Brain schematic representations were provided by Servier Medical Art ().

(B) Neural systems involved in using cognitive strategies, such as reappraisal, to regulate emotion (left, blue boxes), systems involved in generating those responses (left, pink boxes), and systems with an undefined or intermediary role in reappraisal (left, yellow boxes adapted from Ochsner et al., 2012 with permission). The pink box seen at the appraisal stage is meant to indicate that neural systems involved in generating emotion support this process. As described in the text, the effects of different emotion regulation strategies (the red arrows descending from the cognitive control processes box) can be understood in terms of the stages of the emotion generation sequence that they influence. (A) Diagram of the processing steps involved in generating an emotion and the ways in which cognitive control processes (blue box) might be used to regulate them. Third, we will introduce the ethical questions that are concomitant to the emergence of new neuromodulation therapies.Ī model of the cognitive control of emotion (MCCE). Second, we will highlight the potential of neuroimaging and neuromodulation in individualized medicine. First, we will discuss the possibility to identify new biological markers of brain functions. In a general discussion, we will put the brain at the core of fundamental research, prevention and therapy in the context of obesity and eating disorders. Their potential as additional therapeutic tools to combat pharmacorefractory morbid obesity or acute eating disorders will be discussed, in terms of technical challenges, applicability and ethics. In combination with neuroimaging approaches, these techniques are promising experimental tools to unravel the intricate relationships between homeostatic and hedonic brain circuits. The third part of this review will be dedicated to invasive neuromodulation strategies, such as vagus nerve stimulation (VNS) and deep brain stimulation (DBS). Both of these approaches will be compared in light of recent work in this field, while addressing technical and practical questions. Converging evidence points at the value of these non-invasive neuromodulation strategies to study basic mechanisms underlying eating behavior and to treat its disorders. Other promising non-invasive neuromodulation approaches being explored are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). rtfMRI, alone or when combined with other techniques and tools such as EEG and cognitive therapy, could be used to alter neural plasticity and learned behavior to optimize and/or restore healthy cognition and eating behavior. At the leading edge of non-invasive brain-based technologies is real-time fMRI (rtfMRI) neurofeedback, which is a powerful tool to better understand the complexity of human brain–behavior relationships. In the second part of the review, non-invasive strategies to modulate food-related brain processes and functions will be presented. In the first part of this review, advantages and limitations of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), pharmacogenetic fMRI and functional near-infrared spectroscopy (fNIRS) will be discussed in the context of recent work dealing with eating behavior, with a particular focus on obesity.

This opens the way to prevention studies using functional and molecular neuroimaging to perform early diagnostics and to phenotype subjects at risk by exploring different neurobehavioral dimensions of the food choices and motivation processes. Elevated reward region responsivity may trigger food craving and predict future weight gain. In particular, decreased basal metabolism in the prefrontal cortex and striatum as well as dopaminergic alterations have been described in obese subjects, in parallel with increased activation of reward brain areas in response to palatable food cues.

Functional, molecular and genetic neuroimaging has highlighted the existence of brain anomalies and neural vulnerability factors related to obesity and eating disorders such as binge eating or anorexia nervosa.

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