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Present project is concerned with the possibility to modulate the neural regulation of food intake by non-invasive stimulation of the vagus nerve. This nerve carries viscero-afferent information from the gut and other internal organs and therefore serves an important role in ingestive behavior. The electrical stimulation of the vagus nerve (VNS) is a qualified procedure in the treatment of drug-resistant epilepsy and depression. Since weight loss is a known common side effect of VNS treatment in patients with implanted devices, VNS is evaluated as a treatment of obesity. To investigate potential VNS-related changes in the cognitive processing of food-related items, 21 healthy participants were recorded in a 3-Tesla scanner in two counterbalanced sessions. Participants were presented with 72 food pictures and asked to rate how much they liked that food. Before entering the scanner subjects received a 1-h sham or verum stimulation, which was implemented transcutanously with a Cerbomed NEMOS® device. We found significant activations in core areas of the vagal afferent pathway, including left brainstem, thalamus, temporal pole, amygdala, insula, hippocampus, and supplementary motor area for the interaction between ratings (high vs low) and session (verum vs sham stimulation). Significant activations were also found for the main effect of verum compared to sham stimulation in the left inferior and superior parietal cortex. These results demonstrate an effect of tVNS on food image processing even with a preceding short stimulation period. This is a necessary prerequisite for a therapeutic application of tVNS which has to be evaluated in longer-term studies., (© 2020. The Author(s).)

In humans, food is considered a powerful primary reinforcer, whereas money is a secondary reinforcer, as it gains a value through learning experience. Here, we aimed to identify the neural regions supporting the processing of food-related reinforcers, relate it to the neural underpinnings of monetary reinforcers, and explore their modulation by metabolic state (hunger vs satiety). Twenty healthy male participants were tested in two experimental sessions, once hungry and once satiated, using functional magnetic resonance imaging. Participants performed an associative learning task, receiving food or monetary rewards (in the form of images) on separate blocks. Irrespective of incentive type, both food and monetary rewards engaged ventral striatum, medial orbitofrontal cortex and amygdala, regions that have been previously associated with reward processing. Food incentives additionally engaged the opercular part of the inferior frontal gyrus and the insula, collectively known as a primary gustatory cortex. Moreover, in response to negative feedback (here, reward omission), robust activation was observed in anterior insula, supplementary motor area and lateral parts of the prefrontal cortex, including middle and inferior frontal gyrus. Furthermore, the interaction between metabolic state and incentive type resulted in supramarginal gyrus (SMG) activity, among other motor and sensory-related regions. Finally, functional connectivity analysis showed correlation in the hungry state between the SMG and mesolimbic regions, including the hippocampus, midbrain and cingulate areas. Also, the interaction between metabolic state and incentive type revealed coupling between SMG and ventral striatum. Whereas general purpose reward-related regions process incentives of different kinds, the current results suggest that the SMG might play a key role in integrating the information related to current metabolic state and available incentive type.