RESUMO
BACKGROUND: Given the limited therapeutic options for Prader-Willi syndrome (PWS), we conducted an open-label clinical trial to evaluate the effects of transcranial direct current stimulation (tDCS) for hyperphagia, food craving, and aberrant behaviors on this population. METHODS: Twelve subjects with PWS (11-35 years old) were included. The subjects underwent 10 daily 20-minute sessions of tDCS in 2 weeks. The anode was positioned over the left dorsolateral prefrontal cortex, and the cathode over the contralateral region. RESULTS: We observed amelioration of hyperphagic and food craving symptoms (P < 0.05), as well as amelioration of behavioral symptoms measured with the Aberrant Behavior Checklist (P < 0.05). DISCUSSION: To our knowledge, this is the first proof-of-concept trial to report the positive effects of increasing excitability of the left dorsolateral prefrontal cortex, using tDCS, for the behavioral, hyperphagia, and food craving symptoms in PWS, which is a low-cost, well-studied, safe alternative for brain stimulation.
Assuntos
Síndrome de Prader-Willi/terapia , Estimulação Transcraniana por Corrente Contínua , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Liking is one of the most important psychological processes associated with the reward system, being involved in affective processing and pleasure/displeasure encoding. Currently, there is no consensus regarding the combination of physiological indicators which best predict liking, especially when applied to dynamic stimuli such as videos. There is a lack of a standard methodology to assess likeability over time and therefore in assessing narrative and semantic aspects of the stimulus. We developed a time-dependent method to evaluate the physiological correlates of likeability for three different thematic categories, namely: adventure (AV), comedy (CM), and nature landscape (LS). Twenty-eight healthy adults with ages ranging from 18 to 35 years (average: 23.85 years) were enrolled in the study. The participants were asked to provide likeability ratings for videos as they watched them, using a response box. Three 60-s videos were presented, one for each category, in randomized order while the participant's physiological data [electroencephalogram (EEG), electrocardiogram (ECG) and eye tracking (ET)] was recorded. The comedy video (CM) presented the smallest minimum accumulated normalized rating (ANR; p = 0.013) and the LS video presented the highest maximum ANR (p = 0.039). The LS video presented the longest time for first response (p < 0.001) and the AV video presented the shortest time for maximum response (p = 0.016). The LS video had the highest mean likeability rating with 1.43 ± 2.31 points; and the CM video had the lowest with 0.57 ± 1.77. Multiple linear regression models were created to predict the likeability of each video using the following physiological indicators; AV: power in beta band at C4 and P4 (p = 0.004, adj. R 2 = 0.301); CM: alpha power in Fp2 (p = 0.001, adj. R 2 = 0.326) and LS: alpha power in P4, F8, and Fp2; beta power in C4 and P4 and pupil size, (p = 0.002, adj. R 2 = 0.489). Despite its limitations (e.g., using one 1-min video per category) our findings suggest that there is a considerable difference in the psychophysiological correlates of stimuli with different contextual properties and that the use of time-dependent methods to assess videos should be considered as best practices.