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The Effects of Continuous Theta Burst Stimulation to the Left Dorsolateral Prefrontal Cortex on Executive Function, Food Cravings, and Snack Food Consumption

Lowe, Cassandra J. MSc; Hall, Peter A. PhD; Staines, William R. PhD

doi: 10.1097/PSY.0000000000000090
Original Articles

Objectives Prior research has demonstrated that executive function (EF) strength is positively associated with dietary self-control. As such, the differential operation of the brain centers underlying EFs (i.e., dorsolateral prefrontal cortex [DLPFC]) may explain controlled aspects of dietary self-control. The present study was designed to examine the causal relationship between DLPFC function and two aspects of dietary self-control: visceral cravings and actual consumptive behaviors.

Methods The research was conducted using a within-participant design. A sample of 21 healthy female young adults aged 19 to 26 years (mean [M; standard deviation] = 21.10 [1.86] years) received both active and sham continuous theta burst stimulation (cTBS) to the left DLPFC. Before and after each session, subjective food cravings were assessed using the Food Craving Questionnaire—State. After each stimulation session, participants competed three measures of EF (Stroop, Go/No-Go, and Stop-Signal) and a bogus taste test.

Results Participants reported larger increases in snack food cravings after active stimulation (M = 9.98% change, standard error [SE] = 0.45) than after sham stimulation (M = −3.46, SE = 0.39, p = .012) on the reinforcement anticipation dimension of Food Craving Questionnaire—State. Likewise, participants consumed significantly more snack foods after active stimulation (M = 70.62 grams, SE = 5.17) than after sham stimulation (M = 61.33, SE = 3.56, p = .006). Finally, performance on the Stroop task was reduced more after active (M = 71.56 milliseconds, SE = 25.18) than after sham stimulation (M = 20.16, SE = 13.32, p = .033); reduction in Stroop performance mediated the effect of active stimulation on increased appetitive food consumption.

Conclusion These results support the contention that EF strength, as modulated by DLPFC activity, is causally associated with effective dietary self-control.

From the School of Public Health and Health Systems (C.L., P.A.H.) and Department of Kinesiology (P.A.H., W.R.S.), University of Waterloo, Waterloo, Ontario, Canada.

Address correspondence and reprint requests to Peter A. Hall, PhD, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1. E-mail:

A podcast discussion of this article is available online with this issue.

Received for publication February 09, 2014; revision received May 15, 2014.

Copyright © 2014 by American Psychosomatic Society
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