Repeated net-tDCS of the hypothalamus appetite-control network reduces inhibitory control and sweet food intake in persons with overweight or obesity
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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/m 2 , 52.3 % female) received active (anodal or cathodal) or sham 12-channel net-tDCS on the hypothalamus appetite-control network for 25 minutes 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.
Graphical Abstract
Highlights
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Active net-tDCS groups showed better inhibitory control compared to the sham group.
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Stronger increase in hypothalamic functional connectivity associated with better inhibitory control after active net-tDCS.
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No differences were found between the active net-tDCS and sham groups for total kilocaloric intake.
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Anodal net-tDCS showed lower sweet food intake compared to the sham group.
