Virtual reality-based inhibition training influences food-related responses: no additional effects of repetitive transcranial magnetic stimulation

Combining cognitive inhibition training with brain stimulation techniques has received increasing attention as a potential approach to modulating maladaptive food craving and food intake. Building on previous work in this line of research, the current study examined whether virtual reality (VR)-based no-go inhibition training paired with repetitive transcranial magnetic stimulation (rTMS) modulates implicit food-related attitudes, craving and food-choice behaviors. Healthy women with high trait food cravings and a preference for high-calorie foods were assigned to one of four groups in a 2 (rTMS: active vs. sham) × 2 (training: no-go vs. neutral) between-subjects design. High-frequency rTMS was applied over the left dorsolateral prefrontal cortex (DLPFC), and no-go training was implemented in a VR environment using food stimuli tailored to participants’ self-reported preferences. Implicit attitudes and food craving were assessed before and after the intervention, while food choice was measured post-intervention only. Following training, the no-go group showed reduced positive implicit attitudes toward high-calorie foods and increased craving for low-calorie foods compared to pre-training levels, whereas no such changes were observed in the neutral group. Moreover, compared to the neutral group, the no-go group made healthier food choices. No-go training effects on food choice were more pronounced among individuals with low-to-moderate baseline preferences for high-calorie foods. In contrast, no significant main effects or additive effects of rTMS were observed. The present study demonstrates that VR-based no-go training can effectively regulate food-related responses and extends earlier work by demonstrating robust inhibition training effects across implicit and explicit measures, while highlighting the importance of considering individual differences in future research.