Abstract
Studies suggests that stimulation of the left dorsolateral prefrontal cortex (DLPFC) reduces food craving in bulimic patients, but evidence supporting rTMS as a therapeutic tool is lacking. We investigated the safety and therapeutic efficacy of an adjunct high-frequency rTMS program targeting the left DLPFC. Forty-seven females with bulimia nervosa were randomised to a real or sham stimulation group. The real group underwent ten rTMS sessions, each consisting of 20 trains of 5 seconds with 55-second intervals between trains, at a frequency of 10 Hz. The main outcome was the number of binge episodes in the 15 days following the end of stimulation. Overall, no significant improvement in binging and purging symptoms was noted after the program. rTMS was well tolerated. This suggests that ten sessions of high-frequency rTMS to the left DLPFC provide no greater benefit than placebo. Future studies should consider methodological issues as well as alternative targets.