The Effectiveness of Transcranial Direct Current Stimulation (tDCS) and Omega-3 on Food Craving, Executive Functions, Weight, and Depressive Symptoms in Patients with Depression and Overweight: A Randomized Controlled Trial
,
Abstract
Objective: The most important hypothesis of this research was based on the fact that the mechanism of the effect of omega-3 on depression and obesity is formed through its accumulation in the dorsolateral prefrontal cortex (DLPFC), especially in women. Accordingly, we investigated the omega-3 intake and the concurrent stimulation of the DLPFC by tDCS and hypothesized that the synergy of these two treatments can increase the obtained effect size in patients with depression and overweight.
Method: This research was a double-blind randomized controlled trial (RCT) with a factorial design consisting of four treatment and control groups. The participants were females with depression and overweight on an outpatient basis. They received 5 ml/day omega-3 syrup (545 mg DHA, 620 mg EPA) or placebo adjunct with 12 sessions sham/tDCS stimulation administered for 3 weeks with anode-left/cathode-right protocol in the prefrontal cortex (1.5 mA, 15 minutes’ stimulation / 15-20 minutes’ rest intervals/one visit per week, 4 stimulations per visit).
Results: tDCS or omega-3 alone did not significantly improve the executive functions, depression, food cravings, and weight in the experimental groups compared to the control group (P > 0.05). However, tDCS adjunct with the omega-3 had a significant and positive effect on improving weight change (P = 0.011; df = 1; F = 1.27; Eta = 0.108) with a power of 0.73 compared to the control group. Furthermore, their interaction led to an improving trend in executive functions and a decreasing trend in food cravings which are clinically important.
Conclusion: tDCS could strengthen the omega-3 mechanisms of effect through stimulating its accumulation site in the brain (i.e., the DLPFC) and the synergistic effects of these two treatments result in weight control as well as an improvement trend in the executive functions and food craving in women.
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3. Sarokhani D, Parvareh M, Hasanpour Dehkordi A, Sayehmiri K, Moghimbeigi A. Prevalence of Depression among Iranian Elderly: Systematic Review and Meta-Analysis. Iran J Psychiatry. 2018;13(1):55-64.
4. Naicker K, Galambos NL, Zeng Y, Senthilselvan A, Colman I. Social, demographic, and health outcomes in the 10 years following adolescent depression. J Adolesc Health. 2013;52(5):533-8.
5. Paulitsch RG, Demenech LM, Dumith SC. Association of depression and obesity is mediated by weight perception. J Health Psychol. 2021;26(11):2020-30.
6. Dolatian A, Arzaghi SM, Qorbani M, Pishva H. The Relationship between Body Mass Index (BMI) and Depression According to the rs16139NPY Gene. Iran J Psychiatry. 2017;12(3):201-5.
7. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-62.
8. Patsalos O, Keeler J, Schmidt U, Penninx B, Young AH, Himmerich H. Diet, Obesity, and Depression: A Systematic Review. J Pers Med. 2021;11(3).
9. Kober H, Boswell RG. Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment. Clin Psychol Rev. 2018;60:32-44.
10. Dalkner N, Platzer M, Bengesser SA, Birner A, Fellendorf FT, Queissner R, et al. The role of tryptophan metabolism and food craving in the relationship between obesity and bipolar disorder. Clin Nutr. 2018;37(5):1744-51.
11. Lowe CJ, Reichelt AC, Hall PA. The Prefrontal Cortex and Obesity: A Health Neuroscience Perspective. Trends Cogn Sci. 2019;23(4):349-61.
12. Marron EM, Viejo-Sobera R, Cuatrecasas G, Redolar-Ripoll D, Lorda PG, Datta A, et al. Prefronto-cerebellar neuromodulation affects appetite in obesity. Int J Obes (Lond). 2019;43(10):2119-24.
13. Khaleghi A, Pirzad Jahromi G, Zarafshan H, Mostafavi SA, Mohammadi MR. Effects of transcranial direct current stimulation of prefrontal cortex on risk-taking behavior. Psychiatry Clin Neurosci. 2020;74(9):455-65.
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15. Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimul. 2012;5(3):175-95.
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17. Shiasy Y, Shakiba S, Taremian F, Akhavan Hejazi SM, Abasi A. The Effectiveness of Attention Bias Modification with and without Trans Cranial Direct Current Stimulation in Chronic Low Back Pain. Iran J Psychiatry. 2020;15(2):112-25.
18. Dadgar H, Majidi H, Aghaei S. Biological and Neurobiological Mechanisms of Transcranial Direct Current Stimulation. Iran J Psychiatry. 2022;17(3):350-5.
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23. Ray MK, Sylvester MD, Osborn L, Helms J, Turan B, Burgess EE, Boggiano MM. The critical role of cognitive-based trait differences in transcranial direct current stimulation (tDCS) suppression of food craving and eating in frank obesity. Appetite. 2017;116:568-74.
24. Fregni F, Orsati F, Pedrosa W, Fecteau S, Tome FA, Nitsche MA, et al. Transcranial direct current stimulation of the prefrontal cortex modulates the desire for specific foods. Appetite. 2008;51(1):34-41.
25. Burgess EE, Sylvester MD, Morse KE, Amthor FR, Mrug S, Lokken KL, et al. Effects of transcranial direct current stimulation (tDCS) on binge eating disorder. Int J Eat Disord. 2016;49(10):930-6.
26. Georgii C, Goldhofer P, Meule A, Richard A, Blechert J. Food craving, food choice and consumption: The role of impulsivity and sham-controlled tDCS stimulation of the right dlPFC. Physiol Behav. 2017;177:20-6.
27. Montenegro RA, Okano AH, Cunha FA, Gurgel JL, Fontes EB, Farinatti PT. Prefrontal cortex transcranial direct current stimulation associated with aerobic exercise change aspects of appetite sensation in overweight adults. Appetite. 2012;58(1):333-8.
28. Mostafavi SA, Khaleghi A, Mohammadi MR, Akhondzadeh S. Is transcranial direct current stimulation an effective modality in reducing food craving? A systematic review and meta-analysis. Nutr Neurosci. 2020;23(1):55-67.
29. Beaumont JD, Davis D, Dalton M, Nowicky A, Russell M, Barwood MJ. The effect of transcranial direct current stimulation (tDCS) on food craving, reward and appetite in a healthy population. Appetite. 2021;157:105004.
30. Alonzo A, Chan G, Martin D, Mitchell PB, Loo C. Transcranial direct current stimulation (tDCS) for depression: analysis of response using a three-factor structure of the Montgomery-Åsberg depression rating scale. J Affect Disord. 2013;150(1):91-5.
31. Kalu UG, Sexton CE, Loo CK, Ebmeier KP. Transcranial direct current stimulation in the treatment of major depression: a meta-analysis. Psychol Med. 2012;42(9):1791-800.
32. Khaleghi A, Mohammadi MR, Shahi K, Nasrabadi AM. Computational Neuroscience Approach to Psychiatry: A Review on Theory-driven Approaches. Clin Psychopharmacol Neurosci. 2022;20(1):26-36.
33. Santarsieri D, Schwartz TL. Antidepressant efficacy and side-effect burden: a quick guide for clinicians. Drugs Context. 2015;4:212290.
34. Grosso G, Galvano F, Marventano S, Malaguarnera M, Bucolo C, Drago F, Caraci F. Omega-3 fatty acids and depression: scientific evidence and biological mechanisms. Oxid Med Cell Longev. 2014;2014:313570.
35. Lin PY, Huang SY, Su KP. A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression. Biol Psychiatry. 2010;68(2):140-7.
36. Martins JG. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. JACN. 2009;28(5):525-42.
37. Hallahan B, Ryan T, Hibbeln JR, Murray IT, Glynn S, Ramsden CE, et al. Efficacy of omega-3 highly unsaturated fatty acids in the treatment of depression. Br J Psychiatry. 2016;209(3):192-201.
38. Lin PY, Mischoulon D, Freeman MP, Matsuoka Y, Hibbeln J, Belmaker RH, Su KP. Are omega-3 fatty acids antidepressants or just mood-improving agents? The effect depends upon diagnosis, supplement preparation, and severity of depression. Mol Psychiatry. 2012;17(12):1161-3; author reply 3-7.
39. Mischoulon D, Nierenberg AA, Schettler PJ, Kinkead BL, Fehling K, Martinson MA, Hyman Rapaport M. A double-blind, randomized controlled clinical trial comparing eicosapentaenoic acid versus docosahexaenoic acid for depression. J Clin Psychiatry. 2015;76(1):54-61.
40. Green CJ, Pramfalk C, Charlton CA, Gunn PJ, Cornfield T, Pavlides M, et al. Hepatic de novo lipogenesis is suppressed and fat oxidation is increased by omega-3 fatty acids at the expense of glucose metabolism. BMJ Open Diabetes Res Care. 2020;8(1).
41. Keshavarz SA, Mostafavi SA, Akhondzadeh S, Mohammadi MR, Hosseini S, Eshraghian MR, Chamari M. Omega-3 supplementation effects on body weight and depression among dieter women with co-morbidity of depression and obesity compared with the placebo: A randomized clinical trial. Clin Nutr ESPEN. 2018;25:37-43.
42. Ajabnoor SM, Thorpe G, Abdelhamid A, Hooper L. Long-term effects of increasing omega-3, omega-6 and total polyunsaturated fats on inflammatory bowel disease and markers of inflammation: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr. 2021;60(5):2293-316.
43. Martí Del Moral A, Fortique F. Omega-3 fatty acids and cognitive decline: a systematic review. Nutr Hosp. 2019;36(4):939-49.
44. Beck AT, Steer RA, Brown G. Beck depression inventory–II. Psychol Assess. 1996.
45. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN. Depress Anxiety. 2005;21(4):185-92.
46. Wilson MM, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A, et al. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr. 2005;82(5):1074-81.
47. Mohammadi MR, Akhondzadeh S, Keshavarz SA, Mostafavi SA. The Characteristics, Reliability and Validity of the Persian Version of Simplified Nutritional Appetite Questionnaire (SNAQ). J Nutr Health Aging. 2019;23(9):837-42.
48. Mohammadi MR, Akhondzadeh S, Mostafavi S-A, Keshavarz SA, Motlaq TA, Eshraghian MR, Hosseini S. The Reliability and Validity of the Persian Version of Food Craving Questionnaire-Trait-Reduced (FCQ-Tr) in Overweight and Obese Women. JFH. 2018;6(3).
49. Rezaei Niyasr A, Zare H, Barjesteh F. Assessment of cognitive function in obese & overweight children compared with children of normal weight in the Tower of London & stroop test. Health Psychol. 2017;6(22):35-50.
50. Shahgholian M, Azadfallah P, Fathi-Ashtiani A, Khodadadi M. Design of the Wisconsin Card Sorting Test (WCST) computerized version: Theoretical fundamental, developing and psychometrics characteristics. Clin Psychol Sci. 2012;1(4):110-34.
51. Amo Usanos C, Valenzuela PL, de la Villa P, Navarro SM, Melo Aroeira AE, Amo Usanos I, et al. Neuromodulation of the prefrontal cortex facilitates diet-induced weight loss in midlife women: a randomized, proof-of-concept clinical trial. Int J Obes (Lond). 2020;44(3):568-78.
52. Ozturk E. The effect of omega-3 fatty acid supplementation and transcranial direct current stimulation on plasma cytokines 2020.
53. Fassini PG, Das SK, Suen VMM, Magerowski G, Marchini JS, da Silva Junior WA, et al. Appetite effects of prefrontal stimulation depend on COMT Val158Met polymorphism: A randomized clinical trial. Appetite. 2019;140:142-50.
54. Calder PC. Omega-3 fatty acids and inflammatory processes. Nutrients. 2010;2(3):355-74.
55. Barnes P, Drazen J, Rennard S, Thomson N. Asthma and copd basic mechanisms and clinical management second edition preface to the 2nd edition. Asthma and Copd: Basic Mechanisms and Clinical Management. 2009:178ff.
56. Deane KHO, Jimoh OF, Biswas P, O'Brien A, Hanson S, Abdelhamid AS, et al. Omega-3 and polyunsaturated fat for prevention of depression and anxiety symptoms: systematic review and meta-analysis of randomised trials. Br J Psychiatry. 2021;218(3):135-42.
57. Vesco AT, Young AS, Arnold LE, Fristad MA. Omega-3 supplementation associated with improved parent-rated executive function in youth with mood disorders: secondary analyses of the omega 3 and therapy (OATS) trials. J Child Psychol Psychiatry. 2018;59(6):628-36.
58. Rangel-Huerta OD, Gil A. Effect of omega-3 fatty acids on cognition: an updated systematic review of randomized clinical trials. Nutr Rev. 2018;76(1):1-20.
59. McClintock SM, Martin DM, Lisanby SH, Alonzo A, McDonald WM, Aaronson ST, et al. Neurocognitive effects of transcranial direct current stimulation (tDCS) in unipolar and bipolar depression: Findings from an international randomized controlled trial. Depress Anxiety. 2020;37(3):261-72.
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2. Mohammadi MR, Ahmadi N, Khaleghi A, Mostafavi SA, Kamali K, Rahgozar M, et al. Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents. Iran J Psychiatry. 2019;14(1):1-15.
3. Sarokhani D, Parvareh M, Hasanpour Dehkordi A, Sayehmiri K, Moghimbeigi A. Prevalence of Depression among Iranian Elderly: Systematic Review and Meta-Analysis. Iran J Psychiatry. 2018;13(1):55-64.
4. Naicker K, Galambos NL, Zeng Y, Senthilselvan A, Colman I. Social, demographic, and health outcomes in the 10 years following adolescent depression. J Adolesc Health. 2013;52(5):533-8.
5. Paulitsch RG, Demenech LM, Dumith SC. Association of depression and obesity is mediated by weight perception. J Health Psychol. 2021;26(11):2020-30.
6. Dolatian A, Arzaghi SM, Qorbani M, Pishva H. The Relationship between Body Mass Index (BMI) and Depression According to the rs16139NPY Gene. Iran J Psychiatry. 2017;12(3):201-5.
7. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-62.
8. Patsalos O, Keeler J, Schmidt U, Penninx B, Young AH, Himmerich H. Diet, Obesity, and Depression: A Systematic Review. J Pers Med. 2021;11(3).
9. Kober H, Boswell RG. Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment. Clin Psychol Rev. 2018;60:32-44.
10. Dalkner N, Platzer M, Bengesser SA, Birner A, Fellendorf FT, Queissner R, et al. The role of tryptophan metabolism and food craving in the relationship between obesity and bipolar disorder. Clin Nutr. 2018;37(5):1744-51.
11. Lowe CJ, Reichelt AC, Hall PA. The Prefrontal Cortex and Obesity: A Health Neuroscience Perspective. Trends Cogn Sci. 2019;23(4):349-61.
12. Marron EM, Viejo-Sobera R, Cuatrecasas G, Redolar-Ripoll D, Lorda PG, Datta A, et al. Prefronto-cerebellar neuromodulation affects appetite in obesity. Int J Obes (Lond). 2019;43(10):2119-24.
13. Khaleghi A, Pirzad Jahromi G, Zarafshan H, Mostafavi SA, Mohammadi MR. Effects of transcranial direct current stimulation of prefrontal cortex on risk-taking behavior. Psychiatry Clin Neurosci. 2020;74(9):455-65.
14. Gluck ME, Viswanath P, Stinson EJ. Obesity, Appetite, and the Prefrontal Cortex. Curr Obes Rep. 2017;6(4):380-8.
15. Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimul. 2012;5(3):175-95.
16. Hajloo N, Pouresmali A, Alizadeh Goradel J, Mowlaie M. The Effects of Transcranial Direct Current Stimulation of Dorsolateral Prefrontal Cortex on Reduction of Craving in Daily and Social Smokers. Iran J Psychiatry. 2019;14(4):291-6.
17. Shiasy Y, Shakiba S, Taremian F, Akhavan Hejazi SM, Abasi A. The Effectiveness of Attention Bias Modification with and without Trans Cranial Direct Current Stimulation in Chronic Low Back Pain. Iran J Psychiatry. 2020;15(2):112-25.
18. Dadgar H, Majidi H, Aghaei S. Biological and Neurobiological Mechanisms of Transcranial Direct Current Stimulation. Iran J Psychiatry. 2022;17(3):350-5.
19. Shirehjini SN, Shahrabi Farahani M, Ibrahim MK, Salman HM, Motevalli S, Mohammadi MH. Mechanisms of Action of Noninvasive Brain Stimulation with Weak Non-Constant Current Stimulation Approaches. Iran J Psychiatry. 2023;18(1):72-82.
20. Jackson MP, Rahman A, Lafon B, Kronberg G, Ling D, Parra LC, Bikson M. Animal models of transcranial direct current stimulation: Methods and mechanisms. Clin Neurophysiol. 2016;127(11):3425-54.
21. Anderson EC, Cantelon JA, Holmes A, Giles GE, Brunyé TT, Kanarek R. Transcranial direct current stimulation (tDCS) to dorsolateral prefrontal cortex influences perceived pleasantness of food. Heliyon. 2023;9(2):e13275.
22. Mostafavi SA, Khaleghi A, Mohammadi MR. Noninvasive brain stimulation in alcohol craving: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2020;101:109938.
23. Ray MK, Sylvester MD, Osborn L, Helms J, Turan B, Burgess EE, Boggiano MM. The critical role of cognitive-based trait differences in transcranial direct current stimulation (tDCS) suppression of food craving and eating in frank obesity. Appetite. 2017;116:568-74.
24. Fregni F, Orsati F, Pedrosa W, Fecteau S, Tome FA, Nitsche MA, et al. Transcranial direct current stimulation of the prefrontal cortex modulates the desire for specific foods. Appetite. 2008;51(1):34-41.
25. Burgess EE, Sylvester MD, Morse KE, Amthor FR, Mrug S, Lokken KL, et al. Effects of transcranial direct current stimulation (tDCS) on binge eating disorder. Int J Eat Disord. 2016;49(10):930-6.
26. Georgii C, Goldhofer P, Meule A, Richard A, Blechert J. Food craving, food choice and consumption: The role of impulsivity and sham-controlled tDCS stimulation of the right dlPFC. Physiol Behav. 2017;177:20-6.
27. Montenegro RA, Okano AH, Cunha FA, Gurgel JL, Fontes EB, Farinatti PT. Prefrontal cortex transcranial direct current stimulation associated with aerobic exercise change aspects of appetite sensation in overweight adults. Appetite. 2012;58(1):333-8.
28. Mostafavi SA, Khaleghi A, Mohammadi MR, Akhondzadeh S. Is transcranial direct current stimulation an effective modality in reducing food craving? A systematic review and meta-analysis. Nutr Neurosci. 2020;23(1):55-67.
29. Beaumont JD, Davis D, Dalton M, Nowicky A, Russell M, Barwood MJ. The effect of transcranial direct current stimulation (tDCS) on food craving, reward and appetite in a healthy population. Appetite. 2021;157:105004.
30. Alonzo A, Chan G, Martin D, Mitchell PB, Loo C. Transcranial direct current stimulation (tDCS) for depression: analysis of response using a three-factor structure of the Montgomery-Åsberg depression rating scale. J Affect Disord. 2013;150(1):91-5.
31. Kalu UG, Sexton CE, Loo CK, Ebmeier KP. Transcranial direct current stimulation in the treatment of major depression: a meta-analysis. Psychol Med. 2012;42(9):1791-800.
32. Khaleghi A, Mohammadi MR, Shahi K, Nasrabadi AM. Computational Neuroscience Approach to Psychiatry: A Review on Theory-driven Approaches. Clin Psychopharmacol Neurosci. 2022;20(1):26-36.
33. Santarsieri D, Schwartz TL. Antidepressant efficacy and side-effect burden: a quick guide for clinicians. Drugs Context. 2015;4:212290.
34. Grosso G, Galvano F, Marventano S, Malaguarnera M, Bucolo C, Drago F, Caraci F. Omega-3 fatty acids and depression: scientific evidence and biological mechanisms. Oxid Med Cell Longev. 2014;2014:313570.
35. Lin PY, Huang SY, Su KP. A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression. Biol Psychiatry. 2010;68(2):140-7.
36. Martins JG. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. JACN. 2009;28(5):525-42.
37. Hallahan B, Ryan T, Hibbeln JR, Murray IT, Glynn S, Ramsden CE, et al. Efficacy of omega-3 highly unsaturated fatty acids in the treatment of depression. Br J Psychiatry. 2016;209(3):192-201.
38. Lin PY, Mischoulon D, Freeman MP, Matsuoka Y, Hibbeln J, Belmaker RH, Su KP. Are omega-3 fatty acids antidepressants or just mood-improving agents? The effect depends upon diagnosis, supplement preparation, and severity of depression. Mol Psychiatry. 2012;17(12):1161-3; author reply 3-7.
39. Mischoulon D, Nierenberg AA, Schettler PJ, Kinkead BL, Fehling K, Martinson MA, Hyman Rapaport M. A double-blind, randomized controlled clinical trial comparing eicosapentaenoic acid versus docosahexaenoic acid for depression. J Clin Psychiatry. 2015;76(1):54-61.
40. Green CJ, Pramfalk C, Charlton CA, Gunn PJ, Cornfield T, Pavlides M, et al. Hepatic de novo lipogenesis is suppressed and fat oxidation is increased by omega-3 fatty acids at the expense of glucose metabolism. BMJ Open Diabetes Res Care. 2020;8(1).
41. Keshavarz SA, Mostafavi SA, Akhondzadeh S, Mohammadi MR, Hosseini S, Eshraghian MR, Chamari M. Omega-3 supplementation effects on body weight and depression among dieter women with co-morbidity of depression and obesity compared with the placebo: A randomized clinical trial. Clin Nutr ESPEN. 2018;25:37-43.
42. Ajabnoor SM, Thorpe G, Abdelhamid A, Hooper L. Long-term effects of increasing omega-3, omega-6 and total polyunsaturated fats on inflammatory bowel disease and markers of inflammation: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr. 2021;60(5):2293-316.
43. Martí Del Moral A, Fortique F. Omega-3 fatty acids and cognitive decline: a systematic review. Nutr Hosp. 2019;36(4):939-49.
44. Beck AT, Steer RA, Brown G. Beck depression inventory–II. Psychol Assess. 1996.
45. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN. Depress Anxiety. 2005;21(4):185-92.
46. Wilson MM, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A, et al. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr. 2005;82(5):1074-81.
47. Mohammadi MR, Akhondzadeh S, Keshavarz SA, Mostafavi SA. The Characteristics, Reliability and Validity of the Persian Version of Simplified Nutritional Appetite Questionnaire (SNAQ). J Nutr Health Aging. 2019;23(9):837-42.
48. Mohammadi MR, Akhondzadeh S, Mostafavi S-A, Keshavarz SA, Motlaq TA, Eshraghian MR, Hosseini S. The Reliability and Validity of the Persian Version of Food Craving Questionnaire-Trait-Reduced (FCQ-Tr) in Overweight and Obese Women. JFH. 2018;6(3).
49. Rezaei Niyasr A, Zare H, Barjesteh F. Assessment of cognitive function in obese & overweight children compared with children of normal weight in the Tower of London & stroop test. Health Psychol. 2017;6(22):35-50.
50. Shahgholian M, Azadfallah P, Fathi-Ashtiani A, Khodadadi M. Design of the Wisconsin Card Sorting Test (WCST) computerized version: Theoretical fundamental, developing and psychometrics characteristics. Clin Psychol Sci. 2012;1(4):110-34.
51. Amo Usanos C, Valenzuela PL, de la Villa P, Navarro SM, Melo Aroeira AE, Amo Usanos I, et al. Neuromodulation of the prefrontal cortex facilitates diet-induced weight loss in midlife women: a randomized, proof-of-concept clinical trial. Int J Obes (Lond). 2020;44(3):568-78.
52. Ozturk E. The effect of omega-3 fatty acid supplementation and transcranial direct current stimulation on plasma cytokines 2020.
53. Fassini PG, Das SK, Suen VMM, Magerowski G, Marchini JS, da Silva Junior WA, et al. Appetite effects of prefrontal stimulation depend on COMT Val158Met polymorphism: A randomized clinical trial. Appetite. 2019;140:142-50.
54. Calder PC. Omega-3 fatty acids and inflammatory processes. Nutrients. 2010;2(3):355-74.
55. Barnes P, Drazen J, Rennard S, Thomson N. Asthma and copd basic mechanisms and clinical management second edition preface to the 2nd edition. Asthma and Copd: Basic Mechanisms and Clinical Management. 2009:178ff.
56. Deane KHO, Jimoh OF, Biswas P, O'Brien A, Hanson S, Abdelhamid AS, et al. Omega-3 and polyunsaturated fat for prevention of depression and anxiety symptoms: systematic review and meta-analysis of randomised trials. Br J Psychiatry. 2021;218(3):135-42.
57. Vesco AT, Young AS, Arnold LE, Fristad MA. Omega-3 supplementation associated with improved parent-rated executive function in youth with mood disorders: secondary analyses of the omega 3 and therapy (OATS) trials. J Child Psychol Psychiatry. 2018;59(6):628-36.
58. Rangel-Huerta OD, Gil A. Effect of omega-3 fatty acids on cognition: an updated systematic review of randomized clinical trials. Nutr Rev. 2018;76(1):1-20.
59. McClintock SM, Martin DM, Lisanby SH, Alonzo A, McDonald WM, Aaronson ST, et al. Neurocognitive effects of transcranial direct current stimulation (tDCS) in unipolar and bipolar depression: Findings from an international randomized controlled trial. Depress Anxiety. 2020;37(3):261-72.
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| Files | ||
| Issue | Vol 19 No 2 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v19i2.15102 | |
| Keywords | ||
| Depression Executive Function Craving; Omega-3 Transcranial Direct Current Stimulation | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Tabasi M, Mostafavi S-A, Oreyzi H, Mohammadi MR, Khaleghi A. The Effectiveness of Transcranial Direct Current Stimulation (tDCS) and Omega-3 on Food Craving, Executive Functions, Weight, and Depressive Symptoms in Patients with Depression and Overweight: A Randomized Controlled Trial. Iran J Psychiatry. 2024;19(2):158-170.
