# Transcranial Direct Current Stimulation (tDCS) with Cognitive Training to Reduce Impulsivity and Weight in Veterans with Obesity: A Clinical Trial

> **NIH VA I01** · MINNEAPOLIS VA  MEDICAL CENTER · 2022 · —

## Abstract

Impulsivity has been implicated in refractory obesity in bariatric and non-bariatric subjects (Sutin 2011,
Filbey 2017, Gunstad 2017, Galioto 2016, Benard 2017). A healthy prefrontal cortex (PFC) may mitigate
excess impulsivity effects on appetite regulation by providing critical executive function as a gate-keeper.
Galioto et al found that executive function predicts weight loss success in structured medical weight loss
programs (Galioto 2016). Given this background, improving prefrontal executive function to mitigate impulsivity
would be valuable in obesity treatment. Cognitive training for improvement of executive function has not shown
sufficient therapeutic promise. Similarly, transcranial direct current stimulation (tDCS), a noninvasive
neuromodulation modality, aimed at the PFC has been shown to be safe and well tolerated but not sufficiently
effective as monotherapy.
 Combining prefrontal neuromodulation with cognitive training may be the novel, effective way forward
for prefrontal neuromodulation as obesity therapy. Together, the two modalities enhanced executive function in
non-obese subjects with executive function deficits in studies done by members of our team (Gilmore 2018).
Thirty subjects with a clinical history of impulsive behavior were recruited for a sham-controlled protocol
coupling the balloon analog risk task, a decision-making test, with five consecutive days of 25-minute tDCS
treatments in which a 2-mA constant current was delivered over the dorsolateral PFC, anode over right PFC
and cathode over the left PFC. Active tDCS stimulation coupled with cognitive training improved Balloon
Analog Risk Task performance and reduced impulsivity on the Barratt Impulsiveness Scale. Reduction in risky
decision making generalized to a second risk-related decision-making task, the Risk Task, which had not been
utilized during the stimulated training sessions. Reduction in risky decision making persisted at the final two
month follow up visit. This evidence supports our hypothesis that tDCS coupled with brain training can
enhance executive function and improve clinical outcomes in individuals who suffer from impulsivity-related
conditions. Neuroplasticity-based interventions such as this may provide novel treatment approaches to the
challenging clinical problem of obesity.
 We have assembled a team of investigators with combined obesity and neuromodulation expertise to
conduct a randomized double-blind trial of active vs. sham tDCS combined with cognitive training in subjects
with obesity who report out-of-control eating and are enrolling in a structured group lifestyle coaching program.
We will determine if tDCS coupled with cognitive training decreases impulsivity in these individuals with
obesity. Our second aim is to evaluate whether tDCS coupled with executive function training enhances weight
loss.

## Key facts

- **NIH application ID:** 10369985
- **Project number:** 1I01CX002121-01A2
- **Recipient organization:** MINNEAPOLIS VA  MEDICAL CENTER
- **Principal Investigator:** SHALAMAR D SIBLEY
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10369985

## Citation

> US National Institutes of Health, RePORTER application 10369985, Transcranial Direct Current Stimulation (tDCS) with Cognitive Training to Reduce Impulsivity and Weight in Veterans with Obesity: A Clinical Trial (1I01CX002121-01A2). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10369985. Licensed CC0.

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