Repeated net-tDCS of the hypothalamus appetite-control network enhances inhibitory control and decreases sweet food intake in persons with overweight or obesity

IF 7.6 1区医学 Q1 CLINICAL NEUROLOGY

Brain Stimulation Pub Date : 2025-04-11 DOI:10.1016/j.brs.2025.04.013

Theresa Ester-Nacke , Ralf Veit , Julia Thomanek , Magdalena Book , Lukas Tamble , Marie Beermann , Dorina Löffler , Ricardo Salvador , Giulio Ruffini , Martin Heni , Andreas L. Birkenfeld , Christian Plewnia , Hubert Preissl , Stephanie Kullmann

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Abstract

Background

Reduced inhibitory control is associated with obesity and neuroimaging studies indicate that diminished prefrontal cortex activity influence eating behavior and metabolism. The hypothalamus regulates energy homeostasis and is functionally connected to cortical and subcortical regions especially the frontal areas.

Objectives

We tested network-targeted transcranial direct current stimulation (net-tDCS) to influence the excitability of brain regions involved in appetite control.

Methods

In a randomized, double-blind parallel group design, 44 adults with overweight or obesity (BMI 30.6 kg/m², 52.3 % female) received active (anodal or cathodal) or sham 12-channel net-tDCS on the hypothalamus appetite-control network for 25 min on three consecutive days while performing a Stop-Signal-Task to measure response inhibition. Before and after stimulation, state questionnaires assessed changes in desire to eat and food craving. Directly after stimulation, participants received a breakfast buffet to evaluate ad-libitum food intake. An oral glucose tolerance test was conducted at follow-up. Resting-state functional MRI was obtained at baseline and follow-up.

Results

The Stop-Signal Reaction Time (SSRT) was shorter in both active groups versus sham, indicating improved response inhibition. Additionally, a stronger increase in hypothalamic functional connectivity was associated with shorter SSRT. Caloric intake of sweet food was lower in the anodal group versus sham, but no main effects between groups were observed on total and macronutrient intake, food craving ratings and desire to eat. At follow-up, no differences were observed between groups on peripheral metabolism.

Conclusion

Our study suggests that modulating hypothalamic functional network connectivity patterns via net-tDCS may improve food choice and inhibitory control.

Abstract Image

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下丘脑食欲控制网络的重复净tdcs增强了抑制性控制，减少了超重或肥胖人群的甜食摄入量

背景：抑制控制的减弱与肥胖有关，神经影像学研究表明，前额皮质活动的减弱影响饮食行为和代谢。下丘脑调节能量稳态，并在功能上与皮层和皮层下区域，特别是额叶区域相连。目的研究网络定向经颅直流电刺激（net-tDCS）对食欲控制脑区兴奋性的影响。方法采用随机双盲平行组设计，44名超重或肥胖成人（BMI 30.6 kg/m2, 52.3%为女性）连续3天在下丘脑食欲控制网络上接受主动（阳极或阴极）或假12通道网络tdcs，持续25分钟，同时执行停止信号任务以测量反应抑制。在刺激前后，状态问卷评估了食欲和食物渴望的变化。在刺激之后，参与者直接吃了一顿自助早餐，以评估他们的随意食物摄入量。随访时进行口服葡萄糖耐量试验。在基线和随访时进行静息状态功能MRI检查。结果两组患者的停止信号反应时间（SSRT）均较假手术组短，反应抑制能力明显增强。此外，下丘脑功能连通性的增强与较短的SSRT相关。与假手术组相比，阳极组的甜食热量摄入较低，但两组之间在总营养素和常量营养素摄入量、食物渴望等级和食欲方面没有观察到主要影响。随访时，各组外周代谢无明显差异。结论通过网络- tdcs调节下丘脑功能网络连接模式可改善食物选择和抑制控制。

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来源期刊

Brain Stimulation 医学-临床神经学

CiteScore

13.10

自引率

9.10%

发文量

256

审稿时长

72 days

期刊介绍： Brain Stimulation publishes on the entire field of brain stimulation, including noninvasive and invasive techniques and technologies that alter brain function through the use of electrical, magnetic, radiowave, or focally targeted pharmacologic stimulation. Brain Stimulation aims to be the premier journal for publication of original research in the field of neuromodulation. The journal includes: a) Original articles; b) Short Communications; c) Invited and original reviews; d) Technology and methodological perspectives (reviews of new devices, description of new methods, etc.); and e) Letters to the Editor. Special issues of the journal will be considered based on scientific merit.