Role of repetitive transcranial magnetic stimulation in treating metabolic syndrome

Background: Metabolic syndrome is a multifactorial condition characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, leading to increased cardiometabolic risk. Conventional therapies often show limited long-term success due to poor compliance. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique, is emerging as a potential adjunct in managing obesity-related metabolic disorders by modulating neural circuits responsible for appetite and impulse control. Aims and Objectives: To evaluate the effect of high-frequency rTMS on anthropometric, behavioral, and biochemical parameters in obese individuals with metabolic syndrome. Materials and Methods: This randomized, single-blind, sham-controlled trial included 30 obese adults divided equally into intervention (real rTMS) and control (sham) groups. The intervention group received 12 sessions of 10 Hz rTMS over the left dorsolateral prefrontal cortex for 4 weeks. Assessments were conducted at baseline, post-therapy, 15 days, and 30 days. Outcomes included body mass index (BMI), waist circumference (WC), body weight, food craving questionnaire-trait (FCQ-T) scores, fasting blood sugar, hemoglobin, lipid profile, high-sensitivity C-reactive protein (hs-CRP), and serum cortisol. Data were analyzed using the Statistical Package for the Social Sciences v21, with P<0.05 considered significant. Results: rTMS produced significant reductions in BMI (−1.06±0.684 kg/m2), WC (−1.59±1.140 cm), body weight (−2.98±1.731 kg), and FCQ-T scores (−14.13±8.927) over 30 days (P=0.001). Triglycerides and hs-CRP decreased significantly, while high-density lipoprotein cholesterol showed mild improvement. Glycemic parameters showed marginal, non-significant changes. Conclusion: High-frequency rTMS is a safe and effective non-pharmacological adjunct that improves obesity-related anthropometric and behavioral outcomes and exerts favorable metabolic effects in patients with metabolic syndrome.