation (tDCS).Methods: Twelve people with schizophrenia took part in semi-structured interviews after having completed 5 sessions of tDCS. Thematic analysis was used to identify codes and themes.Results: Five themes were identified: (1) motivation for study enrolment; (2) concerns about tDCS; (3) factors reducing the fear of tDCS; (4) experience of tDCS; (5) perceived effects of tDCS.Conclusions: The study provides insight into the perceptions and experiences of each individual. Participants were concerned about the safety of tDCS and associated it with invasive procedures such as electroconvulsive therapy and lobotomy. Educational materials and a good relationship with the researcher played an important role in reducing the fear of brain stimulation. All participants described tDCS as uncomfortable, however, agreed that unpleasant sensations only lasted for a short while (20 s−5 min). After the first session, participants no longer felt anxious about the remaining ones. Strategies to improve treatment experience and study recruitment have been identified.

Background: Antipsychotic drug-induced weight gain puts individuals with schizophrenia at increased cardiometabolic risk. As a potential intervention for this problem, we describe the theoretical background and a protocol for a feasibility randomised controlled trial (RCT) of approach bias modification (ABM) training combined with real versus sham (placebo) transcranial direct current stimulation (tDCS). The primary aim of this trial is to obtain information that will guide decision making and protocol development in relation to a future large-scale RCT of ABM and tDCS in this group of participants. Second, the study will assess the preliminary efficacy of ABM + tDCS in reducing food cravings in people who take antipsychotic medication.Methods: Thirty adults with a DSM-V diagnosis of schizophrenia or schizoaffective disorder treated with antipsychotic medication will be randomly allocated to receive five sessions that will combine ABM and real or sham tDCS, in a parallel group design. In this feasibility study, a broad range of outcome variables will be examined. Measures will include food craving, psychopathology (e.g. symptoms of schizophrenia and depression), neuropsychological processes (such as attentional bias and impulsiveness), and the tolerability and acceptability of tDCS. The feasibility of conducting a large-scale RCT of ABM + tDCS and appropriateness of tDCS as a treatment for antipsychotic drug-induced weight gain will be evaluated by assessment of recruitment and retention rates, acceptability of random allocation, blinding success (allocation concealment), completion of treatment sessions and research assessments (baseline, post-treatment and follow-up). Discussion:The effect sizes generated and other findings from this trial will inform a future large-scale RCT with respect to decisions on primary outcome measures and other aspects of protocol development. In addition, results from this study will provide a preliminary indication of the efficacy of ABM + tDCS treatment for antipsychotic druginduced weight gain.

Background Antipsychotic drug induced weight gain puts individuals with schizophrenia at increased cardiometabolic risk. As a potential intervention for this problem we describe the theoretical background and a protocol for a feasibility randomised controlled trial (RCT) of approach bias modification training (ABM) combined with real versus sham (placebo) transcranial direct current stimulation (tDCS). The primary aim of this trial is to obtain information that will guide decision making and protocol development in relation to a future large-scale RCT of ABM and tDCS in this group of participants. Secondly, the study will assess the preliminary efficacy of [ABM + tDCS] in reducing food cravings in people who take antipsychotic medication. Methods Thirty adults with a DSM-V diagnosis of schizophrenia or schizoaffective disorder treated with anti-psychotic medication will be randomly allocated to receive 5 sessions that will combine ABM and real or sham tDCS, in a parallel group design. In this feasibility study a broad range of outcome variables will be examined. Measures will include food craving, psychopathology (e.g. symptoms of schizophrenia and depression), neuropsychological processes (such as attentional bias, and impulsiveness) and the tolerability and acceptability of tDCS. The feasibility of conducting a large-scale RCT of [ABM + tDCS] and appropriateness of tDCS as a treatment for antipsychotic drug induced weight gain will be evaluated by assessment of recruitment and retention rates, acceptability of random allocation, blinding success (allocation concealment), completion of treatment sessions and research assessments (baseline, post-treatment and follow-up). Discussion The effect sizes generated and other findings from this trial will inform a future large-scale RCT with respect to decisions on primary outcome measures and other aspects of protocol development. In addition, results from this study will provide a preliminary indication of the efficacy of [ABM + tDCS] treatment for antipsychotic drug induced weight gain.

Background Antipsychotic drug induced weight gain puts individuals with schizophrenia at increased cardiometabolic risk. As a potential intervention for this problem we describe the theoretical background and a protocol for a feasibility randomised controlled trial (RCT) of approach bias modification training (ABM) combined with real versus sham (placebo) transcranial direct current stimulation (tDCS). The aim of this trial is to obtain information that will guide decision making and protocol development in relation to a future large-scale RCT of ABM and tDCS in this group of patients and, secondly, to assess the preliminary efficacy [ABM + tDCS] treatment. Methods Thirty adults with a DSM-V diagnosis of schizophrenia or schizoaffective disorder treated with anti-psychotic medication will be randomly allocated to receive 5 sessions that will combine ABM and real or sham tDCS, in a parallel group design. In this feasibility study a broad range of outcome variables will be examined and no primary outcomes have been defined. Measures will include food craving, psychopathology (e.g. symptoms of schizophrenia and depression), neuropsychological processes (such as attentional bias, and impulsiveness) and the tolerability and acceptability of tDCS. The feasibility of conducting a large-scale RCT of [ABM + tDCS] and appropriateness of tDCS as a treatment for antipsychotic drug induced weight gain will be evaluated by assessment of recruitment and retention rates, acceptability of random allocation, blinding success (allocation concealment), completion of treatment sessions and research assessments (baseline, post-treatment and follow-up). Discussion The effect sizes generated and other findings from this trial will inform a future large-scale RCT with respect to decisions on primary outcome measures and other aspects of protocol development. In addition, results from this study will provide a preliminary indication of the efficacy of [ABM + tDCS] treatment for antipsychotic drug induced weight gain.