Effects of prefrontal theta burst stimulation on neuronal activity and subsequent eating behavior: an interleaved rTMS and fNIRS study

Abstract

The dorsolateral prefrontal cortex (dlPFC) and dorsomedial prefrontal cortex (dmPFC) are important nodes for self-control and decision-making, but through separable processes (cognitive control versus evaluative processing). This study aimed to examine the effects of excitatory brain stimulation (intermittent theta-burst stimulation; iTBS) targeting the dlPFC and dmPFC on food choice. iTBS was hypothesized to decrease consumption of appetitive snack foods, via enhanced interference control for dlPFC stimulation and reduced delay discounting for dmPFC stimulation. Using a single-blinded, between-subjects design, participants (N = 43) were randomly assigned to of the three conditions: 1) iTBS targeting the left dlPFC, 2) iTBS targeting bilateral dmPFC, or 3) sham. Participants then completed two cognitive tasks (delay discounting (DD) and Flanker), followed by a taste test. fNIRS imaging revealed increases in medial PFC activity were evident in the dmPFC stimulation group during the DD task; likewise, a neural efficiency effect was observed in the dlPFC stimulation group during the Flanker. Gender significantly moderated consumption during the taste test, with females in the dmPFC showing paradoxical increases in food consumption compared to sham. Findings are consistent with possible amplification of positive evaluative processing in the presence of dietary restraint, vis-a-vis excitation of the mPFC.