Effects of Transcranial Direct Current Stimulation (tDCS) on Go/NoGo Performance Using Food and Non-Food Stimuli in Patients with Prader–Willi Syndrome

Abstract

Prader–Willi syndrome (PWS) is a neurodevelopmental genetic disorder characterized by multiple system involvement with hypotonia, poor suck with feeding difficulties, growth and other hormone deficiencies, intellectual disability, and behavioral problems with childhood onset of hyperphagia resulting in obesity, if not externally controlled. Transcranial direct current stimulation (tDCS) has been increasingly shown to modulate cognitive and behavioral processes in children and adults, including food-intake behaviors in patients with PWS. This study further reports the positive effects of brief tDCS sessions on Go/NoGo task performance involving food and non-food stimuli images, alterations in N2 brain amplitude, and genetic subgroup differences (maternal disomy 15, UPD; 15q11-q13 deletion, DEL) before and after tDCS as assessed by event-related potentials (ERPs) in 10 adults with PWS. The results indicate a group effect on baseline NoGo N2 amplitude in PWS patients with DEL vs UPD (p =0.046) and a decrease in NoGo N2 amplitude following tDCS (p = 0.031). Our tDCS approach also demonstrated a trend towards decreased response time. Collectively, these results replicate and expand prior work highlighting neurophysiological differences in patients with PWS according to genetic subtype and demonstrate the feasibility in examining neuromodulatory effects of tDCS on information processing in this patient population to stimulate additional research and treatment.

Clinical Trials in Prader–Willi Syndrome: A Review

“…These include transcranial direct-current stimulation and transcutaneous vagus nerve stimulation in individuals with PWS, as well as generated information relating to brain regions and function impacted by the PWS diagnosis which require more testing. No specific differences were noted in response to the individual clinical-trial protocols or therapeutic agents related to the PWS molecular genetic classes identified in the PWS participants enrolled in the clinical trials [23,40,[46][47][48][49]58].…”

“…This technique has been undertaken in multiple studies in humans and can stimulate targeted brain regions and networks to increase or decrease cortical excitability in children or adults. In addition, the dorsolateral prefrontal cortex (DLPFC) is involved in the regulation and processing of food craving and motivation accessible by tDCS [46][47][48].…”

“…In 2021, Poje et al [48] further investigated the effect of tDCS on the DLPFC and hyperphagia in patients with PWS by reporting on the positive effects of brief tDCS sessions on the Go/NoGo task performance involving food and non-food stimuli images. Alterations in N2-brainwave-amplitude were recorded utilizing a skull-cap electroencephalogram apparatus, and PWS molecular genetic class differences before and after tDCS were assessed by event-related potentials (ERPs) in ten adults with PWS.…”

Transcranial Direct Current Stimulation in neurogenetic syndromes: new treatment perspectives for Down syndrome?

“…The rationale came from evidence in healthy individuals and in patients with stroke (Fertonani et al, 2010 ; Cattaneo et al, 2011 ; Wirth et al, 2011 ). In the case of PWS, the aim was to enhance prefrontal neural circuit excitability by anodal tDCS with the goal of reducing excessive activity in subcortical structures and, in turn, decreasing hyperphagia (Boggio et al, 2009 ; Bravo et al, 2016 ; Azevedo et al, 2017 , 2021 ; Poje et al, 2021 ). The rationale came from a number of studies in healthy individuals and in patients with substances abuse and food craving (Fregni et al, 2008a , b ; Boggio et al, 2009 ; Goldman et al, 2011 ).…”

Improved food Go/No‐Go scores after transcranial direct current stimulation (tDCS) to prefrontal cortex in a randomized trial

“…Specifically, tDCS has been shown to evoke improvements in response inhibition [28] and decision‐making [29]. For example, faster “Go” reaction time on a food “Go/No‐Go” (GNG) task [30] and improvements in accuracy, mean reaction time, and commission errors on a dual food‐related two‐back GNG task [24] have been observed following anodal tDCS to the right dlPFC in participants with PWS [30] and to the left dlPFC in women [24]. The effectiveness of tDCS may even be improved with the addition of a cognitive task that promotes neuronal activity in the target brain regions [31].…”