Transcranial direct current stimulation reduces food‐craving and measures of hyperphagia behavior in participants with Prader‐Willi syndrome

Abstract

Prader-Willi syndrome (PWS) is a neurodevelopmental genetic disorder characterized by intellectual disabilities and insatiable appetite with compulsive eating leading to severe obesity with detrimental health consequences. Transcranial direct current stimulation (tDCS) has been shown to modulate decision-making and cue-induced food craving in healthy adults. We conducted a pilot double blind, sham-controlled, multicenter study of tDCS modulation of food drive and craving in 10 adult PWS participants, 11 adult obese (OB) and 11 adult healthy-weight control (HWC) subjects. PWS and OB subjects received five consecutive daily sessions of active or sham tDCS over the right dorsolateral prefrontal cortex (DLPFC), while HWC received a single sham and active tDCS in a crossover design. Standardized psychometric instruments assessed food craving, drive and hyperphagia by self-report and caregiver assessment over 30 days. Robust baseline differences were observed in severity scores for the Three-Factor Eating Questionnaire (TFEQ) and Dykens Hyperphagia Questionnaire (DHQ) for PWS compared to HWC while obese participants were more similar to HWC. Active tDCS stimulation in PWS was associated with a significant change from baseline in TFEQ Disinhibition (Factor II) (Ƶ = 1.9, P < 0.05, 30 days) and Total Scores (Ƶ = 2.3, P < 0.02, 30 days), and participant ratings of the DHQ Severity (Ƶ = 1.8, P < 0.06, 5 days) and Total Scores (Ƶ = 1.9, P < 0.05, 15 days). These findings support sustained neuromodulatory effects and efficacy of tDCS to reduce food drive and behaviors impacting hyperphagia in PWS. Transcranial direct current stimulation may represent a straight-forward, low risk and low cost method to improve care, management and quality of life in PWS.

Prefrontal brain stimulation during food-related inhibition training: effects on food craving, food consumption and inhibitory control

“…Although these results are in contrast to previous research they are consistent with a recent study that failed to show an effect of tDCS on cravings and consumption in a sample of healthy individuals ([70]; see also [72]). Furthermore, a recent meta-analysis concluded that single-session tDCS of the DLPFC was not effective at modulating food cravings and that effects on food consumption were unreliable [30].…”

Obesity management in Prader&ndash;Willi syndrome: current perspectives

“…Some devices that are currently being tested also may reduce appetite and improve food-related behavior in individuals with PWS, including transcranial direct current stimulation and vagal nerve stimulators. 119 These techniques seem to provide a safe, painless, inexpensive, nonrestrictive, and noninvasive method to modify neuronal functioning and to positively influence the cognitive process.…”

Food craving, food choice and consumption: The role of impulsivity and sham-controlled tDCS stimulation of the right dlPFC

“…One possible explanation for the null effect of tDCS stimulation could be sample characteristics. Previous studies either only recruited participants with frequent food cravings (Fregni et al, 2008;Goldman et al, 2011;Kekic et al, 2014), or specific medical conditions associated with overeating (Bravo et al, 2016) while the current sample was not preselected regarding such variables. Another possible explanation could be that the current study used a lower current intensity (1 mA) compared to previous studies, which mostly used 2 mA (e.g., Fregni et al, 2008).…”