Deep transcranial magnetic stimulation in combination with skin thermography in obesity: a window on sympathetic nervous system.

Anna Ferrulli, Sara Gandini, Giulio Cammarata, Veronica Redaelli, Stefano Massarini, Concetta Macrì, Ileana Terruzzi, Daniele Cannavaro, Fabio Luzi, Livio Luzi

Acta diabetologica 2022 May

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Obesity is known to be associated with an altered thermoregulation as well as a dysregulation of sympathetic nervous system (SNS). Considering the ability of deep transcranial magnetic stimulation (dTMS) to modulate the SNS, we hypothesized a potential role of dTMS in affecting thermoregulation in obesity. Aims of the study were to monitor the effect of a single session of dTMS on body temperature in subjects with obesity, and to correlate the dTMS-induced changes in body temperature with activation of the SNS (epinephrine and norepinephrine release). Twenty-nine subjects with obesity [5 M, 24 F; age 50 (IQR: 58, 38) yrs; BMI 36.1 (IQR: 33.9, 38.7) kg/m2] were randomized into 2 groups receiving a single session of high frequency stimulation (HF) or sham stimulation. Under neutral thermal conditions, infrared thermography was utilized to assess bilateral fingernail-beds and abdominal temperature. During a single session HF, the average temperature of both fingernail-beds decreased. Right-hand temperature difference was statistically greater in HF vs Sham: median = - 1.45 (IQR: - 2.0, - 1.0) °C for HF, p = 0.009. While temperature variation in the fingernail-bed of left hand was not statistically significant in HF compared to Sham: median = - 1.26 (IQR: - 1.6, -0.5) °C, p = 0.064. Concurrently, when estimating the effect of norepinephrine variation on temperature change of fingernail-bed of left hand, a borderline significant positive association was estimated (beta = 1.09, p = 0.067) in HF. Deep TMS revealed to be effective in modulating temperature in subjects with obesity, partially reversing obesity-induced alterations in heat production and dissipation with a potential SNS-mediated mechanism. © 2022. The Author(s).

Citation

Anna Ferrulli, Sara Gandini, Giulio Cammarata, Veronica Redaelli, Stefano Massarini, Concetta Macrì, Ileana Terruzzi, Daniele Cannavaro, Fabio Luzi, Livio Luzi. Deep transcranial magnetic stimulation in combination with skin thermography in obesity: a window on sympathetic nervous system. Acta diabetologica. 2022 May;59(5):729-742