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Beaumont JD, Dalton M, Davis D, Finlayson G, Nowicky A, Russell M, Barwood MJ. No effect of prefrontal transcranial direct current stimulation (tDCS) on food craving, food reward and subjective appetite in females displaying mild-to-moderate binge-type behaviour. Appetite 2023; 189:106997. [PMID: 37574640 DOI: 10.1016/j.appet.2023.106997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
Previous work suggests there may be an effect of transcranial direct current stimulation (tDCS) on appetite control in people at risk of overconsumption, however findings are inconsistent. This study aimed to further understand the potential eating behaviour trait-dependent effect of tDCS, specifically in those with binge-type behaviour. Seventeen females (23 ± 7 years, 25.4 ± 3.8 kg m-2) with mild-to-moderate binge eating behaviour completed two sessions of double-blind, randomised and counterbalanced anodal and sham tDCS applied over the right dorsolateral prefrontal cortex at 2.0 mA for 20 min. Subjective appetite visual analogue scales (VAS), the Food Craving Questionnaire-State (FCQ-S), and Leeds Food Preference Questionnaire (LFPQ) were completed pre- and post-tDCS. Participants then consumed a fixed-energy meal, followed by the VAS, FCQ-S and LFPQ. No difference between pre- and post-tDCS scores were found across fullness (p = 0.275, BF10 = 0.040), prospective consumption (p = 0.127, BF10 = 0.063), desire to eat (p = 0.247, BF10 = 0.054) or FCQ-S measures (p = 0.918, BF10 = 0.040) when comparing active and sham protocols. Only explicit liking and wanting for high-fat sweet foods were significantly different between conditions, with increased scores following active tDCS. When controlling for baseline hunger, the significant differences were removed (p = 0.138 to 0.161, BF10 = 0.810 to 1.074). The present data does not support the eating behaviour trait dependency of tDCS in a specific cohort of female participants with mild-to-moderate binge eating scores, and results align with those from individuals with healthy trait scores. This suggests participants with sub-clinical binge eating behaviour do not respond to tDCS. Future work should further explore effects in clinical and sub-clinical populations displaying susceptibility to overconsumption and weight gain.
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Affiliation(s)
- Jordan D Beaumont
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK; Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield, S1 1WB, UK.
| | - Michelle Dalton
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Danielle Davis
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Graham Finlayson
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, LS2 9JU, UK
| | - Alexander Nowicky
- Centre for Cognitive Neuroscience, Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Mark Russell
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Martin J Barwood
- Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, LS18 5HD, UK
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2
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Chae Y, Lee IS. Central Regulation of Eating Behaviors in Humans: Evidence from Functional Neuroimaging Studies. Nutrients 2023; 15:3010. [PMID: 37447336 PMCID: PMC10347214 DOI: 10.3390/nu15133010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Neuroimaging has great potential to provide insight into the neural response to food stimuli. Remarkable advances have been made in understanding the neural activity underlying food perception, not only in normal eating but also in obesity, eating disorders, and disorders of gut-brain interaction in recent decades. In addition to the abnormal brain function in patients with eating disorders compared to healthy controls, new therapies, such as neurofeedback and neurostimulation techniques, have been developed that target the malfunctioning brain regions in patients with eating disorders based on the results of neuroimaging studies. In this review, we present an overview of early and more recent research on the central processing and regulation of eating behavior in healthy and patient populations. In order to better understand the relationship between the gut and the brain as well as the neural mechanisms underlying abnormal ingestive behaviors, we also provide suggestions for future directions to enhance our current methods used in food-related neuroimaging studies.
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Affiliation(s)
- Younbyoung Chae
- College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - In-Seon Lee
- College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
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3
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de Klerk MT, Smeets PAM, la Fleur SE. Inhibitory control as a potential treatment target for obesity. Nutr Neurosci 2023; 26:429-444. [PMID: 35343884 DOI: 10.1080/1028415x.2022.2053406] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Strong reward responsiveness to food and insufficient inhibitory control are thought to be implicated in the development and maintenance of obesity. This narrative review addresses the role of inhibitory control in obesity and weight loss, and in how far inhibitory control is a promising target for weight loss interventions. METHODS PubMed, Web of Science, and Google Scholar were searched for papers up to May 2021. 41 papers were included. RESULTS Individuals with obesity have poorer food-specific inhibitory control, particularly when hungry, and less concurrent activation of inhibitory brain areas. Moreover, this was strongly predictive of future weight gain. More activation of inhibitory brain areas, on the other hand, was predictive of weight loss: individuals with successful weight loss initially show inhibitory brain activity comparable to that of normal weight individuals. When successful weight maintenance is achieved for at least 1 year, this inhibitory activity is further increased. Interventions targeting inhibitory control in obese individuals have divergent effects. Firstly, food-specific inhibitory control training is particularly effective for people with low inhibitory control and high BMI. Secondly, neuromodulation paradigms are rather heterogeneous: although rTMS to the left dorsolateral prefrontal cortex induced some weight-loss, multiple sessions of tDCS reduced food consumption (desire) and induced weight loss in two thirds of the papers. Thirdly, neurofeedback results in successful upregulation of brain activity and connectivity, but occasionally leads to increased food intake. In conclusion, inhibitory control is implicated in obesity. It can be targeted to promote weight loss although major weight losses have not been achieved.
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Affiliation(s)
- M T de Klerk
- Image Sciences Institute, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Neurobiology of Energy Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - P A M Smeets
- Image Sciences Institute, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - S E la Fleur
- Neurobiology of Energy Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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4
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Zyuzin J, Combs D, Melrose J, Kodaverdian N, Leather C, Carrillo JD, Monterosso JR, Brocas I. The neural correlates of value representation: From single items to bundles. Hum Brain Mapp 2023; 44:1476-1495. [PMID: 36440955 PMCID: PMC9921239 DOI: 10.1002/hbm.26137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 11/30/2022] Open
Abstract
One of the core questions in Neuro-economics is to determine where value is represented. To date, most studies have focused on simple options and identified the ventromedial prefrontal cortex (VMPFC) as the common value region. We report the findings of an fMRI study in which we asked participants to make pairwise comparisons involving options of varying complexity: single items (Control condition), bundles made of the same two single items (Scaling condition) and bundles made of two different single items (Bundling condition). We construct a measure of choice consistency to capture how coherent the choices of a participant are with one another. We also record brain activity while participants make these choices. We find that a common core of regions involving the left VMPFC, the left dorsolateral prefrontal cortex (DLPFC), regions associated with complex visual processing and the left cerebellum track value across all conditions. Also, regions in the DLPFC, the ventrolateral prefrontal cortex (VLPFC) and the cerebellum are differentially recruited across conditions. Last, variations in activity in VMPFC and DLPFC value-tracking regions are associated with variations in choice consistency. This suggests that value based decision-making recruits a core set of regions as well as specific regions based on task demands. Further, correlations between consistency and the magnitude of signal change with lateral portions of the PFC suggest the possibility that activity in these regions may play a causal role in decision quality.
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Affiliation(s)
| | - Dalton Combs
- University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - James Melrose
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Niree Kodaverdian
- Argyros School of Business and EconomicsChapman UniversityOrangeCAUSA
| | - Calvin Leather
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Juan D. Carrillo
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - John R. Monterosso
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Isabelle Brocas
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
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5
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Fatakdawala I, Ayaz H, Safati AB, Sakib MN, Hall PA. Effects of prefrontal theta burst stimulation on neuronal activity and subsequent eating behavior: an interleaved rTMS and fNIRS study. Soc Cogn Affect Neurosci 2023; 18:6146114. [PMID: 33615370 PMCID: PMC10074772 DOI: 10.1093/scan/nsab023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/02/2021] [Accepted: 02/19/2021] [Indexed: 11/13/2022] Open
Abstract
The dorsolateral prefrontal cortex (dlPFC) and dorsomedial prefrontal cortex (dmPFC) are both important nodes for self-control and decision-making but through separable processes (cognitive control vs evaluative processing). This study aimed to examine the effects of excitatory brain stimulation [intermittent theta burst stimulation (iTBS)] targeting the dlPFC and dmPFC on eating behavior. iTBS was hypothesized to decrease consumption of appetitive snack foods, via enhanced interference control for dlPFC stimulation and reduced delay discounting (DD) for dmPFC stimulation. Using a single-blinded, between-subjects design, participants (N = 43) were randomly assigned to one of three conditions: (i) iTBS targeting the left dlPFC, (ii) iTBS targeting bilateral dmPFC or (iii) sham. Participants then completed two cognitive tasks (DD and Flanker), followed by a bogus taste test. Functional near-infrared spectroscopy imaging revealed that increases in the medial prefrontal cortex activity were evident in the dmPFC stimulation group during the DD task; likewise, a neural efficiency effect was observed in the dlPFC stimulation group during the Flanker. Gender significantly moderated during the taste test, with females in the dmPFC showing paradoxical increases in food consumption compared to sham. Findings suggest that amplification of evaluative processing may facilitate eating indulgence when preponderant social cues are permissive and food is appetitive.
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Affiliation(s)
- Idris Fatakdawala
- School of Public Health and Health Systems, University of Waterloo, Waterloo, CA, ON, Canada
| | - Hasan Ayaz
- School of Biomedical Engineering, Science and Health, Drexel University, Philadelphia, PA, USA.,Department of Psychology, College of Arts and Sciences, Drexel University, Philadelphia, PA, USA.,Drexel Solutions Institute, Drexel University, Philadelphia, PA, USA.,Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA, USA.,Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Adrian B Safati
- School of Public Health and Health Systems, University of Waterloo, Waterloo, CA, ON, Canada
| | - Mohammad N Sakib
- School of Public Health and Health Systems, University of Waterloo, Waterloo, CA, ON, Canada
| | - Peter A Hall
- School of Public Health and Health Systems, University of Waterloo, Waterloo, CA, ON, Canada.,Centre for Bioengineering and Biotechnology, University of Waterloo, Waterloo, Canada.,Department of Psychology, University of Waterloo, Waterloo, ON, Canada
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6
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Hall PA, Best JR, Beaton EA, Sakib MN, Danckert J. Morphology of the prefrontal cortex predicts body composition in early adolescence: cognitive mediators and environmental moderators in the ABCD Study. Soc Cogn Affect Neurosci 2023; 18:nsab104. [PMID: 34471927 PMCID: PMC11305164 DOI: 10.1093/scan/nsab104] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/26/2021] [Accepted: 09/01/2021] [Indexed: 11/14/2022] Open
Abstract
Morphological features of the lateral prefrontal cortex (PFC) in late childhood and early adolescence may provide important clues as to the developmental etiology of clinical conditions such as obesity. Body composition measurements and structural brain imaging were performed on 11 226 youth at baseline (age 9 or 10 years) and follow-up (age 11 or 12 years). Baseline morphological features of the lateral PFC were examined as predictors of body composition. Findings revealed reliable associations between middle frontal gyrus volume, thickness and surface area and multiple indices of body composition. These findings were consistent across both time points and remained significant after covariate adjustment. Cortical thicknesses of the inferior frontal gyrus and lateral orbitofrontal cortex were also reliable predictors. Morphology effects on body composition were mediated by performance on a non-verbal reasoning task. Modest but reliable moderation effects were observed with respect to environmental self-regulatory demand after controlling for sex, race/ethnicity, income and methodological variables. Overall findings suggest that PFC morphology is a reliable predictor of body composition in early adolescence, as mediated through select cognitive functions and partially moderated by environmental characteristics.
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Affiliation(s)
- Peter A Hall
- School of Public Health Sciences, University of
Waterloo, Waterloo, ON N2L 3G1, Canada
| | - John R Best
- Gerontology Research Centre, Simon Fraser
University, Burnaby, BC V6B 5K3, Canada
| | - Elliott A Beaton
- Department of Psychology, University of New
Orleans, New Orleans, LA 70148, USA
| | - Mohammad N Sakib
- School of Public Health Sciences, University of
Waterloo, Waterloo, ON N2L 3G1, Canada
| | - James Danckert
- Department of Psychology, University of
Waterloo, Waterloo, ON N2L 3G1, Canada
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7
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Zhuang D, Abbas J, Al-Sulaiti K, Fahlevi M, Aljuaid M, Saniuk S. Land-use and food security in energy transition: Role of food supply. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.1053031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Food security in a just energy transition is a growing debate about designing sustainable food secure networks worldwide. Energy transition, land-use change, and food security are crucial factors for food security and provision. The increased demand for food products and customer preferences regarding food safety provide various issues for the current agriculture food supply chain (AFSC). Along with rising sustainability concerns, strict government regulation, food security, and traceability concerns compel managers, business houses, and practitioners working in AFSC to adopt new tools, techniques, and methodologies to model current food supply chain problems. Thus, in turn, design the food logistics network for food security. Hence, this study investigates the core determinants of food security and supply in Egypt, Morocco, Tunisia, and Lebanon over the period of 2010–2019. In order to estimate the objectives of the study, we employ the fully modified ordinary least square (FMOLS) and dynamic ordinary least squares estimators (DOLS) to draw the study findings. However, the estimated results show a negative association of land use with food security and supply. Likewise, energy transition, gross domestic product, and agricultural value added (AVA) contribute to the food security supply. In contrast, urbanization's negative but insignificant contribution to the food supply in selected economies exists. Besides, another core objective of the study is to investigate the moderate role of the energy transition on the gross domestic product, agriculture sector, and land use and find the significant contribution to the food supply. However, the current study also tries forecasting for the next 10 years and employs the impulse response function (IRF) and variance decomposition analysis (VDA). Congruently, this study uses the pairwise panel causality test and finds exciting outcomes. The COVID-19 crisis has posed challenges such as energy consumption and food security issues. On behalf of the results, the current study proposes imperative policies to investigate the desired level of food supply. The findings provide valuable insights for experts, policymakers, and officials to take practical measures for energy use and food security challenges.
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8
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Ester T, Kullmann S. Neurobiological regulation of eating behavior: Evidence based on non-invasive brain stimulation. Rev Endocr Metab Disord 2022; 23:753-772. [PMID: 34862944 PMCID: PMC9307556 DOI: 10.1007/s11154-021-09697-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 12/28/2022]
Abstract
The prefrontal cortex is appreciated as a key neurobiological player in human eating behavior. A special focus is herein dedicated to the dorsolateral prefrontal cortex (DLPFC), which is critically involved in executive function such as cognitive control over eating. Persons with obesity display hypoactivity in this brain area, which is linked to overconsumption and food craving. Contrary to that, higher activity in the DLPFC is associated with successful weight-loss and weight-maintenance. Transcranial direct current stimulation (tDCS) is a non-invasive neurostimulation tool used to enhance self-control and inhibitory control. The number of studies using tDCS to influence eating behavior rapidly increased in the last years. However, the effectiveness of tDCS is still unclear, as studies show mixed results and individual differences were shown to be an important factor in the effectiveness of non-invasive brain stimulation. Here, we describe the current state of research of human studies using tDCS to influence food intake, food craving, subjective feeling of hunger and body weight. Excitatory stimulation of the right DLPFC seems most promising to reduce food cravings to highly palatable food, while other studies provide evidence that stimulating the left DLPFC shows promising effects on weight loss and weight maintenance, especially in multisession approaches. Overall, the reported findings are heterogeneous pointing to large interindividual differences in tDCS responsiveness.
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Affiliation(s)
- Theresa Ester
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.
- German Center of Diabetes Research (DZD), Tübingen, Germany.
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.
- German Center of Diabetes Research (DZD), Tübingen, Germany.
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Ebehard Karls University Tübingen, Tübingen, Germany.
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9
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Song S, Zilverstand A, Gui W, Pan X, Zhou X. Reducing craving and consumption in individuals with drug addiction, obesity or overeating through neuromodulation intervention: a systematic review and meta-analysis of its follow-up effects. Addiction 2022; 117:1242-1255. [PMID: 34514666 DOI: 10.1111/add.15686] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 09/01/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Non-invasive brain stimulation has shown potential in clinical applications aiming at reducing craving and consumption levels in individuals with drug addiction or overeating behaviour. However, it is unclear whether these intervention effects are maintained over time. This study aimed to measure the immediate, short- and long-term effects of excitatory transcranial direct current stimulation (tDCS) and high-frequency repetitive transcranial magnetic stimulation (rTMS) targeting at dorsolateral prefrontal cortex (dlPFC) in people with drug addiction or overeating. METHODS A systematic review and random effects meta-analysis. We included 20 articles (total of 22 studies using randomized controlled trials: 3 alcohol dependence, 3 drug dependence, 12 smoking, 4 overeating; total: 720 participants) from January 2000 to June 2020, which reported at least one follow-up assessment of craving, consumption or abstinence levels after the intervention. We compared effects of active versus sham stimulation immediately after the intervention and at the last follow-up assessment, as compared with baseline. RESULTS Excitatory neuromodulation of dlPFC activity reduced craving and consumption immediately after the intervention (craving: g = 0.734, CI = 0.447-1.021, P < 0.001; consumption: g = 0.527, CI = 0.309-0.745; P < 0.001), as well as during short-, mid- and long-term abstinence (craving: g = 0.677, CI = 0.440-0.914, P < 0.001; consumption: g = 0.445, CI = 0.245-0.645, P < 0.001; abstinence levels: g = 0.698, CI = 0.433-0.963, P < 0.001; average time of follow-up: 84 ± 83 days after last stimulation). Additional analysis demonstrated that the intervention effects were sustained in all populations studied (food, nicotine, alcohol or drug abuse) and with both stimulation techniques used (rTMS, tDCS). Interventions targeting at the left (vs right) hemisphere may be more effective. CONCLUSIONS Excitatory neuromodulation targeting the dorsolateral prefrontal cortex appears to lead to a sustained reduction of craving and consumption in individuals with addiction or overeating behaviour.
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Affiliation(s)
- Sensen Song
- Department of Psychology, School of Humanities, Tongji University, Shanghai, China
| | - Anna Zilverstand
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Wenjun Gui
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xuefei Pan
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Xiaolin Zhou
- Department of Psychology, School of Humanities, Tongji University, Shanghai, China
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
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10
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Ghobadi-Azbari P, Malmir N, Vartanian M, Mahdavifar-Khayati R, Robatmili S, Hadian V, Derafsheh S, Nitsche MA, Nosratabadi M, Farhoudian A, Ekhtiari H. Transcranial direct current stimulation to modulate brain reactivity to food cues in overweight and obese adults: study protocol for a randomized controlled trial with fMRI (NeuroStim-Obesity). Trials 2022; 23:297. [PMID: 35413923 PMCID: PMC9003175 DOI: 10.1186/s13063-022-06234-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 03/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background With increasing obese populations worldwide, developing interventions to modulate food-related brain processes and functions is particularly important. Evidence suggests that transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) may modulate the reward–control balance towards facilitation of cognitive control and possible suppression of reward-related mechanisms that drive food cue-induced craving. This protocol describes a clinical trial that investigates the neurocognitive mechanisms of action for tDCS to modulate food cue-reactivity and cravings in people with obesity. Method The NeuroStim-Obesity trial is a prospective, randomized, sham-controlled, double-blind single-session tDCS trial targeting food craving in those with obesity or overweighed. Once randomized, 64 adults with obesity or overweighed complete one session in which they receive either active or sham tDCS over the DLPFC (anode F4 and cathode F3, 2 mA intensity for 20 min). The primary outcome is change in neural response to the food cue-reactivity task in the ventral striatum after a single-session bilateral tDCS compared to sham stimulation. Secondary outcomes include changes in food craving evaluated by the Food Craving Questionnaire-State (FCQ-S). We will also explore the predictive role of brain structure and functional networks assessed by structural and functional magnetic resonance imaging (MRI) during both task performance and the resting-state that are acquired pre- and post-intervention to predict response to tDCS. Discussion The results will provide novel insight into neuroscience for the efficacy of tDCS and will advance the field towards precision medicine for obesity. Exploratory results will examine the potential predictive biomarkers for tDCS response and eventually provide personalized intervention for the treatment of obesity. Trial registration Iranian Registry of Clinical Trials (IRCT) IRCT20121020011172N4. Retrospectively registered on 4 June 2020
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Affiliation(s)
- Peyman Ghobadi-Azbari
- Department of Biomedical Engineering, Shahed University, Tehran, Iran.,Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Nastaran Malmir
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran. .,Department of Psychology, Islamic Azad University, Science and Research Branch, Tehran, Iran.
| | | | | | - Somaye Robatmili
- Department of Psychology, Islamic Azad University, Science and Research Branch, Tehran, Iran
| | - Venus Hadian
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Derafsheh
- Department of Cognitive Neuroscience, Tabriz University, Tabriz, Iran
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Masoud Nosratabadi
- Department of Psychology, Paarand Center for Human Enhancement, Tehran, Iran
| | - Ali Farhoudian
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Ekhtiari
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
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11
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Farhat LC, Carvalho AF, Solmi M, Brunoni AR. Evidence-based Umbrella Review of Cognitive Effects of Prefrontal tDCS. Soc Cogn Affect Neurosci 2020; 17:43-60. [PMID: 32577732 PMCID: PMC8866814 DOI: 10.1093/scan/nsaa084] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 04/29/2020] [Accepted: 06/15/2020] [Indexed: 12/04/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique, which has been increasingly used as an investigational tool in neuroscience. In social and affective neuroscience research, the prefrontal cortex has been primarily targeted, since this brain region is critically involved in complex psychobiological processes subserving both Șhotș and Școldș domains. Although several studies have suggested that prefrontal tDCS can enhance neuropsychological outcomes, meta-analyses have reported conflicting results. Therefore, we aimed to assess the available evidence by performing an umbrella review of meta-analyses. We evaluated the effects of prefrontal active vs sham tDCS on different domains of cognition among healthy and neuropsychiatric individuals. A MeaSurement Tool to Assess Systematic Reviews 2 was employed to evaluate the quality of meta-analyses, and the GRADE system was employed to grade the quality of evidence of every comparison from each meta-analysis. PubMed/MEDLINE, PsycINFO and the Cochrane Database of Systematic Reviews were searched, and 11 meta-analyses were included resulting in 55 comparisons. Only 16 comparisons reported significant effects favoring tDCS, but 13 of them had either very low or low quality of evidence. Of the remaining 39 comparisons which reported non-significant effects, 38 had either very low or low quality of evidence. Meta-analyses were rated as having critically low and low quality. Among several reasons to explain these findings, the lack of consensus and reproducibility in tDCS research is discussed.
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Affiliation(s)
- Luis C Farhat
- Departamento de Psiquiatria da Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Andre F Carvalho
- Center for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,IMPACT Strategic Research Centre (Innovation in Mental and Physical Health and Clinical Treatment), Deakin University, Geelong, Vic., Australia
| | - Marco Solmi
- Padua Neuroscience Center, University of Padua, Padua, Italy.,Department of Neuroscience, University of Padua, Padua, Italy
| | - Andre R Brunoni
- Departamento de Psiquiatria da Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Neurosciences (LIM-27), Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.,Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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12
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Safati AB, Hall PA. Contextual cues as modifiers of cTBS effects on indulgent eating. Brain Stimul 2019; 12:1253-1260. [DOI: 10.1016/j.brs.2019.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/20/2019] [Accepted: 05/01/2019] [Indexed: 11/27/2022] Open
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13
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Hall PA. What mediates exercise effects on dietary choice? Clues from the brain stimulation literature. Int J Obes (Lond) 2019; 43:1650-1651. [PMID: 31189984 DOI: 10.1038/s41366-019-0395-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 04/08/2019] [Accepted: 04/21/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Peter A Hall
- Prevention Neuroscience Laboratory, School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada.
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14
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Song S, Zilverstand A, Gui W, Li HJ, Zhou X. Effects of single-session versus multi-session non-invasive brain stimulation on craving and consumption in individuals with drug addiction, eating disorders or obesity: A meta-analysis. Brain Stimul 2019; 12:606-618. [DOI: 10.1016/j.brs.2018.12.975] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 12/18/2018] [Accepted: 12/24/2018] [Indexed: 01/09/2023] Open
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15
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Lowe CJ, Reichelt AC, Hall PA. The Prefrontal Cortex and Obesity: A Health Neuroscience Perspective. Trends Cogn Sci 2019; 23:349-361. [DOI: 10.1016/j.tics.2019.01.005] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/08/2019] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
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16
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Pleger B. Invasive and Non-invasive Stimulation of the Obese Human Brain. Front Neurosci 2018; 12:884. [PMID: 30555295 PMCID: PMC6281888 DOI: 10.3389/fnins.2018.00884] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/13/2018] [Indexed: 01/18/2023] Open
Abstract
Accumulating evidence suggests that non-invasive and invasive brain stimulation may reduce food craving and calorie consumption rendering these techniques potential treatment options for obesity. Non-invasive transcranial direct current stimulation (tDCS) or repetitive transcranial magnet stimulation (rTMS) are used to modulate activity in superficially located executive control regions, such as the dorsolateral prefrontal cortex (DLPFC). Modulation of the DLPFC’s activity may alter executive functioning and food reward processing in interconnected dopamine-rich regions such as the striatum or orbitofrontal cortex. Modulation of reward processing can also be achieved by invasive deep brain stimulation (DBS) targeting the nucleus accumbens. Another target for DBS is the lateral hypothalamic area potentially leading to improved energy expenditure. To date, available evidence is, however, restricted to few exceptional cases of morbid obesity. The vagal nerve plays a crucial role in signaling the homeostatic demand to the brain. Invasive or non-invasive vagal nerve stimulation (VNS) is thus assumed to reduce appetite, rendering VNS another possible treatment option for obesity. Based on currently available evidence, the U.S. Food and Drug Administration recently approved VNS for the treatment of obesity. This review summarizes scientific evidence regarding these techniques’ efficacy in modulating food craving and calorie intake. It is time for large controlled clinical trials that are necessary to translate currently available research discoveries into patient care.
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Affiliation(s)
- Burkhard Pleger
- Department of Neurology, BG University Clinic Bergmannsheil, Ruhr-University Bochum, Bochum, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,IFB AdiposityDiseases, Leipzig University Medical Centre, Leipzig, Germany.,BMBF nutriCARD, Center of Veterinary Public Health, University of Leipzig, Leipzig, Germany.,Collaborative Research Centre 1052 "Obesity Mechanisms", University Hospital Leipzig, Leipzig, Germany.,Collaborative Research Centre 874 "Integration and Representation of Sensory Processes", Ruhr-University Bochum, Bochum, Germany
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17
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Habib S, Hamid U, Jamil A, Zainab AZ, Yousuf T, Habib S, Tariq SM, Ali F. Transcranial Magnetic Stimulation as a Therapeutic Option for Neurologic and Psychiatric Illnesses. Cureus 2018; 10:e3456. [PMID: 30564535 PMCID: PMC6298622 DOI: 10.7759/cureus.3456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/16/2018] [Indexed: 12/27/2022] Open
Abstract
In recent years, transcranial magnetic stimulation has become an area of interest in the field of neurosciences due to its ability to non-invasively induce sufficient electric current to depolarize superficial axons and networks in the cortex and can be used to explore brain functioning. Evidence shows that transcranial magnetic stimulation could be used as a diagnostic and therapeutic tool for various neurological and psychiatric illnesses. The aim of this review is to introduce the basics of this technology to the readers and to bring together an overview of some of its clinical applications investigated thus far.
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Affiliation(s)
- Sara Habib
- Neurology, Thomas Jefferson University, Philadelphia, USA
| | - Umair Hamid
- Internal Medicine, The Indus Hospital, Lahore, PAK
| | - Ayesha Jamil
- Internal Medicine, Fatima Jinnah Medical University, Lahore, PAK
| | - Aariz Z Zainab
- Radiology, Mayo Hospital King Edward Medical College, Lahore, PAK
| | - Tooba Yousuf
- Family Medicine, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
| | - Sana Habib
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Syed Maaz Tariq
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Faryal Ali
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
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18
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Hall PA, Bickel WK, Erickson KI, Wagner DD. Neuroimaging, neuromodulation, and population health: the neuroscience of chronic disease prevention. Ann N Y Acad Sci 2018; 1428:240-256. [PMID: 29863790 PMCID: PMC6175225 DOI: 10.1111/nyas.13868] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/24/2018] [Accepted: 05/04/2018] [Indexed: 01/10/2023]
Abstract
Preventable chronic diseases are the leading cause of death in the majority of countries throughout the world, and this trend will continue for the foreseeable future. The potential to offset the social, economic, and personal burdens associated with such conditions depends on our ability to influence people's thought processes, decisions, and behaviors, all of which can be understood with reference to the brain itself. Within the health neuroscience framework, the brain can be viewed as a predictor, mediator, moderator, or outcome in relation to health-related phenomena. This review explores examples of each of these, with specific reference to the primary prevention (i.e., prevention of initial onset) of chronic diseases. Within the topic of primary prevention, we touch on several cross-cutting themes (persuasive communications, delay discounting of rewards, and self-control), and place a special focus on obesity as a disorder influenced by both eating behavior and exercise habits.
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Affiliation(s)
- Peter A. Hall
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooOntarioCanada
| | - Warren K. Bickel
- Departments of PsychologyNeuroscience and Health Sciences, Virginia TechRoanokeVirginia
| | - Kirk I. Erickson
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvania
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19
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Hall PA, Lowe CJ. Cravings, currents and cadavers: What is the magnitude of tDCS effects on food craving outcomes? Nutr Neurosci 2018; 23:490-493. [PMID: 30153775 DOI: 10.1080/1028415x.2018.1513678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Peter A Hall
- School of Public Health & Health Systems, University of Waterloo, Canada
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20
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Han JE, Boachie N, Garcia-Garcia I, Michaud A, Dagher A. Neural correlates of dietary self-control in healthy adults: A meta-analysis of functional brain imaging studies. Physiol Behav 2018; 192:98-108. [PMID: 29496487 DOI: 10.1016/j.physbeh.2018.02.037] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/31/2018] [Accepted: 02/16/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Jung Eun Han
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada, 3801 University Street, Montreal H3A 2B4, QC, Canada.
| | - Nadia Boachie
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada, 3801 University Street, Montreal H3A 2B4, QC, Canada.
| | - Isabel Garcia-Garcia
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada, 3801 University Street, Montreal H3A 2B4, QC, Canada.
| | - Andréanne Michaud
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada, 3801 University Street, Montreal H3A 2B4, QC, Canada.
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada, 3801 University Street, Montreal H3A 2B4, QC, Canada.
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21
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Lowe CJ, Staines WR, Manocchio F, Hall PA. The neurocognitive mechanisms underlying food cravings and snack food consumption. A combined continuous theta burst stimulation (cTBS) and EEG study. Neuroimage 2018; 177:45-58. [DOI: 10.1016/j.neuroimage.2018.05.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 01/13/2023] Open
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22
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Hall PA, Lowe CJ, Safati AB, Li H, Klassen EB, Burhan AM. Effects of left dlPFC modulation on social cognitive processes following food sampling. Appetite 2018; 126:73-79. [PMID: 29601918 DOI: 10.1016/j.appet.2018.03.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 03/09/2018] [Accepted: 03/26/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND The dorsolateral prefrontal cortex (dlPFC) plays a central role in the inhibition of eating, but also the modulation of conscious thought processes that might precede, accompany or follow initial food tasting. The latter might be particularly important to the extent that post-tasting cognitions may drive prolonged eating beyond the satiety point. However, we know very little about the effect of the dlPFC on conation following initial food sampling. This investigation compared the effects of dlPFC attenuation using repetitive transcranial magnetic stimulation (rTMS) on social cognition following (Study 1) and prior to (Study 2) a food consumption opportunity. METHODS In Study 1, participants (N = 21; Mage = 21 years) were randomized to active or sham continuous theta-burst stimulation (cTBS; an inhibitory variant of rTMS) targeting the left dlPFC followed by an interference task. Participants subsequently completed measures of attitudes, norms and perceived control following a mock taste test. In Study 2, a second sample of right handed participants (N = 37; Mage = 21 years) were assigned to active or sham cTBS, followed by an interference task and two measures of attitudes (implicit and explicit), both assessed prior to the same taste test paradigm. RESULTS In Study 1, findings revealed a reliable effect of cTBS on post-tasting attitudes (t(1,19) = 3.055, p = .007; d = 1.34), such that attitudes towards calorie dense snack foods were significantly more positive following active stimulation than following sham stimulation. Similar effects were found for social norms (t(1,19) = 3.024, p = .007, d = 1.31) and perceived control (t(1,20) = 19.247, p < .001, d = 0.50). In Study 2, no effects of cTBS were observed on pre-consumption attitudes, despite reliable effects on interference scores and subsequent consumption. CONCLUSIONS The left dlPFC may selectively modulate facilitative social cognition following initial food sampling (but not pre-consumption).
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Affiliation(s)
| | | | | | | | | | - Amer M Burhan
- Western University and Parkwood Institute-Mental Health, Canada
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23
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Lowe CJ, Manocchio F, Safati AB, Hall PA. The effects of theta burst stimulation (TBS) targeting the prefrontal cortex on executive functioning: A systematic review and meta-analysis. Neuropsychologia 2018; 111:344-359. [PMID: 29438672 DOI: 10.1016/j.neuropsychologia.2018.02.004] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 02/02/2018] [Accepted: 02/03/2018] [Indexed: 12/16/2022]
Abstract
Theta burst stimulation (TBS) is a highly efficient repetitive transcranial magnetic stimulation (rTMS) variant employed in experimental and clinical treatment paradigms. Despite widespread usage of TBS targeting the prefrontal cortex (PFC), there has been no systematic review of the evidence linking TBS protocols to changes in task performance on common measures of prefrontal function in general, and executive functions specifically. A systematic review of the literature was conducted using PsycINFO, PubMed, Web of Science and Scopus databases to identify articles examining the effects of TBS targeting the PFC on executive function task performance. Both the up-regulating (intermittent theta burst stimulation; iTBS) and down-regulating (continuous theta burst stimulation; cTBS) variants of TBS were considered. 32 (29 cTBS; 8 iTBS) studies met the inclusion criteria. Participants (n = 759; 51.41% female) were primarily young adults (Mage = 26), with one study examining the effects of cTBS and iTBS in older adults. Results from individual studies were converted to Hedge's g and random-effects models were used to estimate the overall effect size for each protocol. Age, biological sex, and control methodology were examined as potential moderators of the cTBS effect on executive function test performance. Findings indicated a- reliable attentuating effect of cTBS on executive function task performance (g = -.244, Z = -5.920, p < .001); this effect was relatively uniform across included studies (Q= 24.178, p = .838, I2 = 0). Although no significant moderators of the cTBS effect were identified, laterality sub analyses indicated that the magnitude of the effect was significantly higher (Mdiff = .213, Zdiff = 2.546, p = .011) for left-sided (g = -.358, Z = -5.816, p < .001) relative to right-sided (g = -.145, Z = -2.552, p = .011) PFC stimulation. A systematic review of iTBS studies revealed variability in reliability of effects though most were in the theorized direction. TBS protocols appear to be effective in modulating prefrontal cortical excitability in previously theorized directions.
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Affiliation(s)
- Cassandra J Lowe
- Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada N2L 3G1
| | - Felicia Manocchio
- Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada N2L 3G1
| | - Adrian B Safati
- Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada N2L 3G1
| | - Peter A Hall
- Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada N2L 3G1.
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24
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Ulrich M, Lorenz S, Spitzer MW, Steigleder L, Kammer T, Grön G. Theta-burst modulation of mid-ventrolateral prefrontal cortex affects salience coding in the human ventral tegmental area. Appetite 2017; 123:91-100. [PMID: 29247796 DOI: 10.1016/j.appet.2017.12.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/20/2017] [Accepted: 12/12/2017] [Indexed: 01/01/2023]
Abstract
In the context of hedonic (over-)eating the ventral tegmental area (VTA) as a core part of the dopaminergic reward system plays a central role in coding incentive salience of high-caloric food. In the present study, we used functional magnetic resonance imaging (fMRI) to investigate whether transcranial magnetic theta-burst stimulation (TBS) over the right mid-ventrolateral prefrontal cortex (mid-VLPFC) can induce modulation of calorie-sensitive brain activation in the VTA. The prefrontal location for TBS had been predetermined by seed-based resting-state fMRI with a functionally defined portion of the VTA serving as seed region obtained from an independent second fMRI experiment. In a sample of 15 healthy male participants, modulation of calorie-sensitive VTA activation did not significantly differ between the two TBS protocols. Comparisons with baseline revealed that both TBS protocols significantly affected calorie-sensitive neural processing of the mid-VLPFC in a rather similar way. In the VTA significant modulation of calorie-sensitive activation was observed after continuous TBS, whereas the modulatory effect of intermittent TBS was less reliable but also associated with a decrease of activation for high-caloric food images. Neurostimulation of right mid-VLPFC is suggestive as a main entry point of downstream signal changes for high- and low-caloric food cues that could enforce a shift in valuating stimuli of initially different incentive salience.
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Affiliation(s)
- Martin Ulrich
- Department of Psychiatry, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Sabrina Lorenz
- Department of Psychiatry, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Markus W Spitzer
- Department of Psychiatry, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Leon Steigleder
- Department of Psychiatry, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Thomas Kammer
- Department of Psychiatry, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Georg Grön
- Department of Psychiatry, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany.
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