title: Volitional regulation of brain responses to food stimuli in overweight and obese subjects: A real-time fMRI feedback study.
abstract: Obese subjects who achieve weight loss show increased functional connectivity between dorsolateral prefrontal cortex (dlPFC) and ventromedial prefrontal cortex (vmPFC), key areas of executive control and reward processing. We investigated the potential of real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback training to achieve healthier food choices by enhancing self-control of the interplay between these brain areas. We trained eight male individuals with overweight or obesity (age: 31.8 ± 4.4 years, BMI: 29.4 ± 1.4 kg/m2) to up-regulate functional connectivity between the dlPFC and the vmPFC by means of a four-day rt-fMRI neurofeedback protocol including, on each day, three training runs comprised of six up-regulation and six passive viewing trials. During the up-regulation runs of the four training days, participants successfully learned to increase functional connectivity between dlPFC and vmPFC. In addition, a trend towards less high-calorie food choices emerged from before to after training, which however was associated with a trend towards increased covertly assessed snack intake. Findings of this proof-of-concept study indicate that overweight and obese participants can increase functional connectivity between brain areas that orchestrate the top-down control of appetite for high-calorie foods. Neurofeedback training might therefore be a useful tool in achieving and maintaining weight loss.
authors.affiliation: Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany. Electronic address: maartje.spetter@uni-tuebingen.de.
authors.forename: Maartje S
authors.initials: MS
authors.lastname: Spetter
authors.affiliation: Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Graduate School of Neural & Behavioral Sciences, International Max Planck Research School, Tübingen, Germany.
authors.forename: Rahim
authors.initials: R
authors.lastname: Malekshahi
authors.affiliation: Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Ospedale San Camillo, IRCCS, Venice, Italy; WyssCenter for Bio and Neuroengineering, Geneva, Switzerland.
authors.forename: Niels
authors.initials: N
authors.lastname: Birbaumer
authors.affiliation: Department of Cognitive Neuroscience, Maastricht University, The Netherlands; Brain Innovation B.V., Maastricht, The Netherlands.
authors.forename: Michael
authors.initials: M
authors.lastname: Lührs
authors.affiliation: Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany.
authors.forename: Albert H
authors.initials: AH
authors.lastname: van der Veer
authors.affiliation: High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany; Department of Biomedical Magnetic Resonance, University of Tübingen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Scheffler
authors.affiliation: Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany.
authors.forename: Sophia
authors.initials: S
authors.lastname: Spuckti
authors.affiliation: Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Germany; Institute of Pharmaceutical Sciences, Department of Pharmacy and Biochemistry, Interfaculty Center for Pharmacogenomics and Pharma Research, University of Tübingen, Germany; Institute for Diabetes and Obesity, Helmholtz Diabetes Center, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany.
authors.forename: Hubert
authors.initials: H
authors.lastname: Preissl
authors.affiliation: Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Department of Biomedical Magnetic Resonance, University of Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Veit
authors.affiliation: Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany. Electronic address: manfred.hallschmid@uni-tuebingen.de.
authors.forename: Manfred
authors.initials: M
authors.lastname: Hallschmid
mesh_terms: D000328:Adult; D001069:Appetite Regulation; D015992:Body Mass Index; D001921:Brain; D001931:Brain Mapping; D002755:Choice Behavior / Q000502:physiology; D003463:Cues; D002149:Energy Intake; D005502:Food; D005518:Food Preferences / Q000502:physiology; D006801:Humans; D007858:Learning / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D058765:Neurofeedback; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D050177:Overweight; D017397:Prefrontal Cortex; D012201:Reward; D000068356:Self-Control / Q000523:psychology*; D062410:Snacks
keywords: Dorsolateral prefrontal cortex; Neurofeedback; Obesity; Overweight; Real-time functional magnetic resonance imaging; Ventromedial prefrontal cortex