Transcranial direct current stimulation as a potential tool to reduce clinical symptoms in patients with eating disorders: A systematic review

(234) Objective This systematic review aimed to synthesize evidence on the efficacy of transcranial direct current stimulation (tDCS) in improving clinical, cognitive, and behavioral outcomes in eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and mixed ED populations. Methods Following PRISMA guidelines and registered on PROSPERO, a systematic search of electronic databases was conducted for studies published between January 2000 and January 2026. Randomized and non-randomized studies investigating tDCS in ED populations and reporting clinical, psychopathological, or cognitive outcomes were included. Risk of bias was assessed using RoB-2 and ROBINS-I tools. Results Eleven studies met inclusion criteria (8 randomized controlled trials, 3 non-randomized). Most applied anodal tDCS (1–2 mA) over the dorsolateral prefrontal cortex, alone or combined with cognitive/behavioral training. Evidence in AN was limited, showing modest within-group improvements without consistent superiority over sham. In BN, one randomized study reported reductions in binge urge and improvements in mood and self-regulation. The strongest evidence emerged in BED, particularly when combined with inhibitory control training, showing reduced binge frequency and improved executive control. Overall, methodological quality indicated moderate risk of bias. Conclusions tDCS remains an experimental adjunctive treatment for EDs. It appears promising for BED and, to a lesser extent, BN, especially when paired with targeted cognitive interventions, whereas findings in AN are largely null. Heterogeneity across protocols limits definitive conclusions, highlighting the need for larger, well-controlled studies with standardized parameters.