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Zhang Y, Munshi S, Burrows K, Kuplicki R, Figueroa-Hall LK, Aupperle RL, Khalsa SS, Teague TK, Yasuyuki T, Paulus MP, Savitz J, Zheng H. Leptin's Inverse Association with Brain Morphology and Depressive Symptoms - A Discovery and Confirmatory Study Across Two Independent Samples. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00105-8. [PMID: 38631553 DOI: 10.1016/j.bpsc.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Major Depressive Disorder (MDD) has a complex, bi-directional relationship with metabolic dysfunction, yet the neural correlates of this association are not well understood. METHOD In this cross-sectional investigation, we employed a two-step 'discovery and confirmatory' strategy, utilizing two independent samples (Sample 1: 288 participants, Sample 2: 196 participants) to examine the association between circulating indicators of metabolic health (leptin and adiponectin) and brain structures in individuals with MDD. RESULTS We found a replicable inverse correlation between leptin levels and cortical surface area within essential brain areas responsible for emotion regulation, such as the left posterior cingulate cortex, right pars orbitalis, right superior temporal gyrus, and right insula (standardized beta coefficient (SBC) ranged: -0.27 to -0.49, puncorrected <0.05). Notably, this relationship was independent of C-Reactive Protein levels. We also identified a significant interaction effect of leptin levels and diagnosis on the cortical surface area of the right superior temporal gyrus (SBC = 0.26 in sample 1, SBC = 0.30 in sample 2, puncorrected < 0.05). We also observed a positive correlation between leptin levels and atypical depressive symptoms in both MDD groups (r = 0.14 in sample 1, r = 0.29 in sample 2, puncorrected < 0.05). CONCLUSION The inverse association between leptin and cortical surface area in brain regions that are important for emotion processing and leptin's association with sleep disturbances supports the hypothesis that metabolic processes may be related to emotion regulation. However, the molecular mechanisms through which leptin might exert these effects should be explored further.
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Affiliation(s)
- Ye Zhang
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
| | | | | | | | - Leandra K Figueroa-Hall
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - T Kent Teague
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, OK, USA; Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, OK, USA; Department of Pharmaceutical Sciences, University of Oklahoma College of Pharmacy, Tulsa, OK, USA
| | - Taki Yasuyuki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan; Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan; Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
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Slomp M, de Lange IGS, Mul JD, Schrantee A, la Fleur SE. Investigating Habenula Functional Connectivity and Reward-Related Activity in Obesity Using Human Connectome Project Data. Brain Connect 2023; 13:541-552. [PMID: 37578129 DOI: 10.1089/brain.2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
Introduction: The habenula, a brain region involved in aversion, might negatively modulate caloric intake. Functional magnetic resonance imaging (fMRI) studies reported associations between weight loss and habenula functional connectivity. However, whether habenula resting-state functional connectivity (rsFC) and reward-related activity are altered in obesity is yet unknown. Methods: Using data from the Human Connectome Project, we included 300 subjects with various body mass indexes (BMIs) and a healthy long-term blood glucose (hemoglobin A1c [HbA1c]). In addition, we investigated a potential BMI × HbA1c interaction in a separate cohort including subjects with prediabetes (n = 72). Habenula rsFC was assessed using a region of interest (ROI)-to-ROI analysis. Furthermore, a separate analysis using gambling task fMRI data focused on reward-related habenula activity. Results: We did not find an association between BMI and habenula rsFC for any of the ROIs. For the exploratory analysis of the BMI × HbA1c effect, a significant interaction effect was found for the habenula-ventral tegmental area (VTA) connection, but this did not survive multiple comparisons correction. Monetary punishment compared with reward activated the bilateral habenula in the BMI sample, but this activity was not associated with BMI. Discussion: In conclusion, we did not find evidence for an association between BMI and habenula rsFC or reward-related activity. However, there might be an interaction between BMI and HbA1c for the habenula-VTA rsFC, suggestive of a role of the habenula in glucose regulation. Future studies should focus on metabolic parameters in their experimental design to confirm our findings and explore the precise role of the habenula in metabolism.
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Affiliation(s)
- Margo Slomp
- Endocrine Laboratory, Department of Laboratory Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, The Netherlands
- Metabolism and Reward Group, Royal Netherlands Academy of Arts and Sciences, Netherlands Institute of Neuroscience, Amsterdam, The Netherlands
| | - Ilke G S de Lange
- Endocrine Laboratory, Department of Laboratory Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
- Metabolism and Reward Group, Royal Netherlands Academy of Arts and Sciences, Netherlands Institute of Neuroscience, Amsterdam, The Netherlands
| | - Joram D Mul
- Amsterdam Neuroscience, Amsterdam, The Netherlands
- Brain Plasticity Group, Swammerdam Institute for Life Sciences, Faculty of Science, University of Amsterdam, Amsterdam, The Netherlands
| | - Anouk Schrantee
- Amsterdam Neuroscience, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Susanne E la Fleur
- Endocrine Laboratory, Department of Laboratory Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, The Netherlands
- Metabolism and Reward Group, Royal Netherlands Academy of Arts and Sciences, Netherlands Institute of Neuroscience, Amsterdam, The Netherlands
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3
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Brain functional and structural magnetic resonance imaging of obesity and weight loss interventions. Mol Psychiatry 2023; 28:1466-1479. [PMID: 36918706 DOI: 10.1038/s41380-023-02025-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
Obesity has tripled over the past 40 years to become a major public health issue, as it is linked with increased mortality and elevated risk for various physical and neuropsychiatric illnesses. Accumulating evidence from neuroimaging studies suggests that obesity negatively affects brain function and structure, especially within fronto-mesolimbic circuitry. Obese individuals show abnormal neural responses to food cues, taste and smell, resting-state activity and functional connectivity, and cognitive tasks including decision-making, inhibitory-control, learning/memory, and attention. In addition, obesity is associated with altered cortical morphometry, a lowered gray/white matter volume, and impaired white matter integrity. Various interventions and treatments including bariatric surgery, the most effective treatment for obesity in clinical practice, as well as dietary, exercise, pharmacological, and neuromodulation interventions such as transcranial direct current stimulation, transcranial magnetic stimulation and neurofeedback have been employed and achieved promising outcomes. These interventions and treatments appear to normalize hyper- and hypoactivations of brain regions involved with reward processing, food-intake control, and cognitive function, and also promote recovery of brain structural abnormalities. This paper provides a comprehensive literature review of the recent neuroimaging advances on the underlying neural mechanisms of both obesity and interventions, in the hope of guiding development of novel and effective treatments.
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4
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Parsons N, Steward T, Clohesy R, Almgren H, Duehlmeyer L. A systematic review of resting-state functional connectivity in obesity: Refining current neurobiological frameworks and methodological considerations moving forward. Rev Endocr Metab Disord 2022; 23:861-879. [PMID: 34159504 DOI: 10.1007/s11154-021-09665-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 02/07/2023]
Abstract
Obesity is the second most common cause of preventable morbidity worldwide. Resting-state functional magnetic resonance imaging (fMRI) has been used extensively to characterise altered communication between brain regions in individuals with obesity, though findings from this research have not yet been systematically evaluated within the context of prominent neurobiological frameworks. This systematic review aggregated resting-state fMRI findings in individuals with obesity and evaluated the contribution of these findings to current neurobiological models. Findings were considered in relation to a triadic model of problematic eating, outlining disrupted communication between reward, inhibitory, and homeostatic systems. We identified a pattern of consistently increased orbitofrontal and decreased insula cortex resting-state functional connectivity in individuals with obesity in comparison to healthy weight controls. BOLD signal amplitude was also increased in people with obesity across studies, predominantly confined to subcortical regions, including the hippocampus, amygdala, and putamen. We posit that altered orbitofrontal cortex connectivity may be indicative of a shift in the valuation of food-based rewards and that dysfunctional insula connectivity likely contributes to altered homeostatic signal processing. Homeostatic violation signals in obesity may be maintained despite satiety, thereby 'hijacking' the executive system and promoting further food intake. Moving forward, we provide a roadmap for more reliable resting-state and task-based functional connectivity experiments, which must be reconciled within a common framework if we are to uncover the interplay between psychological and biological factors within current theoretical frameworks.
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Affiliation(s)
- Nicholas Parsons
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne Burwood Campus, VIC, Australia
| | - Trevor Steward
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Rebecca Clohesy
- School of Psychology, Deakin University, Melbourne Burwood Campus, VIC, Australia
| | - Hannes Almgren
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Data Analysis, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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5
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Long-term changes in insula-mesolimbic structural and functional connectivity in obese patients after laparoscopic sleeve gastrectomy. Clin Auton Res 2022; 32:237-247. [PMID: 35864386 DOI: 10.1007/s10286-022-00877-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/04/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Brain imaging studies have shown insula-related functional and structural abnormalities in patients with obesity. Laparoscopic sleeve gastrectomy is currently an effective procedure for treating obesity, which promotes acute recovery of brain functional and structural abnormalities in obese patients. The aim of this study was to investigate the long-term impact of laparoscopic sleeve gastrectomy on insula-related structural and functional connectivity. METHODS Diffusion tensor imaging and resting-state functional magnetic resonance imaging were employed to investigate laparoscopic sleeve gastrectomy-induced changes in insula-related structural connectivity and corresponding resting-state functional connectivity in 25 obese patients prior to (PreLSG) and 12 months post-surgery (PostLSG12). RESULTS Results showed significant increases in fractional anisotropy and axial diffusivity between the right insula and anterior cingulate cortex, and higher fractional anisotropy of left insula-putamen, left insula-caudate and anterior cingulate cortex-right posterior cingulate cortex/precuneus at PostLSG12 compared with PreLSG. There were significant negative correlations between axial diffusivity of right insula-anterior cingulate cortex and body mass index, and fractional anisotropy of right insula-anterior cingulate cortex with scores on external eating at PostLSG12. Anxiety and depressive status ratings were negatively correlated with fractional anisotropy of left insula-putamen at PostLSG12. In addition, there was a significant decrease in resting-state functional connectivity between left insula and left caudate. CONCLUSIONS These findings demonstrate long-term changes in insula-related structural and functional connectivity abnormalities promoted by laparoscopic sleeve gastrectomy, which highlight its strong association with long-term weight loss and improvement in eating behaviors.
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Endocannabinoid signaling of homeostatic status modulates functional connectivity in reward and salience networks. Psychopharmacology (Berl) 2022; 239:1311-1319. [PMID: 34212205 DOI: 10.1007/s00213-021-05890-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/27/2021] [Indexed: 12/24/2022]
Abstract
RATIONALE Endocannabinoids are well poised to regulate crosstalk between energy sensing of hunger and satiety and reward-driven motivation. OBJECTIVES Here, we aimed to unravel associations between plasma endocannabinoids and brain connectivity in homeostatic and reward circuits across hunger and satiety states. METHODS Fifteen participants (7 females) underwent two counter-balanced resting-state functional magnetic resonance imaging scans, one after overnight fasting and one after consumption of a standardized filling meal (satiety). Before each scan, we drew blood to measure plasma endocannabinoid concentrations (anandamide [AEA], anandamide-derived POEA, and 2-arachidonoylglycerol [2-AG]), analyzed with liquid chromatography tandem mass spectrometry. RESULTS We found that AEA levels were associated with increased connectivity between the lateral hypothalamus and the ventral striatum during satiety. Furthermore, fasting AEA levels correlated with connectivity between the ventral striatum and the anterior cingulate cortex and the insula. CONCLUSIONS Altogether, results suggest that peripheral AEA concentrations are sensitive to homeostatic changes and linked to neural communication in reward and salience networks. Findings may have significant implications for understanding normal and abnormal interactions between homeostatic input and reward valuation.
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7
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Rasmussen JM, Thompson PM, Entringer S, Buss C, Wadhwa PD. Fetal programming of human energy homeostasis brain networks: Issues and considerations. Obes Rev 2022; 23:e13392. [PMID: 34845821 DOI: 10.1111/obr.13392] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/29/2021] [Accepted: 10/24/2021] [Indexed: 02/07/2023]
Abstract
In this paper, we present a transdisciplinary framework and testable hypotheses regarding the process of fetal programming of energy homeostasis brain circuitry. Our model proposes that key aspects of energy homeostasis brain circuitry already are functional by the time of birth (with substantial interindividual variation); that this phenotypic variation at birth is an important determinant of subsequent susceptibility for energy imbalance and childhood obesity risk; and that this brain circuitry exhibits developmental plasticity, in that it is influenced by conditions during intrauterine life, particularly maternal-placental-fetal endocrine, immune/inflammatory, and metabolic processes and their upstream determinants. We review evidence that supports the scientific premise for each element of this formulation, identify future research directions, particularly recent advances that may facilitate a better quantification of the ontogeny of energy homeostasis brain networks, highlight animal and in vitro-based approaches that may better address the determinants of interindividual variation in energy homeostasis brain networks, and discuss the implications of this formulation for the development of strategies targeted towards the primary prevention of childhood obesity.
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Affiliation(s)
- Jerod M Rasmussen
- Development, Health and Disease Research Program, University of California, Irvine, California, USA.,Department of Pediatrics, University of California, Irvine, California, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Sonja Entringer
- Development, Health and Disease Research Program, University of California, Irvine, California, USA.,Department of Pediatrics, University of California, Irvine, California, USA.,Department of Medical Psychology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Departments of Psychiatry and Human Behavior, Obstetrics and Gynecology, Epidemiology, University of California, Irvine, California, USA
| | - Claudia Buss
- Development, Health and Disease Research Program, University of California, Irvine, California, USA.,Department of Pediatrics, University of California, Irvine, California, USA.,Department of Medical Psychology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Departments of Psychiatry and Human Behavior, Obstetrics and Gynecology, Epidemiology, University of California, Irvine, California, USA
| | - Pathik D Wadhwa
- Development, Health and Disease Research Program, University of California, Irvine, California, USA.,Department of Pediatrics, University of California, Irvine, California, USA.,Departments of Psychiatry and Human Behavior, Obstetrics and Gynecology, Epidemiology, University of California, Irvine, California, USA.,Department of Obstetrics and Gynecology, University of California, Irvine, California, USA.,Department of Epidemiology, University of California, Irvine, California, USA
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8
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Gabay A, London S, Yates KF, Convit A. Does obesity-associated insulin resistance affect brain structure and function of adolescents differentially by sex? Psychiatry Res Neuroimaging 2022; 319:111417. [PMID: 34875560 PMCID: PMC8809005 DOI: 10.1016/j.pscychresns.2021.111417] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 01/03/2023]
Abstract
Metabolic abnormalities affect the adolescent brain. For equivalent abnormalities in metabolism young people exhibit deficits in more cognitive domains than adults. We examine sex differences performance for adolescents with obesity/insulin resistance (IR) and evaluated how sex and IR effected frontal lobe structures and executive functioning. 125 adolescents underwent medical, cognitive, and brain-imaging assessments. Participants were categorized as insulin sensitive (IS) (QUICKI ≥ 0.350) or IR (QUICKI < 0.350). Degree of IR may affect brain and cognition differentially by sex. Females had positive associations between QUICKI and anterior cingulate cortex (ACC) volume, medial orbito-frontal cortex (OFC) thickness, and scores on the Stroop and Digit Symbol Substitution (DSST) tests. Females with IR tended to have thinner insular cortices. No such associations were found in males. In female adolescents, IR may negatively affect brain structure and function. No such effects were found for males. Although needing more development, hormonal effects and inflammation are potential contributors.
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Affiliation(s)
- Andrea Gabay
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America
| | - Stephanie London
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America; Resident in Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
| | - Kathy F Yates
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, New York, Orangeburg, United States of America
| | - Antonio Convit
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America; Department of Medicine, New York University School of Medicine, New York, NY, United States of America; Department of Radiology, New York University School of Medicine, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, New York, Orangeburg, United States of America.
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9
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Syan SK, McIntyre-Wood C, Minuzzi L, Hall G, McCabe RE, MacKillop J. Dysregulated resting state functional connectivity and obesity: A systematic review. Neurosci Biobehav Rev 2021; 131:270-292. [PMID: 34425125 DOI: 10.1016/j.neubiorev.2021.08.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/13/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022]
Abstract
Obesity has been variously linked to differences in brain functional connectivity in regions associated with reward, emotional regulation and cognition, potentially revealing neural mechanisms contributing to its development and maintenance. This systematic review summarizes and critically appraises the existing literature on differences in resting state functional connectivity (Rs-FC) between overweight and individuals with obesity in relation healthy-BMI controls. Twenty-nine studies were identified and the results consistently support the hypothesis that obesity is associated with differences in Rs-FC. Specifically, obesity/overweight was consistently associated with (i) DMN hypoconnectivity and salience network hyperconnectivity; (ii) increased Rs-FC between the hypothalamus and reward, limbic and salience networks, and decreased Rs-FC between the hypothalamus and cognitive regions; (iii) increased power within regions associated with inhibition/emotional reasoning; (iv) decreased nodal efficiency, degree centrality, and global efficiency. Collectively, the results suggest obesity is associated with disrupted connectivity of brain networks responsible for cognition, reward, self-referential processing and emotional regulation.
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Affiliation(s)
- Sabrina K Syan
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Canada; Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada.
| | - Carly McIntyre-Wood
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Canada
| | - Luciano Minuzzi
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Geoffrey Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Randi E McCabe
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Canada; Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
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10
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Chen WG, Schloesser D, Arensdorf AM, Simmons JM, Cui C, Valentino R, Gnadt JW, Nielsen L, Hillaire-Clarke CS, Spruance V, Horowitz TS, Vallejo YF, Langevin HM. The Emerging Science of Interoception: Sensing, Integrating, Interpreting, and Regulating Signals within the Self. Trends Neurosci 2021; 44:3-16. [PMID: 33378655 DOI: 10.1016/j.tins.2020.10.007] [Citation(s) in RCA: 220] [Impact Index Per Article: 73.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/21/2020] [Accepted: 10/14/2020] [Indexed: 02/07/2023]
Abstract
Interoception refers to the representation of the internal states of an organism, and includes the processes by which it senses, interprets, integrates, and regulates signals from within itself. This review presents a unified research framework and attempts to offer definitions for key terms to describe the processes involved in interoception. We elaborate on these definitions through illustrative research findings, and provide brief overviews of central aspects of interoception, including the anatomy and function of neural and non-neural pathways, diseases and disorders, manipulations and interventions, and predictive modeling. We conclude with discussions about major research gaps and challenges.
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Affiliation(s)
- Wen G Chen
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH), Bethesda, MD 20892, USA.
| | - Dana Schloesser
- Office of Behavioral and Social Sciences Research (OBSSR), NIH, Bethesda, MD 20892, USA
| | - Angela M Arensdorf
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Janine M Simmons
- National Institute of Mental Health (NIMH), NIH, Bethesda, MD 20892, USA
| | - Changhai Cui
- National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, MD 20892, USA
| | - Rita Valentino
- National Institute on Drug Abuse (NIDA), NIH, Bethesda, MD 20892, USA
| | - James W Gnadt
- National Institute of Neurological Disorders and Stroke (NINDS), NIH, Bethesda, MD 20892, USA
| | - Lisbeth Nielsen
- National Institute on Aging (NIA), NIH, Bethesda, MD 20892, USA
| | | | - Victoria Spruance
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, MD 20892, USA
| | - Todd S Horowitz
- National Cancer Institute (NCI), NIH, Bethesda, MD 20892, USA
| | - Yolanda F Vallejo
- National Institute of Dental and Craniofacial Research (NIDCR), NIH, Bethesda, MD 20892, USA
| | - Helene M Langevin
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH), Bethesda, MD 20892, USA
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11
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Hébert-Seropian B, Boucher O, Citherlet D, Roy-Côté F, Gravel V, Obaid S, Bouthillier A, Nguyen DK. Decreased self-reported appetite following insular cortex resection in patients with epilepsy. Appetite 2021; 166:105479. [PMID: 34186157 DOI: 10.1016/j.appet.2021.105479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 01/10/2023]
Abstract
Entrenched deep within the Sylvian fissure, the insula has long been considered one of the least understood regions of the human brain, in part due to its restricted accessibility. However, recent evidence suggests that the insula plays a key role in gustation, interoception, cognitive and emotional processes, and likely integrates these different functions to contribute to the homeostatic control of food intake. In the past decade, our team has identified the insula as a potential site of epileptogenicity, which can be successfully treated by microsurgical resection. While most surgeries are successful in controlling insular epileptic seizures and lead to few postoperative deficits, the subtle changes that may occur in food-related experiences are still unknown. Using a self-report questionnaire, the present study sought to fill this gap by assessing changes in appetite in patients who underwent unilateral partial or complete insular resections (n = 17) as part of their epilepsy surgery. We compared them to a group of patients who underwent temporal lobe epilepsy surgery (n = 22) as a lesion-control group. A majority (59%) of the insular patients reported an alteration in appetite, with most of these changes being characterized by a persistent reduction. Such changes were rarely reported following temporal lobectomy (14%). While they significantly differed in terms of appetite changes, both groups were similar when examining post-surgical changes in weight, diet, exercise and eating habits. Insular patients with altered appetite also showed behavioral signs of dysfunctional interoceptive and gustatory functions, corroborating the idea that these systems play a role in the regulation of feeding behaviours. This research pushes our understanding of the mechanisms underlying food intake and could lead to avenues for the treatment of eating disorders.
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Affiliation(s)
- Benjamin Hébert-Seropian
- Département de psychologie, Université du Québec à Montréal, Montreal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Olivier Boucher
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Département de psychologie, Université de Montréal, Montreal, QC, Canada; Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Daphné Citherlet
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Département de neurosciences, Université de Montréal, Montreal, QC, Canada
| | - Frédérique Roy-Côté
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Département de psychologie, Université de Montréal, Montreal, QC, Canada
| | - Victoria Gravel
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Département de psychologie, Université de Montréal, Montreal, QC, Canada
| | - Sami Obaid
- Division de neurochirurgie, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada; Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Alain Bouthillier
- Division de neurochirurgie, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada; Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Dang Khoa Nguyen
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Département de neurosciences, Université de Montréal, Montreal, QC, Canada; Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
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12
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Adise S, Allgaier N, Laurent J, Hahn S, Chaarani B, Owens M, Yuan D, Nyugen P, Mackey S, Potter A, Garavan HP. Multimodal brain predictors of current weight and weight gain in children enrolled in the ABCD study ®. Dev Cogn Neurosci 2021; 49:100948. [PMID: 33862325 PMCID: PMC8066422 DOI: 10.1016/j.dcn.2021.100948] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/20/2020] [Accepted: 03/22/2021] [Indexed: 02/02/2023] Open
Abstract
Multimodal neuroimaging assessments were utilized to identify generalizable brain correlates of current body mass index (BMI) and predictors of pathological weight gain (i.e., beyond normative development) one year later. Multimodal data from children enrolled in the Adolescent Brain Cognitive Development Study® at 9-to-10-years-old, consisted of structural magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), resting state (rs), and three task-based functional (f) MRI scans assessing reward processing, inhibitory control, and working memory. Cross-validated elastic-net regression revealed widespread structural associations with BMI (e.g., cortical thickness, surface area, subcortical volume, and DTI), which explained 35% of the variance in the training set and generalized well to the test set (R2 = 0.27). Widespread rsfMRI inter- and intra-network correlations were related to BMI (R2train = 0.21; R2test = 0.14), as were regional activations on the working memory task (R2train = 0.20; (R2test = 0.16). However, reward and inhibitory control tasks were unrelated to BMI. Further, pathological weight gain was predicted by structural features (Area Under the Curve (AUC)train = 0.83; AUCtest = 0.83, p < 0.001), but not by fMRI nor rsfMRI. These results establish generalizable brain correlates of current weight and future pathological weight gain. These results also suggest that sMRI may have particular value for identifying children at risk for pathological weight gain.
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Affiliation(s)
- Shana Adise
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
| | - Nicholas Allgaier
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Jennifer Laurent
- Department of Nursing, University of Vermont, Burlington, VT, USA
| | - Sage Hahn
- Department of Complex Systems, University of Vermont, Burlington, VT, USA
| | - Bader Chaarani
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Max Owens
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - DeKang Yuan
- Department of Complex Systems, University of Vermont, Burlington, VT, USA
| | - Philip Nyugen
- Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Complex Systems, University of Vermont, Burlington, VT, USA; Department of Nursing, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | - Scott Mackey
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Alexandra Potter
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Hugh P Garavan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA
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13
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Legget KT, Wylie KP, Cornier MA, Berman BD, Tregellas JR. Altered between-network connectivity in individuals prone to obesity. Physiol Behav 2021; 229:113242. [PMID: 33157075 PMCID: PMC7775284 DOI: 10.1016/j.physbeh.2020.113242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Investigating intrinsic brain functional connectivity may help identify the neurobiology underlying cognitive patterns and biases contributing to obesity propensity. To address this, the current study used a novel whole-brain, data-driven approach to examine functional connectivity differences in large-scale network interactions between obesity-prone (OP) and obesity-resistant (OR) individuals. METHODS OR (N = 24) and OP (N = 25) adults completed functional magnetic resonance imaging (fMRI) during rest. Large-scale brain networks were identified using independent component analysis (ICA). Voxel-specific between-network connectivity analysis assessed correlations between ICA component time series' and individual voxel time series, identifying regions strongly connected to many networks, i.e., "hubs". RESULTS Significant group differences in between-network connectivity (OP vs. OR; FDR-corrected) were observed in bilateral basal ganglia (left: q = 0.009; right: q = 0.010) and right dorsolateral prefrontal cortex (dlPFC; q = 0.026), with OP>OR. Basal ganglia differences were largely driven by a more strongly negative correlation with a lateral sensorimotor network in OP, with dlPFC differences driven by a more strongly negative correlation with an inferior visual network in OP. CONCLUSIONS Greater between-network connectivity was observed in the basal ganglia and dlPFC in OP, driven by stronger associations with lateral sensorimotor and inferior visual networks, respectively. This may reflect a disrupted balance between goal-directed and habitual control systems and between internal/external monitoring processes.
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Affiliation(s)
- Kristina T Legget
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States; Research Service, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States.
| | - Korey P Wylie
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States
| | - Marc-Andre Cornier
- Research Service, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States; Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States; Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States
| | - Brian D Berman
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States; Department of Neurology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States; Neurology Section, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
| | - Jason R Tregellas
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States; Research Service, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
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14
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Romei A, Voigt K, Verdejo-Garcia A. A Perspective on Candidate Neural Underpinnings of Binge Eating Disorder: Reward and Homeostatic Systems. Curr Pharm Des 2020; 26:2327-2333. [PMID: 32148192 DOI: 10.2174/1381612826666200309152321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/12/2020] [Indexed: 01/13/2023]
Abstract
People with Binge Eating Disorder (BED) exhibit heightened sensitivity to rewarding stimuli and elevated activity in reward-related brain regions, including the orbitofrontal cortex (OFC), ventral striatum (VS) and insula, during food-cue exposure. BED has also been associated with altered patterns of functional connectivity during resting-state. Investigating neural connectivity in the absence of task stimuli provides knowledge about baseline communication patterns that may influence the behavioural and cognitive manifestation of BED. Elevated resting-state functional connectivity (rsFC) between reward-related brain regions may contribute to uncontrolled eating bouts observed in BED, through heightened food-cue sensitivity and food-craving. The impact of homeostatic state on rsFC of the reward system has not yet been investigated in people with BED. Homeostatic dysfunction is a key driver of excessive food consumption in obesity, whereby rsFC between rewardrelated brain regions does not attenuate during satiety. Future studies should investigate BED related differences in rsFC within the reward system during hunger and satiety, in order to determine whether individuals with BED display an abnormal neural response to changes in homeostatic state. This knowledge would further enhance current understandings of the mechanisms contributing to BED, potentially implicating both reward and homeostatic dysfunctions as drivers of BED.
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Affiliation(s)
- Amelia Romei
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Victoria 3800, Australia
| | - Katharina Voigt
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Victoria 3800, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Victoria 3800, Australia
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15
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Emotion perception and theory of mind in obesity: a systematic review on the impact of social cognitive deficits on dysfunctional eating behaviors. Surg Obes Relat Dis 2020; 17:618-629. [PMID: 33249085 DOI: 10.1016/j.soard.2020.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 02/05/2023]
Abstract
The aim of this paper was to summarize our current understanding of emotion perception and Theory of Mind (ToM) in obesity and how they relate to dysfunctional eating behaviors (DEB), frequently found in candidates for bariatric surgery. The literature was searched using the electronic databases PsychInfo, Medline, and Web of Science databases, and by additional hand searches through reference lists and specialist eating disorders journals. Relevant studies were included if they were written in English, included participants suffering from obesity and evaluation with tasks assessing social cognition, such as emotion recognition and perception, as well as ToM. Twelve studies analyzed for this systematic review suggest that deficits in such social cognitive domains may lie behind many emotional and social difficulties present in people with obesity, be they bariatric or not, which usually favor DEB. Our review suggests that people with obesity of all ages score significantly less than controls on instruments assessing emotion recognition and ToM, justifying a possible relationship between social cognitive impairments and dysfunctional eating behaviors, such as binges, emotional eating, and addition to food, frequently seen in people with obesity. These findings have important implications for our understanding of the social cognitive foundations of eating behavior in individuals with obesity. They can help not only the presurgical behavioral assessment, but also guide postoperative follow-up of this population.
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16
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Zhang P, Liu Y, Yu FX, Wu GW, Li MY, Wang Z, Ding HY, Wang LX, Zhao KX, Zhang ZY, Zhao PF, Li J, Yang ZH, Lv H, Zhang ZT, Wang ZC. Hierarchical integrated processing of reward-related regions in obese males: A graph-theoretical-based study. Appetite 2020; 159:105055. [PMID: 33248191 DOI: 10.1016/j.appet.2020.105055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 10/20/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
Abnormal activities in reward-related regions are associated with overeating or obesity. Preliminary studies have shown that changes in neural activity in obesity include not only regional reward regions abnormalities but also impairments in the communication between reward-related regions and multiple functional areas. A recent study has shown that the transitions between different neural networks are nonrandom and hierarchical, and that activation of particular brain networks is more likely to occur after other brain networks. The aims of this study were to investigate the key nodes of reward-related regions in obese males and explore the hierarchical integrated processing of key nodes. Twenty-four obese males and 24 normal-weight male controls of similar ages were recruited. The fMRI data were acquired using 3.0 T MRI. The fMRI data preprocessing was performed in DPABI and SPM 12. Degree centrality analyses were conducted using GRETNA toolkit, and Granger causality analyses were calculated using DynamicBC toolbox. Decreased degree centrality was observed in left ventral medial prefrontal cortex (vmPFC) and right parahippocampal/hippocampal gyrus in group with obesity. The group with obesity demonstrated increased effective connectivity between left vmPFC and several regions (left inferior temporal gyrus, left supplementary motor area, right insular cortex, right postcentral gyrus, right paracentral lobule and bilateral fusiform gyrus). Increased effective connectivity was observed between right parahippocampal/hippocampal gyrus and left precentral/postcentral gyrus. Decreased effective connectivity was found between right parahippocampal/hippocampal gyrus and left inferior parietal lobule. This study identified the features of hierarchical interactions between the key reward nodes and multiple function networks. These findings may provide more evidence for the existing view of hierarchical organization in reward processing.
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Affiliation(s)
- Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Yang Liu
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Feng-Xia Yu
- Medical Imaging Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Guo-Wei Wu
- School of Language Science and Art, Jiang Su Normal University, Xuzhou, 221116, China
| | - Meng-Yi Li
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Zheng Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - He-Yu Ding
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Li-Xue Wang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Kai-Xin Zhao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Zheng-Yu Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Peng-Fei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Jing Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Zheng-Han Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
| | - Zhong-Tao Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing, 100050, China.
| | - Zhen-Chang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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17
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Shapiro ALB, Moore BF, Sutton B, Wilkening G, Stence N, Dabelea D, Tregellas JR. In Utero Exposure to Maternal Overweight or Obesity is Associated with Altered Offspring Brain Function in Middle Childhood. Obesity (Silver Spring) 2020; 28:1718-1725. [PMID: 32772475 PMCID: PMC7483843 DOI: 10.1002/oby.22908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/21/2020] [Accepted: 05/09/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The impact of in utero exposure to maternal overweight and obesity on offspring metabolic health is well documented. Neurodevelopmental outcomes among these children are, however, less well studied. To address this gap, the current study investigated brain function among 4- to 6-year-old children exposed to maternal overweight or obesity during gestation compared with that of children born to mothers with healthy BMI in pregnancy. METHODS Resting-state functional magnetic resonance imaging was used to study neuronal activity and connectivity during a passive viewing task (movie) among 101 typically developing children enrolled in the Healthy Start study, a longitudinal prebirth cohort in Colorado. RESULTS Forty-nine children (48%) were exposed to maternal overweight or obesity in utero (mean age = 5 years, SD = 0.9). Children born to mothers with overweight or obesity demonstrated hyperactivity in the left posterior cingulate cortex and hypoactivity in the dorsal anterior cingulate and the supplementary motor area (P < 0.05 for all). Children born to mothers with overweight or obesity also showed ubiquitously weaker brain connectivity (P < 0.05 for all). CONCLUSIONS These novel results suggest altered brain function among children exposed to maternal overweight and obesity in utero.
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Affiliation(s)
- Allison L B Shapiro
- Department of Pediatrics, Section of Endocrinology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Brianna F Moore
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Austin, Austin, Texas, USA
| | - Brianne Sutton
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Greta Wilkening
- Department of Pediatrics, Section of Endocrinology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Nicholas Stence
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Dana Dabelea
- Department of Pediatrics, Section of Endocrinology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jason R Tregellas
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Research Service, Denver Veteran's Administration Medical Center, Aurora, Colorado, USA
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18
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Vakli P, Deák-Meszlényi RJ, Auer T, Vidnyánszky Z. Predicting Body Mass Index From Structural MRI Brain Images Using a Deep Convolutional Neural Network. Front Neuroinform 2020; 14:10. [PMID: 32265681 PMCID: PMC7104804 DOI: 10.3389/fninf.2020.00010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 03/02/2020] [Indexed: 12/21/2022] Open
Abstract
In recent years, deep learning (DL) has become more widespread in the fields of cognitive and clinical neuroimaging. Using deep neural network models to process neuroimaging data is an efficient method to classify brain disorders and identify individuals who are at increased risk of age-related cognitive decline and neurodegenerative disease. Here we investigated, for the first time, whether structural brain imaging and DL can be used for predicting a physical trait that is of significant clinical relevance—the body mass index (BMI) of the individual. We show that individual BMI can be accurately predicted using a deep convolutional neural network (CNN) and a single structural magnetic resonance imaging (MRI) brain scan along with information about age and sex. Localization maps computed for the CNN highlighted several brain structures that strongly contributed to BMI prediction, including the caudate nucleus and the amygdala. Comparison to the results obtained via a standard automatic brain segmentation method revealed that the CNN-based visualization approach yielded complementary evidence regarding the relationship between brain structure and BMI. Taken together, our results imply that predicting BMI from structural brain scans using DL represents a promising approach to investigate the relationship between brain morphological variability and individual differences in body weight and provide a new scope for future investigations regarding the potential clinical utility of brain-predicted BMI.
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Affiliation(s)
- Pál Vakli
- Brain Imaging Centre, Research Centre for Natural Sciences, Budapest, Hungary
| | | | - Tibor Auer
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Zoltán Vidnyánszky
- Brain Imaging Centre, Research Centre for Natural Sciences, Budapest, Hungary
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19
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Oliva R, Morys F, Horstmann A, Castiello U, Begliomini C. Characterizing impulsivity and resting-state functional connectivity in normal-weight binge eaters. Int J Eat Disord 2020; 53:478-488. [PMID: 31868249 DOI: 10.1002/eat.23212] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 11/27/2019] [Accepted: 12/03/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Binge eating is characterized by episodes of uncontrolled eating, within discrete periods of time. Although it is usually described in obese individuals or as a symptom of Binge Eating Disorder (BED), this behavior can also occur in the normal-weight (NW) population. An interesting premise suggests that impulsivity might contribute to the onset of binge eating and the progression toward weight gain. Drawing upon this evidence, here we explored impulsivity in NW individuals reporting binge-eating episodes through a functional connectivity approach. We hypothesized that, even in the absence of an eating disorder, NW binge eaters would be characterized by connectivity pattern changes in corticostriatal regions implicated in impulsivity, similarly to the results described in BED individuals. METHODS A resting-state functional magnetic resonance imaging study tested 39 NW men and women, with and without binge eating (binge eaters, BE and non-BE). Brain functional connectivity was explored by means of graph theoretic centrality measures and traditional seed-based analysis; trait impulsivity was assessed with self-report questionnaires. RESULTS The BE group was characterized by a higher degree of trait impulsivity. Brain functional connectivity measures revealed lower degree centrality within the right middle frontal gyrus, left insula/putamen and left temporoparietal regions and a lower functional connectivity between the right middle frontal gyrus and right insula in the BE group. DISCUSSION The results support previous evidence on BED of altered functional connectivity and higher impulsivity at the roots of overeating behavior, but further extend this concept excluding any potential confounding effect exerted by the weight status.
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Affiliation(s)
- Rossella Oliva
- Department of General Psychology, University of Padova, Padova, Italy
| | - Filip Morys
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Annette Horstmann
- FB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Umberto Castiello
- Department of General Psychology, University of Padova, Padova, Italy
| | - Chiara Begliomini
- Department of General Psychology, University of Padova, Padova, Italy
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20
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Roelofs TJM, Straathof M, van der Toorn A, Otte WM, Adan RAH, Dijkhuizen RM. Diet as connecting factor: Functional brain connectivity in relation to food intake and sucrose tasting, assessed with resting-state functional MRI in rats. J Neurosci Res 2019; 100:1182-1190. [PMID: 31769534 PMCID: PMC9291979 DOI: 10.1002/jnr.24563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 10/22/2019] [Accepted: 11/10/2019] [Indexed: 11/08/2022]
Abstract
Eating disorders and obesity form a major health problem in Western Society. To be able to provide adequate treatment and prevention, it is necessary to understand the neural mechanisms underlying the development of eating disorders and obesity. Specific brain networks have been shown to be involved in feeding behavior. We therefore hypothesized that functional connectivity in neural networks involved in feeding behavior is dependent on the status of homeostatic energy balance, thus on being hungry or satiated. To test our hypothesis, we measured functional connectivity and amplitudes of neural signals within neural networks in relation to food intake and sucrose tasting in rats. Therefore, 16 male Wistar rats, of which eight were food-restricted and eight were satiated, underwent resting-state functional magnetic resonance imaging (rs-fMRI) at 9.4 T. Subsequently, half of these animals underwent a sucrose tasting procedure followed by a second rs-fMRI scan. Functional connectivity and amplitude of low-frequency signal fluctuations were statistically analyzed in a linear mixed model. Although we did not detect a significant effect of food intake on functional connectivity before sucrose tasting, there was a trend toward interaction between group (satiated vs. hungry) and treatment (sucrose tasting). Functional connectivity between feeding-related regions tended to decrease stronger upon sucrose tasting in satiated rats as compared to food-restricted rats. Furthermore, rs-fMRI signal amplitudes decreased stronger upon sucrose tasting in satiated rats, as compared to food-restricted rats. These findings indicate that food intake and sucrose tasting can affect functional network organization, which may explain the specific patterns in feeding behavior.
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Affiliation(s)
- Theresia J M Roelofs
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.,Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Milou Straathof
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Annette van der Toorn
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Willem M Otte
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.,Department of Child Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Roger A H Adan
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
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21
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Kerem L, Hadjikhani N, Holsen L, Lawson EA, Plessow F. Oxytocin reduces the functional connectivity between brain regions involved in eating behavior in men with overweight and obesity. Int J Obes (Lond) 2019; 44:980-989. [PMID: 31740723 PMCID: PMC7192759 DOI: 10.1038/s41366-019-0489-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 10/11/2019] [Accepted: 10/31/2019] [Indexed: 02/06/2023]
Abstract
Background: Oxytocin (OXT), shown to decrease food intake in animal models and men, is a promising novel treatment for obesity. We have shown that in men with overweight and obesity, intranasal (IN) OXT reduced the functional magnetic resonance imaging (fMRI) blood oxygenation level-dependent signal in the ventral tegmental area (VTA), the origin of the mesolimbic dopaminergic reward system, in response to high-calorie food vs. non-food images. Here, we employed functional connectivity fMRI analysis, which measures the synchrony in activation between neural systems in a context-dependent manner. We hypothesized that OXT would attenuate the functional connectivity of the VTA with key food motivation brain areas only when participants viewed high-calorie food stimuli. Methods: This randomized, double-blind, placebo-controlled crossover study of 24 IU IN OXT included 10 men with overweight or obesity (mean±SEM BMI: 28.9±0.8 kg/m2). Following drug administration, subjects completed an fMRI food motivation paradigm including images of high and low-calorie foods, non-food objects, and fixation stimuli. A psychophysiological interaction analysis was performed with the VTA as seed region. Results: Following OXT administration, compared with placebo, participants exhibited significantly attenuated functional connectivity between the VTA and the insula, oral somatosensory cortex, amygdala, hippocampus, operculum, and middle temporal gyrus in response to viewing high-calorie foods (Z≥3.1, cluster-corrected, p<0.05). There was no difference in functional connectivity between VTA and these brain areas when comparing OXT and placebo for low-calorie food, non-food, and fixation images. Conclusion: In men with overweight and obesity, OXT attenuates the functional connectivity between the VTA and food motivation brain regions in response to high-calorie visual food images. These findings could partially explain the observed anorexigenic effect of OXT, providing insight into the mechanism through which OXT ameliorates food cue-induced reward anticipation in patients with obesity. Additional studies are ongoing to further delineate the anorexigenic effect of OXT in obesity.
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Affiliation(s)
- Liya Kerem
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Division of Pediatric Endocrinology, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Nouchine Hadjikhani
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Harvard Medical School, Boston, MA, USA.,Gillberg Neuropsychiatry Center, University of Gothenburg, Gothenburg, Sweden
| | - Laura Holsen
- Division of Women's Health, Department of Medicine and Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Franziska Plessow
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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Brutman JN, Sirohi S, Davis JF. Recent Advances in the Neurobiology of Altered Motivation Following Bariatric Surgery. Curr Psychiatry Rep 2019; 21:117. [PMID: 31707546 DOI: 10.1007/s11920-019-1084-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW There is compelling evidence in the clinical population that long-term weight loss secondary to bariatric surgery is mitigated by the reemergence of maladaptive feeding behaviors and in some cases new onset substance abuse. RECENT FINDINGS A review of the current literature suggests that physical restructuring of the GI tract during WLS alters secretion of feeding peptides and nutrient-sensing mechanisms that directly target the brain's endogenous reward system, the mesolimbic dopamine system. Post-surgical changes in GI physiology augment activation of the mesolimbic system. In some patients, this process may contribute to a reduced appetite for palatable food whereas in others it may support maladaptive motivated behavior for food and chemical drugs. It is concluded that future studies are required to detail the timing and duration of surgical-induced changes in GI-mesolimbic communication to more fully understand this phenomenon.
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Affiliation(s)
- Julianna N Brutman
- Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, 1815 Ferdinand's Lane, Pullman, WA, 99164, USA
| | - Sunil Sirohi
- Laboratory of Endocrine and Neuropsychiatric Disorders, Division of Basic Pharmaceutical Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Jon F Davis
- Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, 1815 Ferdinand's Lane, Pullman, WA, 99164, USA.
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23
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van Opstal AM, Wijngaarden MA, van der Grond J, Pijl H. Changes in brain activity after weight loss. Obes Sci Pract 2019; 5:459-467. [PMID: 31687170 PMCID: PMC6819976 DOI: 10.1002/osp4.363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The importance of the regulatory role of the brain in directing glucose homeostasis, energy homeostasis, eating behaviour, weight control and obesity is increasingly recognized. Brain activity in (sub)cortical neuronal networks involved in homeostatic control and hedonic responses is generally increased in persons with obesity. Currently, it is not known if these functional changes can be affected by dieting. The aim of the current study was to investigate whether prolonged fasting and/or weight loss influences neuronal brain activity in obese persons. METHODS Fourteen participants with obesity were included (two male participants and 12 female participants, body mass index 35.2 ± 1.2 kg m-2). Whole-brain resting-state functional magnetic resonance imaging was performed after an overnight fast, after a prolonged 48-h fast and after an 8-week weight loss intervention. RESULTS An 8-week weight loss intervention decreased BOLD signal in areas of the brain involved in salience, sensory motor and executive control. BOLD signal in these areas correlated with leptin levels and body mass index. CONCLUSIONS Weight loss decreased activity in brain areas involved in feeding behaviour and reward processing. These results indicate that these obesity-associated alterations in neuronal activity are related to excessive body weight and might change after weight loss.
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Affiliation(s)
- A. M. van Opstal
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - M. A. Wijngaarden
- Department of Internal Medicine, Section EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
| | - J. van der Grond
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - H. Pijl
- Department of Internal Medicine, Section EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
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24
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Hermann P, Gál V, Kóbor I, Kirwan CB, Kovács P, Kitka T, Lengyel Z, Bálint E, Varga B, Csekő C, Vidnyánszky Z. Efficacy of weight loss intervention can be predicted based on early alterations of fMRI food cue reactivity in the striatum. NEUROIMAGE-CLINICAL 2019; 23:101803. [PMID: 30991304 PMCID: PMC6463125 DOI: 10.1016/j.nicl.2019.101803] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/04/2019] [Accepted: 03/26/2019] [Indexed: 12/24/2022]
Abstract
Increased fMRI food cue reactivity in obesity, i.e. higher responses to high- vs. low-calorie food images, is a promising marker of the dysregulated brain reward system underlying enhanced susceptibility to obesogenic environmental cues. Recently, it has also been shown that weight loss interventions might affect fMRI food cue reactivity and that there is a close association between the alteration of cue reactivity and the outcome of the intervention. Here we tested whether fMRI food cue reactivity could be used as a marker of diet-induced early changes of neural processing in the striatum that are predictive of the outcome of the weight loss intervention. To this end we investigated the relationship between food cue reactivity in the striatum measured one month after the onset of the weight loss program and weight changes obtained at the end of the six-month intervention. We observed a significant correlation between BMI change measured after six months and early alterations of fMRI food cue reactivity in the striatum, including the bilateral putamen, right pallidum, and left caudate. Our findings provide evidence for diet-induced early alterations of fMRI food cue reactivity in the striatum that can predict the outcome of the weight loss intervention.
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Affiliation(s)
- Petra Hermann
- Brain Imaging Centre, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest H-1117, Hungary.
| | - Viktor Gál
- Brain Imaging Centre, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest H-1117, Hungary
| | - István Kóbor
- MR Research Center, Semmelweis University, Budapest H-1085, Hungary
| | - C Brock Kirwan
- Brain Imaging Centre, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest H-1117, Hungary; Neuroscience Center, Brigham Young University, Provo, UT 84602, USA
| | - Péter Kovács
- Obesity Research Group, Gedeon Richter Plc., Budapest H-1103, Hungary
| | - Tamás Kitka
- Obesity Research Group, Gedeon Richter Plc., Budapest H-1103, Hungary
| | - Zsuzsanna Lengyel
- Obesity Research Group, Gedeon Richter Plc., Budapest H-1103, Hungary
| | - Eszter Bálint
- Department of General Pharmacology, Gedeon Richter Plc., Budapest H-1103, Hungary
| | - Balázs Varga
- Department of General Pharmacology, Gedeon Richter Plc., Budapest H-1103, Hungary
| | - Csongor Csekő
- Department of General Pharmacology, Gedeon Richter Plc., Budapest H-1103, Hungary
| | - Zoltán Vidnyánszky
- Brain Imaging Centre, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest H-1117, Hungary.
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25
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He Q, Huang X, Zhang S, Turel O, Ma L, Bechara A. Dynamic Causal Modeling of Insular, Striatal, and Prefrontal Cortex Activities During a Food-Specific Go/NoGo Task. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:1080-1089. [PMID: 30691967 DOI: 10.1016/j.bpsc.2018.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 12/05/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND This study aimed to investigate the dynamic interactions among three neural systems that are implicated in substance and behavioral addictions in response to food cues in young adults. These include an impulsive system involving the striatum, a reflective system involving the prefrontal cortex, and a homeostasis sensing system involving the insular cortex. METHODS College students (N = 45) with various levels of body mass index were recruited. Functional magnetic resonance imaging data were acquired while participants performed food-related Go/NoGo tasks, with low-calorie and high-calorie food cues. Participants were scanned under both food satiety and deprivation conditions. Dynamic causal modeling was applied to the data to examine the causal architecture of coupled or distributed dynamics among the aforementioned systems. RESULTS Participants showed difficulty inhibiting responses to high-calorie foods as suggested by higher false alarm rate and decision bias for low-calorie food Go task. This difficulty was enhanced during the food deprivation condition. Deprivation increased neural activity of both the insula and the striatum bilaterally in response to high-calorie foods during Go trials and anterior cingulate cortex and dorsolateral prefrontal cortex activity during NoGo trials. Dynamic causal modeling analysis revealed that food deprivation modulated the communications between the insula, striatum, and dorsolateral prefrontal cortex, and the modulations were positively associated with body mass index. CONCLUSIONS The results support tripartite views of decision making. Deprivation states, such as hunger, trigger insular activity, which modulates the balance between impulsive and reflective systems when facing tempting food cues.
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Affiliation(s)
- Qinghua He
- Faculty of Psychology, Southwest University, Collaborative Innovation Center of Assessment toward Basic Education Quality, Beibei, Chongqing; Chongqing Collaborative Innovation Center for Brain Science, Collaborative Innovation Center of Assessment toward Basic Education Quality, Beibei, Chongqing; Southwest University Branch, Collaborative Innovation Center of Assessment toward Basic Education Quality, Beibei, Chongqing.
| | - Xiaolu Huang
- Faculty of Psychology, Southwest University, Collaborative Innovation Center of Assessment toward Basic Education Quality, Beibei, Chongqing
| | - Shuyue Zhang
- Faculty of Education, Guangxi Normal University, Guangxi Colleges and Universities Key Laboratory of Cognitive Neuroscience and Applied Psychology, Guilin, Guangxi, China
| | - Ofir Turel
- Information Systems and Decision Sciences, California State University, Fullerton, California; Brain and Creativity Institute, University of Southern California, Los Angeles, California; Department of Psychology, University of Southern California, Los Angeles, California
| | - Liangsuo Ma
- Department of Radiology, Virginia Commonwealth University, Richmond, Virginia; Institute for Drug and Alcohol Studies, Richmond, Virginia
| | - Antoine Bechara
- Brain and Creativity Institute, University of Southern California, Los Angeles, California; Department of Psychology, University of Southern California, Los Angeles, California
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26
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Pleger B. Invasive and Non-invasive Stimulation of the Obese Human Brain. Front Neurosci 2018; 12:884. [PMID: 30555295 PMCID: PMC6281888 DOI: 10.3389/fnins.2018.00884] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/13/2018] [Indexed: 01/18/2023] Open
Abstract
Accumulating evidence suggests that non-invasive and invasive brain stimulation may reduce food craving and calorie consumption rendering these techniques potential treatment options for obesity. Non-invasive transcranial direct current stimulation (tDCS) or repetitive transcranial magnet stimulation (rTMS) are used to modulate activity in superficially located executive control regions, such as the dorsolateral prefrontal cortex (DLPFC). Modulation of the DLPFC’s activity may alter executive functioning and food reward processing in interconnected dopamine-rich regions such as the striatum or orbitofrontal cortex. Modulation of reward processing can also be achieved by invasive deep brain stimulation (DBS) targeting the nucleus accumbens. Another target for DBS is the lateral hypothalamic area potentially leading to improved energy expenditure. To date, available evidence is, however, restricted to few exceptional cases of morbid obesity. The vagal nerve plays a crucial role in signaling the homeostatic demand to the brain. Invasive or non-invasive vagal nerve stimulation (VNS) is thus assumed to reduce appetite, rendering VNS another possible treatment option for obesity. Based on currently available evidence, the U.S. Food and Drug Administration recently approved VNS for the treatment of obesity. This review summarizes scientific evidence regarding these techniques’ efficacy in modulating food craving and calorie intake. It is time for large controlled clinical trials that are necessary to translate currently available research discoveries into patient care.
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Affiliation(s)
- Burkhard Pleger
- Department of Neurology, BG University Clinic Bergmannsheil, Ruhr-University Bochum, Bochum, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,IFB AdiposityDiseases, Leipzig University Medical Centre, Leipzig, Germany.,BMBF nutriCARD, Center of Veterinary Public Health, University of Leipzig, Leipzig, Germany.,Collaborative Research Centre 1052 "Obesity Mechanisms", University Hospital Leipzig, Leipzig, Germany.,Collaborative Research Centre 874 "Integration and Representation of Sensory Processes", Ruhr-University Bochum, Bochum, Germany
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27
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Farr OM, Mantzoros CS. Obese individuals with type 2 diabetes demonstrate decreased activation of the salience-related insula and increased activation of the emotion/salience-related amygdala to visual food cues compared to non-obese individuals with diabetes: A preliminary study. Diabetes Obes Metab 2018; 20:2500-2503. [PMID: 29882627 PMCID: PMC6133716 DOI: 10.1111/dom.13403] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 12/18/2022]
Abstract
A better understanding of the underlying pathophysiology of obesity and its comorbidities is needed to develop more effective therapeutics. In the current study, differences in brain activation to food cues between obese (n = 6) versus non-obese (n = 5) individuals with type 2 diabetes were examined cross-sectionally using functional magnetic resonance imaging. Obese individuals with type 2 diabetes demonstrate less activation of the salience- and reward-related insula while fasting and increased activation of the amygdala to highly desirable foods after a meal. These findings in individuals with type 2 diabetes suggest a persistence of differences between obese versus non-obese individuals. Future, larger studies should confirm this differential activation between lean and obese individuals with and without type 2 diabetes.
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Affiliation(s)
- Olivia M Farr
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts
| | - Christos S Mantzoros
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts
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28
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Dourish CT, Clifton PG. Multidisciplinary approaches to the study of eating disorders and obesity: Recent progress in research and development and future prospects. J Psychopharmacol 2017; 31:1383-1387. [PMID: 29157103 DOI: 10.1177/0269881117740779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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