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During Phase 1, the a-tDCS\u2009+\u2009AE group received five consecutive sessions of a-tDCS, while the Sham\u2009+\u2009AE group received sham tDCS. In Phase 2, both the a-tDCS\u2009+\u2009AE and Sham\u2009+\u2009AE groups completed three sessions of moderate-intensity continuous aerobic exercise per week for four weeks. Outcome measures, including food cravings (FC) and cognitive flexibility (CF), were assessed at baseline, after five days of tDCS, and after four weeks of AE. Follow-up measurements for FC and CF were also conducted one month post-intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>FC was lower in the a-tDCS\u2009+\u2009AE group compared to Sham\u2009+\u2009AE and Control groups in Phase 1 (Cohen\u2019s d\u2009=\u20091.4 and 1.9, respectively). In Phase 2, a-tDCS\u2009+\u2009AE and Sham\u2009+\u2009AE groups showed lower FC than the Control group (d\u2009=\u20093.8 and d\u2009=\u20092.8, respectively), and a-tDCS\u2009+\u2009AE also showed a lower FC compared to the Sham\u2009+\u2009AE group (d\u2009=\u20091.5). FC remained lower in the a-tDCS\u2009+\u2009AE group compared to Sham\u2009+\u2009AE and Control groups at follow-up (d\u2009=\u20091.7 and d\u2009=\u20092.4, respectively). CF was higher in the a-tDCS\u2009+\u2009AE compared to Sham\u2009+\u2009AE and Control groups (d\u2009=\u20092.1 and d\u2009=\u20091.4, respectively) and in the sham\u2009+\u2009AE (d\u2009=\u20091.0) compared to control in Phase 2. At follow-up, CF was higher only in the a-tDCS\u2009+\u2009AE group compared to the Control (d\u2009=\u20091.2). IMP scores were higher in the a-tDCS\u2009+\u2009AE group compared to the other groups in Phases 1 (d\u2009=\u20091.0 and d\u2009=\u20091.4) and 2 (d\u2009=\u20095.4 and d\u2009=\u20091.9). RDM was higher in the a-tDCS\u2009+\u2009AE compared to the Control group in phase 2 (d\u2009=\u20091.3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multisession a-tDCS combined with four weeks of moderate AE synergistically reduces food cravings and improves related variables to a greater extent than AE alone, with sustained effects, in women with overweight or obesity and symptoms of food craving.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>This study was registered in the Iranian Registry of Clinical Trials (IRCT id: IRCT20210617051606N7; Registration date: 04.02.2023).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12966-025-01773-0","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T09:35:11Z","timestamp":1748856911000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Multisession transcranial direct current stimulation and aerobic exercise synergistically improve food craving symptoms, impulsivity, and cognitive flexibility in women with overweight and obesity: a randomized controlled trial"],"prefix":"10.1186","volume":"22","author":[{"given":"Sahar Malek","family":"Khataei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6120-9252","authenticated-orcid":false,"given":"Ehsan","family":"Amiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Gomes da Silva","family":"Machado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"1773_CR1","doi-asserted-by":"crossref","unstructured":"Huang J, Wang C, Zhang H-B, Zheng H, Huang T, Di J-Z. 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J Neurosci. 2017;37(13):3445\u20136.","journal-title":"J Neurosci"}],"container-title":["International Journal of Behavioral Nutrition and Physical Activity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12966-025-01773-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12966-025-01773-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12966-025-01773-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:35:28Z","timestamp":1781606128000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12966-025-01773-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,2]]},"references-count":110,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1773"],"URL":"https:\/\/doi.org\/10.1186\/s12966-025-01773-0","relation":{},"ISSN":["1479-5868"],"issn-type":[{"value":"1479-5868","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,2]]},"assertion":[{"value":"30 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Ethics Committee\n                      (approval number: IR.RAZI.REC.1401.014)\n                      , and registered in the Iranian Registry of Clinical Trials\n                      (IRCT ID: IRCT20210617051606N7).\n                      All the experimental procedures were conducted following the Declaration of Helsinki. Informed consent was obtained from all subjects before participation in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participants"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"68"}}