High-frequency rTMS to treat refractory binge eating disorder and comorbid depression: a case report

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.