title: 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.
authors.affiliation: Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Gabriela L
authors.initials: GL
authors.lastname: Bravo
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Albert B
authors.initials: AB
authors.lastname: Poje
authors.affiliation: Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Iago
authors.initials: I
authors.lastname: Perissinotti
authors.affiliation: Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Bianca F
authors.initials: BF
authors.lastname: Marcondes
authors.affiliation: Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Mauricio F
authors.initials: MF
authors.lastname: Villamar
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Manzardo
authors.affiliation: Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Laura
authors.initials: L
authors.lastname: Luque
authors.affiliation: Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jean F
authors.initials: JF
authors.lastname: LePage
authors.affiliation: Division of Endocrinology, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Diane
authors.initials: D
authors.lastname: Stafford
authors.affiliation: Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Felipe
authors.initials: F
authors.lastname: Fregni
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, Kansas City, Kansas.|Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Merlin G
authors.initials: MG
authors.lastname: Butler
mesh_terms: D000328:Adult; D001519:Behavior; D001835:Body Weight; D003071:Cognition; D066249:Craving; D005260:Female; D006801:Humans; D006963:Hyperphagia / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011218:Prader-Willi Syndrome / Q000150:complications* / Q000628:therapy*; D011795:Surveys and Questionnaires; D065908:Transcranial Direct Current Stimulation
keywords: Prader-Willi syndrome; hyperphagia; obesity; transcranial direct current stimulation