David Val-Laillet

BACKGROUND Chronic diseases share common behavioral risk factors, including unbalanced diet, physical inactivity, tobacco use, and alcohol consumption. Digital tools may help clinicians screen for and address these risk factors within routine care, but evidence of their short-term efficacy remains limited. OBJECTIVE To estimate the short-term efficacy of CliniCAP, a partially automated mobile-assisted screening and brief intervention (m-SBI), on adherence to 18 health prevention recommendations among patients with chronic conditions, and to examine variation in readiness to change across multiple health behaviors METHODS A prospective randomized controlled study was conducted in four departments of two academic University Hospitals, including one Cancer treatment Centre. Adult outpatients with stabilized chronic disease or localized cancer in post-treatment follow-up were randomized to receive either the intervention (experimental group) or routine lifestyle advice (control group). The primary outcome was the number of health prevention recommendations followed (range 0-18, covering dietary habits, physical activity, alcohol and tobacco use), assessed at baseline, 1 and 3-month follow-up using mixed-effects logistic models. Stage of change (precontemplation, contemplation, preparation, action/maintenance) was also assessed for each behavior. RESULTS Among 164 participants (82 per group), the number of prevention recommendations followed increased by 10.0% in the experimental group versus 3.4% in the control group. The improvement in the experimental group was significantly greater than in the control group at both one month (OR = 1.29; 95% CI: 1.03–1.61) and three months (OR = 1.30; 95% CI: 1.03–1.64). A significantly higher proportion of experimental-group participants progressed to the action/maintenance stage for dietary behaviors compared to control (37% vs. 23%). No significant between-group differences emerged for physical activity, alcohol, or tobacco use. CONCLUSIONS A brief, partially automated m-SBI significantly improved overall adherence to health prevention recommendations and dietary behavior change over three months, supporting its feasibility and clinical relevance as a scalable tool for routine clinical practice. CLINICALTRIAL NCT06616064, registered on September 24, 2024. https://clinicaltrials.gov/study/NCT06616064

Overconsumption of hyperpalatable foods and obesity are associated with reduced activity of brain regions involved in executive functions, including the dorsolateral prefrontal cortex (dlPFC). Neurofeedback (NF) based on functional near-infrared spectroscopy (fNIRS) appears as an easily feasible neuromodulation method to assist voluntary improvement of inhibitory cognitive control. This study is primarily designed to assess the efficacy of fNIRS-based NF training targeting the dlPFC for strengthening inhibitory control in patients with food addiction (FA) and obesity. Fifty females eligible for obesity surgery and presenting FA will be recruited. The intervention will consist of eight fNIRS-based NF sessions over a month, with the first and last sessions conducted in combination with functional magnetic resonance imaging. Volunteers will be instructed to maintain as high as possible a visual gauge representing the real-time level of their dlPFC activity, by using their own mental strategies. Participants will be randomly assigned to either the "neurofeedback" group (n=25) or the "control" group (n=25; sham signal). Outcomes will include neuroimaging, clinical, fasting biological, and psychometric measures. These data will be compared between groups at baseline, just after the intervention, and three months post-intervention, except for neuroimaging measures. The primary endpoint will be the changes in cognitive control, assessed by variations in the cortico-striatal resting-state FC. This study protocol proposes a novel therapeutic approach for patients with obesity and FA. If NF proves to be effective in enhancing inhibitory control over eating behavior, this intervention could be proposed as part of the multidisciplinary obesity care pathway or for obesity prevention. The study protocol was registered in ClinicalTrials.gov on March 11^th 2022 (Identifier: NCT05277714; URL: https://clinicaltrials.gov/study/NCT05277714).

Pig vocalizations convey information about the emotional states of individuals, varying with arousal and valence. Studies show that different call types reflect distinct emotional contexts and social interactions for the receivers. However, little is known about the brain mechanisms behind the perception of conspecifics’ vocalizations. This study used BOLD fMRI to explore how pigs’ brains respond to emotionally varied vocalizations, with the aim to identify activity in regions linked to emotion, reward, and social processing. Eight healthy 2-month-old pigs underwent auditory brainstem response (ABR) testing and BOLD fMRI to assess brain responses to pig vocalizations with different hedonic valence. Sounds were delivered via MRI-compatible earphones, and imaging was performed on a 1.5T scanner. Data were analyzed using voxel-based and ROI-based statistics in SPM12 with small volume correction (SVC). Due to hearing anomalies or MRI artefacts, only 5 pigs were included in the final analysis. Functional MRI revealed that vocalizations activated regions of the auditory pathway and the left amygdala (pFWE at peak < 0.05 after SVC for all), with specific differences between positive and negative sounds. Clusters of activated voxels covering part of hippocampal areas, caudate nuclei and putamen were found with both positive and aversive vocal sounds. Limbic regions, including the amygdala and insula (p<0.05), as well as the right hippocampus after SVC (pFWE = 0.015) were uniquely engaged during the perception of negative conspecific vocalizations, indicating distinct processing based on emotional valence. This study shows for the first time that piglets’ brain can process and differentiate emotional vocalizations from other pigs, even under general anesthesia. Positive and negative vocal sound playbacks activated distinct brain regions related to hearing, emotion and reward. These findings highlight pigs’ cognitive and emotional processing of vocal cues. This study is part of a wider research program aimed at developing the fMRI protocol with acoustic stimulation in juvenile pigs.

Electroacupuncture (EA), a modern adaptation of traditional acupuncture, is increasingly used to treat various conditions, including gastrointestinal disorders, although its mechanisms remain debated. Previous work in healthy minipigs showed that acute EA modulates gut–brain axis activity, with notable effects on brain responses. This study examined the effects of chronic EA on brain function, physiology, and behavior in obese minipigs.Sixteen adult Yucatan minipigs were fed a high-fat/high-sucrose diet for two months, then assigned to either a control group (n=8) or a chronic EA group (n=8), which received 12 sessions of 20-minute EA targeting Sanwan/Dafengmen acupoints. Brain activity was assessed using BOLD fMRI during acute EA (before and after diet) and oral sucrose stimulation (after treatment). Behavioral tests, blood sampling, and post-mortem gene expression analyses across four brain regions were also conducted.Acute EA modulated cortical-limbic-striatal circuits differently in normal-weight versus obese animals. Chronic EA altered brain responses to sucrose in regions involved in cognitive control, reward, decision-making, and memory (p<0.05). Gene expression analyses revealed region-specific effects on 15 genes related to blood–brain barrier integrity, inflammation, neurotransmission, synaptic plasticity, and metabolism. Following return to a normal diet, both groups lost weight, but only EA-treated animals showed greater reductions in adiposity (p<0.001) and plasma free fatty acids (p=0.028). Differences in dopamine and tryptophan levels were also observed (p<0.05).These findings demonstrate that chronic EA modulates brain function and metabolic pathways in obese minipigs, supporting its potential role in treating obesity and related disorders.

Due to its central role in cognitive control, the dorso–lateral prefrontal cortex (dlPFC) has been the target of multiple brain modulation studies. In the context of the present pilot study, the dlPFC was the target of eight repeated neurofeedback (NF) sessions with functional near infrared spectroscopy (fNIRS) to assess the brain responses during NF and with functional and resting state magnetic resonance imaging (task-based fMRI and rsMRI) scanning. Fifteen healthy participants were recruited. Cognitive task fMRI and rsMRI were performed during the 1st and the 8th NF sessions. During NF, our data revealed an increased activity in the dlPFC as well as in brain regions involved in cognitive control and self-regulation learning (pFWE < 0.05). Changes in functional connectivity between the 1st and the 8th session revealed increased connectivity between the posterior cingulate cortex and the dlPFC, and between the posterior cingulate cortex and the dorsal striatum (pFWE < 0.05). Decreased left dlPFC-left insula connectivity was also observed. Behavioural results revealed a significant effect of hunger and motivation on the participant control feeling and a lower control feeling when participants did not identify an effective mental strategy, providing new insights on the effects of behavioural factors that may affect the NF learning.