High-Frequency rTMS to Treat Refractory Binge Eating Disorder and Comorbid Depression: A Case Report
Tathiana Pires Baczynski, Carolina Hanna de Aquino Chaim, Bruno Palazzo Nazar, Mauro Giovanni Carta, Oscar Arias-Carrion, Adriana Cardoso Silva, Sergio Machado and Antonio Egidio Nardi
Affiliation: Institute of Psychiatry, Federal Univesity of Rio de Janeiro (IPUB/UFRJ), Brazil.
Binge eating disorder (BED) has limited therapeutic options. Repetitive transcranial magnetic stimulation
(rTMS) is a modulation technique of cortical excitability that has shown good results in treating certain psychiatric
disorders by correcting dysfunctional cortical regions. We hypothesize that rTMS could be an alternative therapy for BED
through potential modulation action on frontostriatal abnormalities and dopaminergic pathways noted by neuroimaging.
We report the case of a young woman presenting refractory BED and comorbid depression treated with 20 sessions of
rTMS for 30 minutes over the left dorsolateral prefrontal cortex at 10 Hz for about a month (2400 stimuli per day). She
answered two self-report questionnaires, the Binge Eating Scale (BES) and the Beck Depression Inventory (BDI). Before
rTMS treatment, the BES score was 38, and the BDI score was 42. Three days after rTMS treatment, the BES score was
27 and the BDI score was 23, and the patient referred to no binge eating episodes for that week. Therefore, rTMS could
offer a new option of treatment for BED and comorbid depression.
Keywords: Binge eating disorder, depression, dopamine, frontostriatal pathways, obesity, repetitive transcranial magnetic
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