Repetitive Transcranial Magnetic Stimulation: A Potential Treatment for Obesity in Patients with Schizophrenia

Abstract

Obesity is highly prevalent in patients with schizophrenia and, in association with metabolic syndrome, contributes to premature deaths of patients due to cardiovascular disease complications. Moreover, pharmacologic, and behavioral interventions have not stemmed the tide of obesity in schizophrenia. Therefore, novel effective interventions are urgently needed. Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy for inducing weight loss in obese non-psychiatric samples but this promising intervention has not been evaluated as a weight loss intervention in patients with schizophrenia. In this narrative review, we describe three brain mechanisms (hypothalamic inflammation, dysregulated mesocorticolimbic reward system, and impaired prefrontal cortex function) implicated in the pathogenesis and pathophysiology of obesity and emphasize how the three mechanisms have also been implicated in the neurobiology of schizophrenia. We then argue that, based on the three overlapping brain mechanisms in obesity and schizophrenia, rTMS would be effective as a weight loss intervention in patients with schizophrenia and comorbid obesity. We end this review by describing how deep TMS, relative to conventional TMS, could potentially result in larger effect size for weight loss. While this review is mainly conceptual and based on an extrapolation of findings from non-schizophrenia samples, our aim is to stimulate research in the use of rTMS for weight loss in patients with schizophrenia.

Effect of Repetitive Transcranial Magnetic Stimulation in Inducing Weight Loss in Patients with Chronic Schizophrenia: A Randomized, Double-Blind Controlled 4-Week Study

“…Specifically, a most recent review speculates that rTMS can effectively reduce excessive food consumption and promote weight loss in SZ patients after citing those recent findings in non-SZ individuals [ 27 ]. For example, three previous pilot RCTs reported that rTMS could reduce the consumption of foods and cause body weight loss in the general population [ 18 , 25 , 26 ].…”

Low-frequency repetitive magnetic stimulation suppresses neuroblastoma progression by downregulating the Wnt/β-catenin signaling pathway

“…rMS frequency is considered to be the primary determinant of differential effects in various types of diseases [6]. Generally, clinical rMS has been classified as high-frequency (>5 Hz) and low-frequency (≤1 Hz) [7][8][9]. High-frequency stimulation has an excitatory effect, whereas low-frequency stimulation has an inhibitory effect [10,11].…”