Abstract：
BACKGROUND: Binge eating disorder (BED) is a common and disabling condition, typically presenting with multiple psychiatric and obesity-related comorbidities. Evidence-based treatments are either resource-intensive (psychotherapies) or have side-effects (medications): these achieve remission in around 50% of cases. Novel treatments are needed.
OBJECTIVE: This randomised sham-controlled trial aimed to assess feasibility, acceptability and preliminary efficacy of at-home, self-administered transcranial direct current stimulation (tDCS) and attention bias modification training (ABMT) in adults with binge eating disorder.
METHODS: Eighty-two participants with binge eating disorder were randomly allocated to real tDCS with ABMT, sham tDCS with ABMT, ABMT only or waitlist control. Intervention groups received ten sessions of their allocated treatment over 2-3 weeks. tDCS (2 mA, 20 min) was self-administered using a bilateral (anode right/cathode left) montage targeting the dorsolateral prefrontal cortex. Outcomes were assessed at baseline, post-treatment and 6-week follow-up.
RESULTS: Prespecified feasibility criteria (recruitment ≥80 participants and retention rate ≥75%) were exceeded, and treatment completion rates were high (98.7%). All interventions reduced binge eating episodes, eating disorder symptoms and related psychopathology between baseline and follow-up, relative to waitlist control (medium-to-large between-group effect sizes for change scores). Small-to-medium effect sizes for change scores favoured real tDCS with ABMT versus comparators, suggesting the verum intervention produces superior outcomes.
CONCLUSIONS: At-home, self-administered tDCS with ABMT is feasible and acceptable, and preliminary data on efficacy are promising. This approach could be a useful and scalable alternative or adjunct to established treatments for binge eating disorder. Confirmatory trials can, and should, be pursued.
OBJECTIVE: This randomised sham-controlled trial aimed to assess feasibility, acceptability and preliminary efficacy of at-home, self-administered transcranial direct current stimulation (tDCS) and attention bias modification training (ABMT) in adults with binge eating disorder.
METHODS: Eighty-two participants with binge eating disorder were randomly allocated to real tDCS with ABMT, sham tDCS with ABMT, ABMT only or waitlist control. Intervention groups received ten sessions of their allocated treatment over 2-3 weeks. tDCS (2 mA, 20 min) was self-administered using a bilateral (anode right/cathode left) montage targeting the dorsolateral prefrontal cortex. Outcomes were assessed at baseline, post-treatment and 6-week follow-up.
RESULTS: Prespecified feasibility criteria (recruitment ≥80 participants and retention rate ≥75%) were exceeded, and treatment completion rates were high (98.7%). All interventions reduced binge eating episodes, eating disorder symptoms and related psychopathology between baseline and follow-up, relative to waitlist control (medium-to-large between-group effect sizes for change scores). Small-to-medium effect sizes for change scores favoured real tDCS with ABMT versus comparators, suggesting the verum intervention produces superior outcomes.
CONCLUSIONS: At-home, self-administered tDCS with ABMT is feasible and acceptable, and preliminary data on efficacy are promising. This approach could be a useful and scalable alternative or adjunct to established treatments for binge eating disorder. Confirmatory trials can, and should, be pursued.
摘要：
背景：暴食症（BED）是一种常见且致残的疾病，通常表现为多种精神病和肥胖相关的合并症。循证治疗要么是资源密集型（心理治疗），要么有副作用（药物）：这些治疗在大约50％的病例中获得缓解。需要新的治疗方法。
目的：这项随机假对照试验旨在评估可行性，在家的可接受性和初步功效，在暴饮暴食症的成年人中，自我管理的经颅直流电刺激（tDCS）和注意力偏见修正训练（ABMT）。
方法：82名暴食症患者被随机分配到使用ABMT的真实tDCS，假tDCS与ABMT，仅ABMT或waitlist控件。干预组在2-3周内接受了十次分配的治疗。tDCS(2mA,20分钟）使用针对背外侧前额叶皮层的双侧（阳极右/阴极左）蒙太奇进行自我管理。结果在基线评估，治疗后和6周随访。
结果：超过了预定的可行性标准（招募≥80名参与者和保留率≥75％），治疗完成率高（98.7%）。所有干预措施都减少了暴饮暴食事件，基线和随访之间的进食障碍症状和相关的精神病理学，相对于waitlist对照(变化分数的中等到大的组间效应大小)。与比较器相比，变化分数的中小效应大小有利于ABMT的实际tDCS，表明verum干预产生了更好的结果。
结论：在家里，使用ABMT自我管理的tDCS是可行和可接受的，和疗效的初步数据是有希望的。这种方法可能是对暴食症的既定治疗方法的有用且可扩展的替代或辅助方法。验证性试验可以，并且应该，被追求。
目的：这项随机假对照试验旨在评估可行性，在家的可接受性和初步功效，在暴饮暴食症的成年人中，自我管理的经颅直流电刺激（tDCS）和注意力偏见修正训练（ABMT）。
方法：82名暴食症患者被随机分配到使用ABMT的真实tDCS，假tDCS与ABMT，仅ABMT或waitlist控件。干预组在2-3周内接受了十次分配的治疗。tDCS(2mA,20分钟）使用针对背外侧前额叶皮层的双侧（阳极右/阴极左）蒙太奇进行自我管理。结果在基线评估，治疗后和6周随访。
结果：超过了预定的可行性标准（招募≥80名参与者和保留率≥75％），治疗完成率高（98.7%）。所有干预措施都减少了暴饮暴食事件，基线和随访之间的进食障碍症状和相关的精神病理学，相对于waitlist对照(变化分数的中等到大的组间效应大小)。与比较器相比，变化分数的中小效应大小有利于ABMT的实际tDCS，表明verum干预产生了更好的结果。
结论：在家里，使用ABMT自我管理的tDCS是可行和可接受的，和疗效的初步数据是有希望的。这种方法可能是对暴食症的既定治疗方法的有用且可扩展的替代或辅助方法。验证性试验可以，并且应该，被追求。
