{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T10:13:12Z","timestamp":1769767992943,"version":"3.49.0"},"reference-count":68,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T00:00:00Z","timestamp":1619654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RF-2011-02349303"],"award-info":[{"award-number":["RF-2011-02349303"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]},{"name":"IRCCS Multimedica","award":["Ricerca Corrente"],"award-info":[{"award-number":["Ricerca Corrente"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Growing evidence highlights the crucial role of gut microbiota in affecting different aspects of obesity. Considering the ability of deep transcranial magnetic stimulation (dTMS) to modulate the cortical excitability, the reward system, and, indirectly, the autonomic nervous system (ANS), we hypothesized a potential role of dTMS in affecting the brain-gut communication pathways, and the gut microbiota composition in obesity. In a hospital setting, 22 subjects with obesity (5 M, 17 F; 44.9 \u00b1 2.2 years; BMI 37.5 \u00b1 1.0 kg\/m2) were randomized into three groups receiving 15 sessions (3 per week for 5 weeks) of high frequency (HF), low frequency (LF) dTMS, or sham stimulation. Fecal samples were collected at baseline and after 5 weeks of treatment. Total bacterial DNA was extracted from fecal samples using the QIAamp DNA Stool Mini Kit (Qiagen, Italy) and analyzed by a metagenomics approach (Ion Torrent Personal Genome Machine). After 5 weeks, a significant weight loss was found in HF (HF: \u22124.1 \u00b1 0.8%, LF: \u22121.9 \u00b1 0.8%, sham: \u22121.3 \u00b1 0.6%, p = 0.042) compared to LF and sham groups, associated with a decrease in norepinephrine compared to baseline (HF: \u221261.5 \u00b1 15.2%, p &lt; 0.01; LF: \u221231.8 \u00b1 17.1%, p &lt; 0.05; sham: \u221235.8 \u00b1 21.0%, p &gt; 0.05). Furthermore, an increase in Faecalibacterium (+154.3% vs. baseline, p &lt; 0.05) and Alistipes (+153.4% vs. baseline, p &lt; 0.05) genera, and a significant decrease in Lactobacillus (\u221277.1% vs. baseline, p &lt; 0.05) were found in HF. Faecalibacterium variations were not significant compared to baseline in the other two groups (LF: +106.6%, sham: +27.6%; p &gt; 0.05) as well as Alistipes (LF: \u221254.9%, sham: \u221215.1%; p &gt; 0.05) and Lactobacillus (LF: \u221226.0%, sham: +228.3%; p &gt; 0.05) variations. Norepinephrine change significantly correlated with Bacteroides (r2 = 0.734; p &lt; 0.05), Eubacterium (r2 = 0.734; p &lt; 0.05), and Parasutterella (r2 = 0.618; p &lt; 0.05) abundance variations in HF. In conclusion, HF dTMS treatment revealed to be effective in modulating gut microbiota composition in subjects with obesity, reversing obesity-associated microbiota variations, and promoting bacterial species representative of healthy subjects with anti-inflammatory properties.<\/jats:p>","DOI":"10.3390\/ijms22094692","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T01:43:24Z","timestamp":1619660604000},"page":"4692","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Deep Transcranial Magnetic Stimulation Affects Gut Microbiota Composition in Obesity: Results of Randomized Clinical Trial"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8518-5547","authenticated-orcid":false,"given":"Anna","family":"Ferrulli","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099 Milan, Italy"},{"name":"Department of Biomedical Sciences for Health, University of Milan, 20123 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5206-540X","authenticated-orcid":false,"given":"Lorenzo","family":"Drago","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, University of Milan, 20123 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1348-4548","authenticated-orcid":false,"given":"Sara","family":"Gandini","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology, European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7070-253X","authenticated-orcid":false,"given":"Stefano","family":"Massarini","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Bellerba","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology, European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0304-1564","authenticated-orcid":false,"given":"Pamela","family":"Senesi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099 Milan, Italy"},{"name":"Department of Biomedical Sciences for Health, University of Milan, 20123 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ileana","family":"Terruzzi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099 Milan, Italy"},{"name":"Department of Biomedical Sciences for Health, University of Milan, 20123 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3183-0552","authenticated-orcid":false,"given":"Livio","family":"Luzi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099 Milan, Italy"},{"name":"Department of Biomedical Sciences for Health, University of Milan, 20123 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1097\/PSY.0000000000000495","article-title":"Gut microbiota and the gut-brain axis: New insights in the pathophysiology of metabolic syndrome","volume":"79","author":"Frissen","year":"2017","journal-title":"Psychosom. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s12020-018-1605-5","article-title":"Microbiota and metabolic diseases","volume":"61","author":"Pascale","year":"2018","journal-title":"Endocrine"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Guirro, M., Costa, A., Gual-Grau, A., Herrero, P., Torrell, H., Canela, N., and Arola, L. (2019). Effects from diet-induced gut microbiota dysbiosis and obesity can be ameliorated by fecal microbiota transplantation: A multiomics approach. PLoS ONE, 14.","DOI":"10.1101\/654228"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"603086","DOI":"10.3389\/fcimb.2020.603086","article-title":"Colon Carcinogenesis: The Interplay Between Diet and Gut Microbiota","volume":"10","author":"Loke","year":"2020","journal-title":"Front. Cell Infect. Microbiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/PPO.0000000000000049","article-title":"The microbiome and obesity-an established risk for certain types of cancer","volume":"20","author":"Rogers","year":"2014","journal-title":"Cancer J."},{"key":"ref_6","first-page":"1","article-title":"Impact of dietary fat on gut microbiota and low-grade systemic inflammation: Mechanisms and clinical implications on obesity","volume":"4","author":"Valente","year":"2017","journal-title":"Int. J. Food Sci. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1017\/S0029665114001700","article-title":"Gut microbiota and energy balance: Role in obesity","volume":"74","author":"Blaut","year":"2015","journal-title":"Proc. Nutr. Soc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"25","DOI":"10.3389\/fendo.2020.00025","article-title":"The Role of Short-Chain Fatty Acids from Gut Microbiota in Gut-Brain Communication","volume":"11","author":"Silva","year":"2020","journal-title":"Front. Endocrinol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1038\/s41575-020-0341-5","article-title":"Brain-gut-microbiome interactions in obesity and food addiction","volume":"17","author":"Gupta","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"919","DOI":"10.3389\/fpsyg.2014.00919","article-title":"Dopamine and glucose, obesity, and reward deficiency syndrome","volume":"5","author":"Blum","year":"2014","journal-title":"Front. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"pyv114","DOI":"10.1093\/ijnp\/pyv114","article-title":"Gut Microbiota and Brain Function: An Evolving Field in Neuroscience","volume":"19","author":"Foster","year":"2016","journal-title":"Int. J. Neuropsychopharmacol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"G1288","DOI":"10.1152\/ajpgi.00341.2012","article-title":"Critical role of gut microbiota in the production of biologically active, free catecholamines in the gut lumen of mice","volume":"303","author":"Asano","year":"2012","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/j.1365-2672.2012.05344.x","article-title":"\u03b3-Aminobutyric acid production by culturable bacteria from the human intestine","volume":"113","author":"Barrett","year":"2012","journal-title":"J. Appl. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.anaerobe.2016.10.011","article-title":"GABA production and structure of gadB\/gadC genes in Lactobacillus and Bifidobacterium strains from human microbiota","volume":"42","author":"Yunes","year":"2016","journal-title":"Anaerobe"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.procbio.2013.02.021","article-title":"Gamma-aminobutyric acid production in black soybean milk by Lactobacillus brevis FPA 3709 and the antidepressant effect of the fermented product on a forced swimming rat model","volume":"48","author":"Ko","year":"2013","journal-title":"Process Biochem."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"199","DOI":"10.2220\/biomedres.41.199","article-title":"Microbiota-gut-brain axis: Enteroendocrine cells and the enteric nervous system form an interface between the microbiota and the central nervous system","volume":"41","author":"Kuwahara","year":"2020","journal-title":"Biomed. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3864","DOI":"10.1210\/jcem.82.11.4339","article-title":"Substantial production of dopamine in the human gastrointestinal tract","volume":"82","author":"Eisenhofer","year":"1997","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"RC157","DOI":"10.1523\/JNEUROSCI.21-15-j0003.2001","article-title":"Repetitive transcranial magnetic stimulation of the human prefrontal cortex induces dopamine release in the caudate nucleus","volume":"21","author":"Strafella","year":"2001","journal-title":"J. Neurosci."},{"key":"ref_19","unstructured":"Pascual-Leone, A., Davey, N., Rothwell, J., Wassermann, E., and Puri, B. (2002). Handbook of Transcranial Magnetic Stimulation, Arnold."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.pneurobio.2010.10.003","article-title":"Modulation of cortical excitability induced by repetitive transcranial magnetic stimulation: Influence of timing and geometrical parameters and underlying mechanisms","volume":"93","author":"Pell","year":"2011","journal-title":"Prog. Neurobiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.euroneuro.2015.11.011","article-title":"Transcranial magnetic stimulation of dorsolateral prefrontal cortex reduces cocaine use: A pilot study","volume":"26","author":"Terraneo","year":"2016","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1113\/JP273137","article-title":"Acute and chronic effects of noradrenergic enhancement on transcranial direct current stimulation-induced neuroplasticity in humans","volume":"595","author":"Kuo","year":"2017","journal-title":"J. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s12020-018-1791-1","article-title":"High frequency deep transcranial magnetic stimulation acutely increases \u03b2-endorphins in obese humans","volume":"64","author":"Ferrulli","year":"2019","journal-title":"Endocrine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1111\/dom.13741","article-title":"Weight loss induced by deep transcranial magnetic stimulation in obesity: A randomized, double-blind, sham-controlled study","volume":"21","author":"Ferrulli","year":"2019","journal-title":"Diabetes. Obes. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s12020-020-02496-x","article-title":"Safety and tolerability of repeated sessions of deep transcranial magnetic stimulation in obesity","volume":"71","author":"Ferrulli","year":"2021","journal-title":"Endocrine"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Devoto, F., Ferrulli, A., Zapparoli, L., Massarini, S., Banfi, G., Paulesu, E., and Luzi, L. (2021). Repetitive deep TMS for the reduction of body weight: Bimodal effect on the functional brain connectivity in \u201cdiabesity\u201d. Nutr. Metab. Cardiovasc. Dis., in press.","DOI":"10.1016\/j.numecd.2021.02.015"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.neubiorev.2016.05.001","article-title":"A meta-analysis of non-invasive brain stimulation and autonomic functioning: Implications for brain-heart pathways to cardiovascular disease","volume":"74","author":"Makovac","year":"2017","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/S0025-6196(12)62272-1","article-title":"The central autonomic network: Functional organization, dysfunction, and perspective","volume":"68","author":"Benarroch","year":"1993","journal-title":"Mayo Clin. Proc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1016\/j.brs.2020.07.019","article-title":"Effects of transcranial direct current stimulation on the gut microbiome: A case report","volume":"13","author":"Artifon","year":"2020","journal-title":"Brain Stimul."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"452","DOI":"10.30802\/AALAS-CM-18-000039","article-title":"Effects of Intraoperative Vagal Nerve Stimulation on the Gas-trointestinal Microbiome in a Mouse Model of Amyotrophic Lateral Sclerosis","volume":"68","author":"Haney","year":"2018","journal-title":"Comp. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1038\/nature07540","article-title":"A core gut microbiome in obese and lean twins","volume":"457","author":"Turnbaugh","year":"2009","journal-title":"Nature"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"11070","DOI":"10.1073\/pnas.0504978102","article-title":"Obesity alters gut microbial ecology","volume":"102","author":"Ley","year":"2005","journal-title":"Proc. Natl. Acad. Sci. USA."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s12263-017-0566-2","article-title":"Obesity and microbiota: An example of an intricate relationship","volume":"12","author":"Duranti","year":"2017","journal-title":"Genes Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1038\/4441022a","article-title":"Microbial ecology: Human gut microbes associated with obesity","volume":"444","author":"Ley","year":"2006","journal-title":"Nature"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1038\/ijo.2011.153","article-title":"Obesity-associated gut microbiota is enriched in Lactobacillus reuteri and depleted in Bifidobacterium animalis and Methanobrevibacter smithii","volume":"36","author":"Million","year":"2012","journal-title":"Int. J. Obes."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"7353642","DOI":"10.1155\/2016\/7353642","article-title":"Role of Gut Microbiota in the Aetiology of Obesity: Proposed Mechanisms and Review of the Literature","volume":"2016","author":"Khan","year":"2016","journal-title":"J. Obes."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1530\/EJE-17-0403","article-title":"Modulation of the gut microbiome: A systematic review of the effect of bariatric surgery","volume":"178","author":"Guo","year":"2018","journal-title":"Eur. J. Endocrinol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3291367","DOI":"10.1155\/2019\/3291367","article-title":"A Review on Role of Microbiome in Obesity and Antiobesity Properties of Probiotic Supplements","volume":"2019","author":"Sivamaruthi","year":"2019","journal-title":"BioMed Res. Int."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Louis, S., Tappu, R.M., Damms-Machado, A., Huson, D.H., and Bischoff, S.C. (2016). Characterization of the Gut Microbial Community of Obese Patients Following a Weight-Loss Intervention Using Whole Metagenome Shotgun Sequencing. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0149564"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e159","DOI":"10.1038\/nutd.2015.9","article-title":"Specific gut microbiota features and metabolic markers in postmenopausal women with obesity","volume":"5","author":"Brahe","year":"2015","journal-title":"Nutr. Diabetes"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Etxeberria, U., Hijona, E., Aguirre, L., Milagro, F.I., Bujanda, L., Rimando, A.M., Mart\u00ednez, J.A., and Portillo, M.P. (2017). Pterostilbene-induced changes in gut microbiota composition in relation to obesity. Mol. Nutr. Food Res., 61.","DOI":"10.1002\/mnfr.201500906"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1038\/s41430-020-0607-6","article-title":"Profile of the gut microbiota of adults with obesity: A systematic review","volume":"74","author":"Crovesy","year":"2020","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Navarro, T., Salazar, N., Guti\u00e9rrez-D\u00edaz, I., de Los Reyes-Gavil\u00e1n, C.G., Gueimonde, M., and Gonz\u00e1lez, S. (2017). Different Intestinal Microbial Profile in Over-Weight and Obese Subjects Consuming a Diet with Low Content of Fiber and Antioxidants. Nutrients, 9.","DOI":"10.3390\/nu9060551"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1038\/ijo.2008.260","article-title":"Shifts in clostridia, bacteroides and immunoglobulin-coating fecal bacteria associated with weight loss in obese adolescents","volume":"33","author":"Nadal","year":"2009","journal-title":"Int. J. Obes."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.3201\/eid1911.130618","article-title":"Possible association between obesity and Clostridium difficile infection","volume":"19","author":"Leung","year":"2013","journal-title":"Emerg. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1757-4749-5-23","article-title":"Commensal Clostridia: Leading players in the maintenance of gut homeostasis","volume":"5","author":"Lopetuso","year":"2013","journal-title":"Gut Pathog."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1479-7364-7-24","article-title":"Transcriptomics to study the effect of a Mediterranean-inspired diet on inflammation in Crohn\u2019s disease patients","volume":"7","author":"Marlow","year":"2013","journal-title":"Hum. Genom."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"E607","DOI":"10.1002\/oby.20466","article-title":"Human intestinal microbiota composition is associated with local and systemic inflammation in obesity","volume":"21","author":"Verdam","year":"2013","journal-title":"Obesity"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3049","DOI":"10.2337\/db10-0253","article-title":"Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: Links with metabolic and lowgrade inflammation markers","volume":"59","author":"Furet","year":"2010","journal-title":"Diabetes"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s00535-015-1064-1","article-title":"The microbiota in inflammatory bowel disease","volume":"50","author":"Sheehan","year":"2015","journal-title":"J. Gastroenterol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3164\/jcbn.15-152","article-title":"Comparison of the gut microbial community between obese and lean peoples using 16S gene sequencing in a Japanese population","volume":"59","author":"Andoh","year":"2016","journal-title":"J. Clin. Biochem. Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"186","DOI":"10.4161\/gmic.20168","article-title":"The gut microbiota and its relationship to diet and obesity: New insights","volume":"3","author":"Clarke","year":"2012","journal-title":"Gut Microbes"},{"key":"ref_53","first-page":"5672","article-title":"Insulin resistance is associated with specific gut microbiota in appendix samples from morbidly obese patients","volume":"8","author":"Cardona","year":"2016","journal-title":"Am. J. Transl. Res."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Naderpoor, N., Mousa, A., Gomez-Arango, L.F., Barrett, H.L., Dekker Nitert, M., and de Courten, B. (2019). Faecal Microbiota Are Related to Insulin Sensitivity and Secretion in Overweight or Obese Adults. J. Clin. Med., 8.","DOI":"10.3390\/jcm8040452"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jad.2006.03.029","article-title":"Effects of repetitive transcranial magnetic stimulation on [11C]raclopride binding and cognitive function in patients with depression","volume":"95","author":"Kuroda","year":"2006","journal-title":"J. Affect. Disord."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.euroneuro.2017.03.008","article-title":"Deep Transcranial Magnetic Stimulation of the Dorsolateral Prefrontal Cortex in Alcohol Use Disorder Patients: Effects on Dopamine Transporter Availability and Alcohol Intake","volume":"27","author":"Addolorato","year":"2017","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.bbrc.2004.12.009","article-title":"Modulation of monoamine transporter expression and function by repetitive transcranial magnetic stimulation","volume":"327","author":"Ikeda","year":"2005","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1002\/jcp.25518","article-title":"Neurotransmitters: The Critical Modulators Regulating Gut-Brain Axis","volume":"232","author":"Mittal","year":"2017","journal-title":"J. Cell Physiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1053\/j.gastro.2020.10.066","article-title":"The Microbiota-Gut-Brain Axis: From Motility to Mood","volume":"160","author":"Margolis","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Haro, C., Rangel-Z\u00fa\u00f1iga, O.A., Alcal\u00e1-D\u00edaz, J.F., G\u00f3mez-Delgado, F., P\u00e9rez-Mart\u00ednez, P., Delgado-Lista, J., Quintana-Navarro, G.M., Landa, B.B., Navas-Cort\u00e9s, J.A., and Tena-Sempere, M. (2016). Intestinal Microbiota Is Influenced by Gender and Body Mass Index. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0154090"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1038\/ismej.2012.27","article-title":"Structural resilience of the gut microbiota in adult mice under high-fat dietary perturbations","volume":"6","author":"Zhang","year":"2012","journal-title":"ISME J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/j.biopsych.2014.05.020","article-title":"Smoking cessation induced by deep repetitive transcranial mag-netic stimulation of the prefrontal and insular cortices: A prospective, randomized controlled trial","volume":"76","author":"Dannon","year":"2014","journal-title":"Biol. Psychiatry"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.clinph.2004.11.008","article-title":"Transcranial magnetic stimulation of deep brain regions: Evidence for efficacy of the H-coil","volume":"116","author":"Zangen","year":"2005","journal-title":"Clin. Neurophysiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/WNP.0b013e31802fa393","article-title":"Three-dimensional distribution of the electric field induced in the brain by transcranial magnetic stimulation using figure-8 and deep H-coils","volume":"24","author":"Roth","year":"2007","journal-title":"J. Clin. Neurophysiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"S174","DOI":"10.1097\/00005768-200105001-00988","article-title":"Test-retest reliability of body fat percentage results using dual energy X-ray absorptiometry and the Bod Pod","volume":"33","author":"Bailey","year":"2001","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1016\/S0002-8223(02)90358-5","article-title":"Concurrent validity of the BOD POD and dual energy x-rayabsorptiometry techniques for assessing body composition in young women","volume":"102","author":"Maddalozzo","year":"2002","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/0115426507022004377","article-title":"Indirect calorimetry: A practical guide for clinicians","volume":"22","author":"Haugen","year":"2007","journal-title":"Nutr. Clin. Pract."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s00592-017-1064-0","article-title":"Routine resting energy expenditure measurement increases effectiveness of dietary intervention in obesity","volume":"55","author":"Massarini","year":"2018","journal-title":"Acta Diabetol."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/22\/9\/4692\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:54:58Z","timestamp":1760162098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/22\/9\/4692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,29]]},"references-count":68,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["ijms22094692"],"URL":"https:\/\/doi.org\/10.3390\/ijms22094692","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,29]]}}}