Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Brief Communication
  • Published:

Clinical Research

Prefronto-cerebellar neuromodulation affects appetite in obesity

International Journal of Obesity volume 43, pages 2119–2124 (2019)Cite this article

Subjects

Abstract

Human neuroimaging studies have consistently reported changes in cerebellar function and integrity in association with obesity. To date, however, the nature of this link has not been studied directly. Emerging evidence suggests a role for the cerebellum in higher cognitive functions through reciprocal connections with the prefrontal cortex. The purpose of this exploratory study was to examine appetite changes associated with noninvasive prefronto-cerebellar neuromodulation in obesity. Totally, 12 subjects with class I obesity (mean body mass index 32.9 kg/m2) underwent a randomized, single-blinded, sham-controlled, crossover study, during which they received transcranial direct current stimulation ((tDCS); active/sham) aimed at simultaneously enhancing the activity of the prefrontal cortex and decreasing the activity of the cerebellum. Changes in appetite (state and food-cue-triggered) and performance in a food-modified working memory task were evaluated. We found that active tDCS caused an increase in hunger and desire to eat following food-cue exposure. In line with these data, subjects also tended to make more errors during the working memory task. No changes in basic motor performance occurred. This study represents the first demonstration that prefronto-cerebellar neuromodulation can influence appetite in individuals with obesity. While preliminary, our findings support a potential role for prefronto-cerebellar pathways in the behavioral manifestations of obesity.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2

References

  1. Vainik U, Dagher A, Dubé L, Fellows LK. Neurobehavioural correlates of body mass index and eating behaviours in adults: a systematic review. Neurosci Biobehav Rev. 2013;37:279–99.

    Article  Google Scholar 

  2. Carnell S, Gibson C, Benson L, Ochner CN, Geliebter A. Neuroimaging and obesity: current knowledge and future directions. Obes Rev. 2012;13:43–56.

    Article  CAS  Google Scholar 

  3. García-García I, Michaud A, Dadar M, Zeighami Y, Neseliler S, Collins DL, et al. Neuroanatomical differences in obesity: meta-analytic findings and their validation in an independent dataset. Int J Obes. 2018. https://doi.org/10.1038/s41366-018-0164-4.

  4. Gautier JF, Chen K, Salbe AD, Bandy D, Pratley RE, Heiman M, et al. Differential brain responses to satiation in obese and lean men. Diabetes. 2000;49:838–46.

    Article  CAS  Google Scholar 

  5. Tomasi D, Wang G-J, Wang R, Backus W, Geliebter A, Telang F, et al. Association of body mass and brain activation during gastric distention: implications for obesity. PLoS ONE. 2009;4:e6847.

    Article  Google Scholar 

  6. Noori HR, Cosa Linan A, Spanagel R. Largely overlapping neuronal substrates of reactivity to drug, gambling, food and sexual cues: a comprehensive meta-analysis. Eur Neuropsychopharmacol. 2016;26:1419–30.

    Article  CAS  Google Scholar 

  7. Weise CM, Piaggi P, Reinhardt M, Chen K, Savage CR, Krakoff J. et al. The obese brain as a heritable phenotype: a combined morphometry and twin study. Int J Obes. 2017;41:458–66.

    Article  CAS  Google Scholar 

  8. Berman SM, Paz-Filho G, Wong M-L, Kohno M, Licinio J, London ED. Effects of leptin deficiency and replacement on cerebellar response to food-related cues. Cerebellum. 2013;12:59–67.

    Article  CAS  Google Scholar 

  9. Raschpichler M, Straatman K, Schroeter ML, Arelin K, Schlögl H, Fritzsch D et al. Abdominal fat distribution and its relationship to brain changes: the differential effects of age on cerebellar structure and function: a cross-sectional, exploratory study. BMJ Open 2013; 3. https://doi.org/10.1136/bmjopen-2012-001915.

  10. Zhu J-N, Wang J-J. The cerebellum in feeding control: possible function and mechanism. Cell Mol Neurobiol. 2008;28:469–78.

    Article  Google Scholar 

  11. Schmahmann JD. The Cerebellum and Cognition. Academic Press: San Diego, CA, 1997.

  12. D’Angelo E, Casali S. Seeking a unified framework for cerebellar function and dysfunction: from circuit operations to cognition. Front Neural Circuits. 2012;6:116.

    PubMed  Google Scholar 

  13. Buckner RL. The cerebellum and cognitive function: 25 years of insight from anatomy and neuroimaging. Neuron. 2013;80:807–15.

    Article  CAS  Google Scholar 

  14. Koziol LF, Budding D, Andreasen N, D’Arrigo S, Bulgheroni S, Imamizu H. et al. Consensus paper: the cerebellum’s role in movement and cognition. Cerebellum. 2014;13:151–77.

    Article  Google Scholar 

  15. Moreno-Rius J, Miquel M. The cerebellum in drug craving. Drug Alcohol Depend. 2017;173:151–8.

    Article  Google Scholar 

  16. Palesi F, De Rinaldis A, Castellazzi G, Calamante F, Muhlert N, Chard D, et al. Contralateral cortico-ponto-cerebellar pathways reconstruction in humans in vivo: implications for reciprocal cerebro-cerebellar structural connectivity in motor and non-motor areas. Sci Rep. 2017;7:12841.

    Article  Google Scholar 

  17. Bostan AC, Strick PL. The basal ganglia and the cerebellum: nodes in an integrated network. Nat Rev Neurosci. 2018;19:338–50.

    Article  CAS  Google Scholar 

  18. Bikson M, Grossman P, Thomas C, Zannou AL, Jiang J, Adnan T, et al. Safety of transcranial direct current stimulation: evidence based update 2016. Brain Stimul. 2016;9:641–61.

    Article  Google Scholar 

  19. Heinitz S, Reinhardt M, Piaggi P, Weise CM, Diaz E, Stinson EJ, et al. Neuromodulation directed at the prefrontal cortex of subjects with obesity reduces snack food intake and hunger in a randomized trial. Am J Clin Nutr. 2017;106:1347–57.

    Article  CAS  Google Scholar 

  20. Val-Laillet D, Aarts E, Weber B, Ferrari M, Quaresima V, Stoeckel LE, et al. Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity. Neuroimage Clin. 2015;8:1–31.

    Article  CAS  Google Scholar 

  21. Bersani FS, Minichino A, Bernabei L, Spagnoli F, Corrado A, Vergnani L, et al. Prefronto-cerebellar tDCS enhances neurocognition in euthymic bipolar patients. Findings from a placebo-controlled neuropsychological and psychophysiological investigation. J Affect Disord. 2017;209:262–9.

    Article  Google Scholar 

  22. Grimaldi G, Argyropoulos GP, Boehringer A, Celnik P, Edwards MJ, Ferrucci R, et al. Non-invasive cerebellar stimulation—a consensus paper. Cerebellum. 2014;13:121–38.

    Article  CAS  Google Scholar 

  23. Woods AJ, Antal A, Bikson M, Boggio PS, Brunoni AR, Celnik P. et al. A technical guide to tDCS, and related non-invasive brain stimulation tools. Clin Neurophysiol. 2016;127:1031–48.

    Article  CAS  Google Scholar 

  24. Blundell JE, De Graaf K, Finlayson G, Halford JCG, Hetherington M, King NA, et al. Measuring food intake, hunger, satiety and satiation in the laboratory. In: Allison DB, Baskin ML, editors. Handbook of assessment methods for eating behaviours and weight-related problems: measures, theory and research. 2nd. ed. Sage: Newbury Park, California; 2009, p. 283–325.

  25. Demirtas-Tatlidede A, Freitas C, Pascual-Leone A, Schmahmann JD. Modulatory effects of theta burst stimulation on cerebellar nonsomatic functions. Cerebellum. 2011;10:495–503.

    Article  Google Scholar 

  26. Contreras-Rodríguez O, Vilar-López R, Andrews ZB, Navas JF, Soriano-Mas C, Verdejo-García A. Altered cross-talk between the hypothalamus and non-homeostatic regions linked to obesity and difficulty to lose weight. Sci Rep. 2017;7:9951.

    Article  Google Scholar 

  27. Carnell S, Benson L, Pantazatos SP, Hirsch J, Geliebter A. Amodal brain activation and functional connectivity in response to high-energy-density food cues in obesity. Obesity. 2014;22:2370–8.

    Article  Google Scholar 

Download references

Acknowledgments

Dr. Alonso-Alonso is a recipient of grants from the Boston Nutrition and Obesity Research Center, P30 DK046200, the Nutrition Obesity Research Center at Harvard, P30 DK040561, and the Center for Nutritional Research Charitable Trust. We thank Universitat Oberta de Catalunya for its support in this research and Clinica Sagrada Familia for its involvement in the study. We also thank all participants who took part in this study for their time and help.

Author information

Author notes

  1. Co-first authors: Elena M. Marron, Raquel Viejo-Sobera

  2. These authors contributed equally: Elena M. Marron, Raquel Viejo-Sobera.

Authors and Affiliations

  1. Cognitive NeuroLab, Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain

    Elena M. Marron, Raquel Viejo-Sobera, Diego Redolar-Ripoll & Pilar García Lorda

  2. Laboratory of Bariatric and Nutritional Neuroscience, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Elena M. Marron, Greta Magerowski & Miguel Alonso-Alonso

  3. Endocrinology Department, Clínica Sagrada Familia. Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain

    Guillem Cuatrecasas

  4. Soterix Medical, New York City, NY, USA

    Abhishek Datta

  5. Department of Biomedical Engineering, City College of New York (CCNY), New York, NY, USA

    Marom Bikson

Authors
  1. Elena M. Marron
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Raquel Viejo-Sobera
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guillem Cuatrecasas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Diego Redolar-Ripoll
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pilar García Lorda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Abhishek Datta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marom Bikson
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Greta Magerowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Miguel Alonso-Alonso
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Elena M. Marron or Miguel Alonso-Alonso.

Ethics declarations

Conflict of interest

Drs. Abhishek Datta and Marom Bikson are co-founders of Soterix Medical. The City University of New York has patent applications in Drs. Datta and Bikson’s name on brain stimulation. The remaining authors declare no conflict of interest.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Marron, E.M., Viejo-Sobera, R., Cuatrecasas, G. et al. Prefronto-cerebellar neuromodulation affects appetite in obesity. Int J Obes 43, 2119–2124 (2019). https://doi.org/10.1038/s41366-018-0278-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41366-018-0278-8

This article is cited by

Search

Advanced search

Quick links