1
|
Ferracci S, Manippa V, D'Anselmo A, Bolovon L, Guagnano MT, Brancucci A, Porcelli P, Conti C. The role of impulsivity and binge eating in outpatients with overweight or obesity: an EEG temporal discounting study. J Eat Disord 2024; 12:130. [PMID: 39227881 PMCID: PMC11373217 DOI: 10.1186/s40337-024-01080-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 08/07/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Binge eating (BE) is associated with a range of cognitive control deficits related to impulsivity, including lower response inhibition, preference for immediate gratification, and maladaptive decision-making. The aim was to investigate whether impulsivity and BE may interact with the decision process and underlying brain activity in outpatients with overweight or obesity who are starting a treatment to achieve weight loss. METHODS A sample of 26 treatment-seeking outpatients with overweight or obesity was evaluated for impulsivity, BE, and temporal discounting rates. Impulsivity was measured with the Barratt Impulsiveness Scale (BIS-11), according to which two groups were composed: high BIS and low BIS; BE was assessed with the eating disorders module of the Structured Clinical Interview for DSM5-Research Version, according to which two groups were composed: with (BE group) or without BE (NBE group). Changes in subjective value of rewards were measured with the Temporal Discounting Task (TDt) where participants had to choice between sooner but smaller vs. later but larger monetary rewards. These choices were made in two differently delayed conditions ("Now" and "Not-now"). Brain rhythms were recorded through high-density electroencephalogram (hd-EEG) during the TDt. RESULTS Patients with BE reported more impulsive tendencies and perceived sooner rewards as more gratifying when both options were delayed (Not-now condition, p = 0.02). The reward choice in the TDt was accompanied by a general EEG alpha band desynchronization in parietal areas observed without differences between experimental conditions and patients groups. No effects were observed within the Now condition or in the other EEG bands. CONCLUSIONS The tendency to favor immediate rewards may constitute an obstacle to adhering to treatment plans and achieving weight loss goals for outpatients with overweight or obesity. Clinicians are therefore encouraged to include psychological factors, such as impulsivity and dysfunctional eating behaviors, when designing weight loss programs. By addressing these psychological aspects, clinicians can better support patients in overcoming barriers to adherence and achieving sustainable weight loss. TRIAL REGISTRATION This study was approved by the Ethics Committee of the Department of Psychological, Health, and Territorial Sciences of the University G. d'Annunzio of Chieti-Pescara (Prot. n. 254 of 03/14/2017).
Collapse
Affiliation(s)
- Sara Ferracci
- Department of Communication Sciences, Humanities and International Studies, University "Carlo Bo", Urbino, Italy
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Valerio Manippa
- Department of Education, Psychology and Communication, University "Aldo Moro", Bari, Italy
| | - Anita D'Anselmo
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
- Department of Medicine and Aging Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Luca Bolovon
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Maria Teresa Guagnano
- Department of Medicine and Aging Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Alfredo Brancucci
- Department of Motor, Human and Health Sciences, University "Foro Italico", Rome, Italy
| | - Piero Porcelli
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Chiara Conti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy.
| |
Collapse
|
2
|
Godet A, Serrand Y, Léger B, Moirand R, Bannier E, Val-Laillet D, Coquery N. Functional near-infrared spectroscopy-based neurofeedback training targeting the dorsolateral prefrontal cortex induces changes in cortico-striatal functional connectivity. Sci Rep 2024; 14:20025. [PMID: 39198481 PMCID: PMC11358514 DOI: 10.1038/s41598-024-69863-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/09/2024] [Indexed: 09/01/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- A Godet
- INRAE, INSERM, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Univ Rennes, Rennes, France
| | - Y Serrand
- INRAE, INSERM, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Univ Rennes, Rennes, France
| | - B Léger
- INRAE, INSERM, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Univ Rennes, Rennes, France
| | - R Moirand
- INRAE, INSERM, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Univ Rennes, Rennes, France
- Unité d'Addictologie, CHU Rennes, Rennes, France
| | - E Bannier
- Inria, CRNS, Inserm, IRISA UMR 6074, Empenn U1228, Univ Rennes, Rennes, France.
- Radiology Department, CHU Rennes, Rennes, France.
| | - D Val-Laillet
- INRAE, INSERM, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Univ Rennes, Rennes, France.
| | - N Coquery
- INRAE, INSERM, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Univ Rennes, Rennes, France
| |
Collapse
|
3
|
Ester-Nacke T, Berti K, Veit R, Dannecker C, Salvador R, Ruffini G, Heni M, Birkenfeld AL, Plewnia C, Preissl H, Kullmann S. Network-targeted transcranial direct current stimulation of the hypothalamus appetite-control network: a feasibility study. Sci Rep 2024; 14:11341. [PMID: 38762574 PMCID: PMC11102513 DOI: 10.1038/s41598-024-61852-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/10/2024] [Indexed: 05/20/2024] Open
Abstract
The hypothalamus is the key regulator for energy homeostasis and is functionally connected to striatal and cortical regions vital for the inhibitory control of appetite. Hence, the ability to non-invasively modulate the hypothalamus network could open new ways for the treatment of metabolic diseases. Here, we tested a novel method for network-targeted transcranial direct current stimulation (net-tDCS) to influence the excitability of brain regions involved in the control of appetite. Based on the resting-state functional connectivity map of the hypothalamus, a 12-channel net-tDCS protocol was generated (Neuroelectrics Starstim system), which included anodal, cathodal and sham stimulation. Ten participants with overweight or obesity were enrolled in a sham-controlled, crossover study. During stimulation or sham control, participants completed a stop-signal task to measure inhibitory control. Overall, stimulation was well tolerated. Anodal net-tDCS resulted in faster stop signal reaction time (SSRT) compared to sham (p = 0.039) and cathodal net-tDCS (p = 0.042). Baseline functional connectivity of the target network correlated with SSRT after anodal compared to sham stimulation (p = 0.016). These preliminary data indicate that modulating hypothalamus functional network connectivity via net-tDCS may result in improved inhibitory control. Further studies need to evaluate the effects on eating behavior and metabolism.
Collapse
Affiliation(s)
- Theresa Ester-Nacke
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany.
- German Center of Diabetes Research (DZD), Tübingen, Germany.
| | - Katharina Berti
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | - Ralf Veit
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | - Corinna Dannecker
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | | | | | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
- Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, Eberhard Karls University Tübingen, Tübingen, Germany
- Division of Endocrinology and Diabetology, Department of Internal Medicine 1, University Hospital Ulm, Ulm, Germany
| | - Andreas L Birkenfeld
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, German Center for Mental Health (DZPG), Neurophysiology and Interventional Neuropsychiatry, University Hospital Tübingen, Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| |
Collapse
|
4
|
Janet R, Smallwood J, Hutcherson CA, Plassmann H, Mckeown B, Tusche A. Body mass index-dependent shifts along large-scale gradients in human cortical organization explain dietary regulatory success. Proc Natl Acad Sci U S A 2024; 121:e2314224121. [PMID: 38648482 PMCID: PMC11067012 DOI: 10.1073/pnas.2314224121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 03/14/2024] [Indexed: 04/25/2024] Open
Abstract
Making healthy dietary choices is essential for keeping weight within a normal range. Yet many people struggle with dietary self-control despite good intentions. What distinguishes neural processing in those who succeed or fail to implement healthy eating goals? Does this vary by weight status? To examine these questions, we utilized an analytical framework of gradients that characterize systematic spatial patterns of large-scale neural activity, which have the advantage of considering the entire suite of processes subserving self-control and potential regulatory tactics at the whole-brain level. Using an established laboratory food task capturing brain responses in natural and regulatory conditions (N = 123), we demonstrate that regulatory changes of dietary brain states in the gradient space predict individual differences in dietary success. Better regulators required smaller shifts in brain states to achieve larger goal-consistent changes in dietary behaviors, pointing toward efficient network organization. This pattern was most pronounced in individuals with lower weight status (low-BMI, body mass index) but absent in high-BMI individuals. Consistent with prior work, regulatory goals increased activity in frontoparietal brain circuits. However, this shift in brain states alone did not predict variance in dietary success. Instead, regulatory success emerged from combined changes along multiple gradients, showcasing the interplay of different large-scale brain networks subserving dietary control and possible regulatory strategies. Our results provide insights into how the brain might solve the problem of dietary control: Dietary success may be easier for people who adopt modes of large-scale brain activation that do not require significant reconfigurations across contexts and goals.
Collapse
Affiliation(s)
- Rémi Janet
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
| | - Jonathan Smallwood
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
| | - Cendri A. Hutcherson
- Department of Psychology, University of Toronto, Toronto, ONM5S 2E5, Canada
- Department of Marketing, Rotman School of Management, University of Toronto, Toronto, ONM5S 3E6, Canada
| | - Hilke Plassmann
- Marketing Area, INSEAD, FontainebleauF-77300, France
- Control-Interoception-Attention Team, Paris Brain Institute (ICM), Sorbonne University, Paris75013, France
| | - Bronte Mckeown
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
| | - Anita Tusche
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA91125
| |
Collapse
|
5
|
Camacho-Barcia L, Giel KE, Jiménez-Murcia S, Álvarez Pitti J, Micali N, Lucas I, Miranda-Olivos R, Munguia L, Tena-Sempere M, Zipfel S, Fernández-Aranda F. Eating disorders and obesity: bridging clinical, neurobiological, and therapeutic perspectives. Trends Mol Med 2024; 30:361-379. [PMID: 38485648 DOI: 10.1016/j.molmed.2024.02.007] [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] [Received: 09/29/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 04/13/2024]
Abstract
Eating disorders (EDs) and obesity are complex health conditions sharing various risk and maintenance factors, intensified in cases of comorbidity. This review explores the similarities and connections between these conditions, examining different facets from a multidisciplinary perspective, among them comorbidities, metabolic and psychological factors, neurobiological aspects, and management and therapy implications. We aim to investigate the common characteristics and complexities of weight and EDs and explore their interrelationships in individuals who experience both. The rising prevalence of EDs in people with obesity necessitates integrated approaches to study this comorbidity and to identify and analyze both common and distinct features of these conditions. This review may offer new opportunities for simultaneous prevention and management approaches, as well as future lines of research.
Collapse
Affiliation(s)
- Lucia Camacho-Barcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre of Excellence for Eating Disorders (KOMET), University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Julio Álvarez Pitti
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain; Innovation in Paediatrics and Technologies-iPEDITEC- research group, Research Foundation, Consorcio Hospital General, University of Valencia, Valencia, Spain
| | - Nadia Micali
- Eating Disorders Research Unit, Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark; Great Ormond Street Institute of Child Health, University College London, London, UK; Institute of Biological Psychiatry, Psychiatric Center Sct. Hans, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Romina Miranda-Olivos
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucero Munguia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Tena-Sempere
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain
| | - Stephan Zipfel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre of Excellence for Eating Disorders (KOMET), University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| |
Collapse
|
6
|
Mattavelli G, Gorrino I, Tornaghi D, Canessa N. Cognitive and motor impulsivity in the healthy brain, and implications for eating disorders and obesity: A coordinate-based meta-analysis and systematic review. Cortex 2024; 171:90-112. [PMID: 37984247 DOI: 10.1016/j.cortex.2023.10.008] [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] [Received: 01/18/2023] [Revised: 05/10/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
Alterations in the impulse-control balance, and in its neural bases, have been reported in obesity and eating disorders (EDs). Neuroimaging studies suggest a role of fronto-parietal networks in impulsive behaviour, with evaluation and anticipatory processes additionally recruiting meso-limbic regions. However, whether distinct facets of cognitive and motor impulsivity involve common vs. specific neural correlates remains unclear. We addressed this issue through Activation Likelihood Estimation (ALE) meta-analyses of fMRI studies on delay discounting (DD) and go/no-go (GNG) tasks, alongside conjunction and subtraction analyses. We also performed systematic reviews of neuroimaging studies using the same tasks in individuals with obesity or EDs. ALE results showed consistent activations in the striatum, anterior/posterior cingulate cortex, medial/left superior frontal gyrus and left supramarginal gyrus for impulsive choices in DD, while GNG tasks elicited mainly right-lateralized fronto-parietal activations. Conjunction and subtraction analyses showed: i) common bilateral responses in the caudate nucleus; ii) DD-specific responses in the ventral striatum, anterior/posterior cingulate cortex, left supramarginal and medial frontal gyri; iii) GNG-specific activations in the right inferior parietal cortex. Altered fronto-lateral responses to both tasks are suggestive of dysfunctional cortico-striatal balance in obesity and EDs, but these findings are controversial due to the limited number of studies directly comparing patients and controls. Overall, we found evidence for distinctive neural correlates of the motor and cognitive facets of impulsivity: the right inferior parietal lobe underpins action inhibition, whereas fronto-striatal regions and the left supramarginal gyrus are related to impulsive decision-making. While showing that further research on clinical samples is required to better characterize the neural bases of their behavioural changes, these findings help refining neurocognitive model of impulsivity and highlight potential translational implications for EDs and obesity treatment.
Collapse
Affiliation(s)
- Giulia Mattavelli
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy; Cognitive Neuroscience Laboratory of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
| | - Irene Gorrino
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
| | - Diana Tornaghi
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
| | - Nicola Canessa
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy; Cognitive Neuroscience Laboratory of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| |
Collapse
|
7
|
Schultes B, Ernst B, Hallschmid M, Bueter M, Meyhöfer SM. The 'Behavioral Balance Model': A new perspective on the aetiology and therapy of obesity. Diabetes Obes Metab 2023; 25:3444-3452. [PMID: 37694802 DOI: 10.1111/dom.15271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/13/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
Obesity is a debilitating disease of global proportions that necessitates refined, concept-driven therapeutic approaches. Policy makers, the public and even health care professionals, but also individuals with obesity harbour many misconceptions regarding this disease, which leads to prejudice, negative attitudes, stigmatization, discrimination, self-blame, and failure to provide and finance adequate medical care. Decades of intensive, successful scientific research on obesity have only had a very limited effect on this predicament. We propose a science-based, easy-to-understand conceptual model that synthesizes the complex pathogenesis of obesity including biological, psychological, social, economic and environmental aspects with the aim to explain and communicate better the nature of obesity and currently available therapeutic modalities. According to our integrative 'Behavioral Balance Model', 'top-down cognitive control' strategies are implemented (often with limited success) to counterbalance the increased 'bottom-up drive' to gain weight, which is triggered by biological, psycho-social and environmental mechanisms in people with obesity. Besides offering a deeper understanding of obesity, the model also highlights why there is a strong need for multimodal therapeutic approaches that may not only increase top-down control but also reduce a pathologically increased bottom-up drive.
Collapse
Affiliation(s)
- Bernd Schultes
- Metabolic Center St. Gallen, friendlyDocs Ltd, St. Gallen, Switzerland
| | - Barbara Ernst
- Metabolic Center St. Gallen, friendlyDocs Ltd, St. Gallen, Switzerland
| | - Manfred Hallschmid
- Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen (IDM), Tübingen, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Marco Bueter
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
- Department of Surgery, Spital Männedorf, Männedorf, Switzerland
| | - Sebastian M Meyhöfer
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany
| |
Collapse
|
8
|
Turk T, Hufanga S, Latailakepa S, Fifita L, Tolu OKH, Hola H, Khran J, Osornprasop S. Conducting formative research during a pandemic threat to inform the development of an obesity prevention social and behaviour change communication strategy in Tonga. Health Promot J Austr 2023. [PMID: 37871907 DOI: 10.1002/hpja.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/25/2023] Open
Abstract
ISSUE ADDRESSED The global epidemic of obesity is overtaking many parts of the world with the Pacific Islands at particular risk. Tonga population surveys identify significant increases in overweight and obesity with Social and Behaviour Change Communication (SBCC) offering opportunities for curbing the rise in non-communicable diseases. Formative research was conducted during the Covid-19 pandemic to assess stakeholder and program beneficiary needs and wants toward an obesity prevention SBCC strategy in Tonga. METHODS Semi-structured interviews with 17 key informants and 18 focus group discussions (N = 168) were conducted in Tongatapu. Data analysis was conducted on Nvivo 2020 qualitative software with desk research of secondary data supporting in-field findings. RESULTS Potential barriers to behavioural compliance included social/cultural norms, poor attitudes; low motivation and capability; and vulnerabilities of gender and other social determinants. Opportunities included the Tongan collective mindset and the desire for greater social interaction and fun. Strong political will to affect change was apparent with the need to consider targeting to youth, social mobilisation of communities through empowering messaging, and an integrated range of activities. CONCLUSIONS Co-design in the formative research process was able to be fostered via online communication processes to overcome the challenges of Covid-19 travel restrictions. The innovative approach provided a number of learnings including identification of national and regional priorities and improved efficiencies in SBCC planning, implementation and evaluation. SO WHAT?: Formative research adopting co-design approaches with stakeholders and program beneficiaries can provide optimal engagement and ownership in the SBCC strategy including insights into messaging approaches.
Collapse
Affiliation(s)
- Tahir Turk
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
- Communication Partners International, Springfield, New South Wales, Australia
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Yokum S, Stice E. Relation of BOLD response to food-specific and generic motor response inhibition tasks to body fat gain in adults with overweight and obesity. Physiol Behav 2023; 267:114206. [PMID: 37094746 PMCID: PMC10205669 DOI: 10.1016/j.physbeh.2023.114206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/10/2023] [Accepted: 04/21/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Low inhibitory control has been theorized to contribute to the development and maintenance of obesity. Knowledge on the neurobiological indicators of inhibitory control deficits predicting future weight gain is limited. The current study examined if individual differences in blood-oxygenation-level-dependent (BOLD) activity associated with food-specific and general motor response inhibition predict future body fat change in adults with overweight or obesity. METHODS BOLD activity and behavioral responses of adults with overweight or obesity (N = 160) were recorded while performing a food-specific stop signal task (n = 92) or a generic stop signal task (n = 68). Percent body fat was measured at baseline, posttest, 3-month, and 6-month follow-up. RESULTS Elevated BOLD activity in somatosensory (postcentral gyrus), and attention (precuneus) regions during successful inhibition in the food-specific stop signal task and elevated BOLD activity in a motor region (anterior cerebellar lobe) in the generic stop signal task predicted greater body fat gain over 6-month follow-up. Elevated BOLD activity in inhibitory control regions (inferior-, middle-, superior frontal gyri) and error monitoring regions (anterior cingulate cortex, insula) during erroneous responses in the generic stop signal task predicted body fat loss. CONCLUSIONS Results suggest that improving motor response inhibition and error monitoring may facilitate weight loss in adults with overweight and obesity.
Collapse
Affiliation(s)
- Sonja Yokum
- Oregon Research Institute, 3800 Sports Way, Springfield OR 97477, USA.
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford CA 94305, USA
| |
Collapse
|
10
|
Chae Y, Lee IS. Central Regulation of Eating Behaviors in Humans: Evidence from Functional Neuroimaging Studies. Nutrients 2023; 15:3010. [PMID: 37447336 PMCID: PMC10347214 DOI: 10.3390/nu15133010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Neuroimaging has great potential to provide insight into the neural response to food stimuli. Remarkable advances have been made in understanding the neural activity underlying food perception, not only in normal eating but also in obesity, eating disorders, and disorders of gut-brain interaction in recent decades. In addition to the abnormal brain function in patients with eating disorders compared to healthy controls, new therapies, such as neurofeedback and neurostimulation techniques, have been developed that target the malfunctioning brain regions in patients with eating disorders based on the results of neuroimaging studies. In this review, we present an overview of early and more recent research on the central processing and regulation of eating behavior in healthy and patient populations. In order to better understand the relationship between the gut and the brain as well as the neural mechanisms underlying abnormal ingestive behaviors, we also provide suggestions for future directions to enhance our current methods used in food-related neuroimaging studies.
Collapse
Affiliation(s)
- Younbyoung Chae
- College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - In-Seon Lee
- College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| |
Collapse
|
11
|
Nelson TD, Stice E. Contextualizing the Neural Vulnerabilities Model of Obesity. Nutrients 2023; 15:2988. [PMID: 37447312 DOI: 10.3390/nu15132988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
In recent years, investigators have focused on neural vulnerability factors that increase the risk of unhealthy weight gain, which has provided a useful organizing structure for obesity neuroscience research. However, this framework, and much of the research it has informed, has given limited attention to contextual factors that may interact with key vulnerabilities to impact eating behaviors and weight gain. To fill this gap, we propose a Contextualized Neural Vulnerabilities Model of Obesity, extending the existing theory to more intentionally incorporate contextual factors that are hypothesized to interact with neural vulnerabilities in shaping eating behaviors and weight trajectories. We begin by providing an overview of the Neural Vulnerabilities Model of Obesity, and briefly review supporting evidence. Next, we suggest opportunities to add contextual considerations to the model, including incorporating environmental and developmental context, emphasizing how contextual factors may interact with neural vulnerabilities to impact eating and weight. We then synthesize earlier models and new extensions to describe a Contextualized Neural Vulnerabilities Model of Obesity with three interacting components-food reward sensitivity, top-down regulation, and environmental factors-all within a developmental framework that highlights adolescence as a key period. Finally, we propose critical research questions arising from the framework, as well as opportunities to inform novel interventions.
Collapse
Affiliation(s)
- Timothy D Nelson
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| |
Collapse
|
12
|
Huo S, Li J, Guo J, Yan H, Deng X, Liu Y, Zhao J. Young Adults with Negative Body Image at Fatness Subscale Are More Restrained Than Normal Adults during a Chocolate Discounting Task. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6122. [PMID: 37372709 DOI: 10.3390/ijerph20126122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/24/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
Research has confirmed that people with obesity exhibit special responses to food stimuli when it comes to food-related decision tasks. However, it is unclear whether the phenomenon exists in people who feel mentally obese, even though they are not obese. The aim of this study was to investigate the behavioral and neural correlations of food-related decision-making between young adults with negative body image at fatness subscale and a control group, so as to explore the differences in executive functioning between them. We used a time-delayed discounting task (DDT) and recruited 13 young female adults in each group to participate in the electroencephalogram (EEG) experiment. The number of selections for low immediate rewards and high delayed rewards was used as a performance indicator for DDT. Behavioral results showed a significant interaction effect between selection types and groups, where more delayed rewards and shorter immediate rewards were selected in the group with negative body image at fatness subscale than in the control group. Statistical correlations between body mass index (BMI) and selection times were found in the control group, but this phenomenon did not occur in the experimental group. The event-related potentials found that the P100 of young adults with a negative body image at fatness subscale was greater than those in the control group. P200 showed a significant interaction effect between groups, electrodes, and selection types. N200 and N450 in delayed rewards were more negative than in immediate rewards for both groups. These findings suggest that young adults with negative body image at fatness subscale are more restrained than young adults in the control group when choosing chocolates. Moreover, individuals with negative body image at fatness subscale might be more sensitive to food stimuli than individuals in the control group, because their P100 amplitude was significantly larger than that of individuals in the control group when exposed to food-related stimuli.
Collapse
Affiliation(s)
- Sirui Huo
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Jun Li
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Jiaqi Guo
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Han Yan
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Xiaoyi Deng
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Yong Liu
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing 400715, China
| | - Jia Zhao
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing 400715, China
- Chongqing Collaborative Innovation Center for Brain Science, Chongqing 400715, China
| |
Collapse
|
13
|
de Klerk MT, Smeets PAM, la Fleur SE. Inhibitory control as a potential treatment target for obesity. Nutr Neurosci 2023; 26:429-444. [PMID: 35343884 DOI: 10.1080/1028415x.2022.2053406] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Strong reward responsiveness to food and insufficient inhibitory control are thought to be implicated in the development and maintenance of obesity. This narrative review addresses the role of inhibitory control in obesity and weight loss, and in how far inhibitory control is a promising target for weight loss interventions. METHODS PubMed, Web of Science, and Google Scholar were searched for papers up to May 2021. 41 papers were included. RESULTS Individuals with obesity have poorer food-specific inhibitory control, particularly when hungry, and less concurrent activation of inhibitory brain areas. Moreover, this was strongly predictive of future weight gain. More activation of inhibitory brain areas, on the other hand, was predictive of weight loss: individuals with successful weight loss initially show inhibitory brain activity comparable to that of normal weight individuals. When successful weight maintenance is achieved for at least 1 year, this inhibitory activity is further increased. Interventions targeting inhibitory control in obese individuals have divergent effects. Firstly, food-specific inhibitory control training is particularly effective for people with low inhibitory control and high BMI. Secondly, neuromodulation paradigms are rather heterogeneous: although rTMS to the left dorsolateral prefrontal cortex induced some weight-loss, multiple sessions of tDCS reduced food consumption (desire) and induced weight loss in two thirds of the papers. Thirdly, neurofeedback results in successful upregulation of brain activity and connectivity, but occasionally leads to increased food intake. In conclusion, inhibitory control is implicated in obesity. It can be targeted to promote weight loss although major weight losses have not been achieved.
Collapse
Affiliation(s)
- M T de Klerk
- Image Sciences Institute, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Neurobiology of Energy Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - P A M Smeets
- Image Sciences Institute, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - S E la Fleur
- Neurobiology of Energy Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
14
|
Ely AV, Wetherill RR. Reward and inhibition in obesity and cigarette smoking: Neurobiological overlaps and clinical implications. Physiol Behav 2023; 260:114049. [PMID: 36470508 PMCID: PMC10694810 DOI: 10.1016/j.physbeh.2022.114049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Cigarette smoking and obesity are the leading causes of premature morbidity and mortality and increase the risk of all-cause mortality four-fold when comorbid. Individuals with these conditions demonstrate neurobiological and behavioral differences regarding how they respond to rewarding stimuli or engage in inhibitory control. This narrative review examines the role of reward and inhibition in cigarette smoking and obesity independently, as well as recent research demonstrating an effect of increased body mass index (BMI) on neurocognitive function in individuals who smoke. It is possible that chronic smoking and overeating of highly palatable food, contributing to obesity, dysregulates reward neurocircuitry, subsequently leading to hypofunction of brain networks associated with inhibitory control. These brain changes do not appear to be specific to food or nicotine and, as a result, can potentiate continued cross-use. Changes to reward and inhibitory function due to increased BMI may also make cessation more difficult for those comorbid for obesity and smoking.
Collapse
Affiliation(s)
- Alice V Ely
- Cooper University Health Care, Center for Healing, Division of Addiction Medicine, Camden, NJ 08103, USA.
| | - Reagan R Wetherill
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA 19104, USA
| |
Collapse
|
15
|
Poghosyan V, Ioannou S, Al-Amri KM, Al-Mashhadi SA, Al-Mohammed F, Al-Otaibi T, Al-Saeed W. Spatiotemporal profile of altered neural reactivity to food images in obesity: Reward system is altered automatically and predicts efficacy of weight loss intervention. Front Neurosci 2023; 17:948063. [PMID: 36845430 PMCID: PMC9944082 DOI: 10.3389/fnins.2023.948063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction Obesity presents a significant public health problem. Brain plays a central role in etiology and maintenance of obesity. Prior neuroimaging studies have found that individuals with obesity exhibit altered neural responses to images of food within the brain reward system and related brain networks. However, little is known about the dynamics of these neural responses or their relationship to later weight change. In particular, it is unknown if in obesity, the altered reward response to food images emerges early and automatically, or later, in the controlled stage of processing. It also remains unclear if the pretreatment reward system reactivity to food images is predictive of subsequent weight loss intervention outcome. Methods In this study, we presented high-calorie and low-calorie food, and nonfood images to individuals with obesity, who were then prescribed lifestyle changes, and matched normal-weight controls, and examined neural reactivity using magnetoencephalography (MEG). We performed whole-brain analysis to explore and characterize large-scale dynamics of brain systems affected in obesity, and tested two specific hypotheses: (1) in obese individuals, the altered reward system reactivity to food images occurs early and automatically, and (2) pretreatment reward system reactivity predicts the outcome of lifestyle weight loss intervention, with reduced activity associated with successful weight loss. Results We identified a distributed set of brain regions and their precise temporal dynamics that showed altered response patterns in obesity. Specifically, we found reduced neural reactivity to food images in brain networks of reward and cognitive control, and elevated reactivity in regions of attentional control and visual processing. The hypoactivity in reward system emerged early, in the automatic stage of processing (< 150 ms post-stimulus). Reduced reward and attention responsivity, and elevated neural cognitive control were predictive of weight loss after six months in treatment. Discussion In summary, we have identified, for the first time with high temporal resolution, the large-scale dynamics of brain reactivity to food images in obese versus normal-weight individuals, and have confirmed both our hypotheses. These findings have important implications for our understanding of neurocognition and eating behavior in obesity, and can facilitate development of novel integrated treatment strategies, including tailored cognitive-behavioral and pharmacological therapies.
Collapse
Affiliation(s)
- Vahe Poghosyan
- Department of Neurophysiology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia,*Correspondence: Vahe Poghosyan,
| | - Stephanos Ioannou
- Department of Physiological Sciences, Alfaisal University, Riyadh, Saudi Arabia
| | - Khalid M. Al-Amri
- Obesity, Endocrinology and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Sufana A. Al-Mashhadi
- Research Unit, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Fedaa Al-Mohammed
- Department of Neurophysiology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Tahani Al-Otaibi
- Department of Neurophysiology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Wjoud Al-Saeed
- Research Unit, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
16
|
Zapparoli L, Devoto F, Giannini G, Zonca S, Gallo F, Paulesu E. Neural structural abnormalities behind altered brain activation in obesity: Evidence from meta-analyses of brain activation and morphometric data. Neuroimage Clin 2022; 36:103179. [PMID: 36088842 PMCID: PMC9474923 DOI: 10.1016/j.nicl.2022.103179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 12/14/2022]
Abstract
Obesity represents a risk factor for disability with a major bearing on life expectancy. Neuroimaging techniques are contributing to clarify its neurobiological underpinnings. Here, we explored whether structural brain abnormalities might accompany altered brain activations in obesity. We combined and compared data from brain activation studies for food stimuli and the data reported in structural voxel-based morphometry studies. We found that obese individuals have reduced grey matter density and functional activations in the thalamus and midbrain. A functional connectivity analysis based on these two clusters and its quantitative decoding showed that these regions are part of the reward system functional brain network. Moreover, we found specific grey matter hypo-densities in prefrontal cortex for the obese subjects, regions involved in controlled behaviour. These results support theories of obesity that point to reduced bottom-up reward processes (i.e., the Reward Deficit Theory), but also top-down theories postulating a deficit in cognitive control (i.e., the Inhibitory Control Deficit Theory). The same results also warrant a more systematic exploration of obesity whereby the reward of food and the intentional control over consummatory behaviour is manipulated.
Collapse
Affiliation(s)
- Laura Zapparoli
- Psychology Department and NeuroMi – Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy,IRCCS Orthopedic Institute Galeazzi, Milan, Italy,Corresponding authors.
| | - Francantonio Devoto
- Psychology Department and NeuroMi – Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Gianluigi Giannini
- Psychology Department and NeuroMi – Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Sara Zonca
- Psychology Department and NeuroMi – Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Francesca Gallo
- Psychology Department and NeuroMi – Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Eraldo Paulesu
- Psychology Department and NeuroMi – Milan Centre for Neuroscience, University of Milano-Bicocca, Milan, Italy,IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| |
Collapse
|
17
|
Ester T, Kullmann S. Neurobiological regulation of eating behavior: Evidence based on non-invasive brain stimulation. Rev Endocr Metab Disord 2022; 23:753-772. [PMID: 34862944 PMCID: PMC9307556 DOI: 10.1007/s11154-021-09697-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 12/28/2022]
Abstract
The prefrontal cortex is appreciated as a key neurobiological player in human eating behavior. A special focus is herein dedicated to the dorsolateral prefrontal cortex (DLPFC), which is critically involved in executive function such as cognitive control over eating. Persons with obesity display hypoactivity in this brain area, which is linked to overconsumption and food craving. Contrary to that, higher activity in the DLPFC is associated with successful weight-loss and weight-maintenance. Transcranial direct current stimulation (tDCS) is a non-invasive neurostimulation tool used to enhance self-control and inhibitory control. The number of studies using tDCS to influence eating behavior rapidly increased in the last years. However, the effectiveness of tDCS is still unclear, as studies show mixed results and individual differences were shown to be an important factor in the effectiveness of non-invasive brain stimulation. Here, we describe the current state of research of human studies using tDCS to influence food intake, food craving, subjective feeling of hunger and body weight. Excitatory stimulation of the right DLPFC seems most promising to reduce food cravings to highly palatable food, while other studies provide evidence that stimulating the left DLPFC shows promising effects on weight loss and weight maintenance, especially in multisession approaches. Overall, the reported findings are heterogeneous pointing to large interindividual differences in tDCS responsiveness.
Collapse
Affiliation(s)
- Theresa Ester
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.
- German Center of Diabetes Research (DZD), Tübingen, Germany.
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.
- German Center of Diabetes Research (DZD), Tübingen, Germany.
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Ebehard Karls University Tübingen, Tübingen, Germany.
| |
Collapse
|
18
|
Kozarzewski L, Maurer L, Mähler A, Spranger J, Weygandt M. Computational approaches to predicting treatment response to obesity using neuroimaging. Rev Endocr Metab Disord 2022; 23:773-805. [PMID: 34951003 PMCID: PMC9307532 DOI: 10.1007/s11154-021-09701-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 12/11/2022]
Abstract
Obesity is a worldwide disease associated with multiple severe adverse consequences and comorbid conditions. While an increased body weight is the defining feature in obesity, etiologies, clinical phenotypes and treatment responses vary between patients. These variations can be observed within individual treatment options which comprise lifestyle interventions, pharmacological treatment, and bariatric surgery. Bariatric surgery can be regarded as the most effective treatment method. However, long-term weight regain is comparably frequent even for this treatment and its application is not without risk. A prognostic tool that would help predict the effectivity of the individual treatment methods in the long term would be essential in a personalized medicine approach. In line with this objective, an increasing number of studies have combined neuroimaging and computational modeling to predict treatment outcome in obesity. In our review, we begin by outlining the central nervous mechanisms measured with neuroimaging in these studies. The mechanisms are primarily related to reward-processing and include "incentive salience" and psychobehavioral control. We then present the diverse neuroimaging methods and computational prediction techniques applied. The studies included in this review provide consistent support for the importance of incentive salience and psychobehavioral control for treatment outcome in obesity. Nevertheless, further studies comprising larger sample sizes and rigorous validation processes are necessary to answer the question of whether or not the approach is sufficiently accurate for clinical real-world application.
Collapse
Affiliation(s)
- Leonard Kozarzewski
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Clinic of Endocrinology, Diabetes and Metabolism, 10117, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Cardiovascular Research, 10117, Berlin, Germany
| | - Lukas Maurer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Clinic of Endocrinology, Diabetes and Metabolism, 10117, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Cardiovascular Research, 10117, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Anja Mähler
- Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center (ECRC), 13125, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, NeuroCure Clinical Research Center, 10117, Berlin, Germany
| | - Joachim Spranger
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Clinic of Endocrinology, Diabetes and Metabolism, 10117, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Cardiovascular Research, 10117, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Martin Weygandt
- Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center (ECRC), 13125, Berlin, Germany.
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, NeuroCure Clinical Research Center, 10117, Berlin, Germany.
| |
Collapse
|
19
|
Abstract
PURPOSE OF REVIEW The current article discusses five neural vulnerability theories for weight gain and reviews evidence from prospective studies using imaging and behavioral measures reflecting neural function, as well as randomized experiments with humans and animals that are consistent or inconsistent with these theories. RECENT FINDINGS Recent prospective imaging studies examining predictors of weight gain and response to obesity treatment, and repeated-measures imaging studies before and after weight gain and loss have advanced knowledge of etiologic processes and neural plasticity resulting from weight change. Overall, data provide strong support for the incentive sensitization theory of obesity and moderate support for the reward surfeit theory, inhibitory control deficit theory, and dynamic vulnerability model of obesity, which attempted to synthesize the former theories into a single etiologic model. Data provide little support for the reward deficit theory. Important directions for future studies are delineated.
Collapse
Affiliation(s)
- Eric Stice
- Department of Psychiatry, Stanford University, Stanford, CA, 94305, USA.
| | - Sonja Yokum
- Oregon Research Institute, Eugene, OR, 97403, USA
| |
Collapse
|
20
|
Iceta S, Panahi S, García-García I, Michaud A. The Impact of Restrictive and Non-restrictive Dietary Weight Loss Interventions on Neurobehavioral Factors Related to Body Weight Control: the Gaps and Challenges. Curr Obes Rep 2021; 10:385-395. [PMID: 34318394 DOI: 10.1007/s13679-021-00452-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Restrictive diets, such as low-calorie diets, are difficult to maintain in the long term. For this reason, their popularity has decreased compared to non-restrictive approaches, which instead promote healthy eating strategies. Since both strategies may entail different neurobiological mechanisms, this review will examine the current evidence on the effects of restrictive and non-restrictive interventions on neurobehavioral factors. RECENT FINDINGS Restrictive diets appear to improve eating behaviors, and the evidence reviewed argues against the notion that they may worsen the severity of binge eating. Moreover, they may lead to short-term changes in brain structure and improvements in cerebrovascular markers which, in turn, could impact eating behaviors. Non-restrictive interventions may have a positive effect on weight management and eating behaviors. However, evidence of their neural effects is scarce. Small sample sizes, short follow-ups, and the absence of control groups are limitations of the studies targeting both interventions. Rigorous long-term randomized studies are needed to examine the neurobehavioral effects of restrictive and non-restrictive approaches.
Collapse
Affiliation(s)
- Sylvain Iceta
- Quebec Heart and Lung Institute Research Center, Québec, QC, G1V 4G5, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada
- School of Nutrition, Université Laval, Québec, QC, G1V OA6, Canada
| | - Shirin Panahi
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada
- Faculty of Educational Sciences, Department of Physical Education, Université Laval, Québec, QC, G1V OA6, Canada
- Faculty of Medicine, Department of Kinesiology, Université Laval, Québec, QC, G1V OA6, Canada
| | - Isabel García-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, 08035, Barcelona, Spain
| | - Andréanne Michaud
- Quebec Heart and Lung Institute Research Center, Québec, QC, G1V 4G5, Canada.
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Québec, QC, G1V OA6, Canada.
- School of Nutrition, Université Laval, Québec, QC, G1V OA6, Canada.
| |
Collapse
|
21
|
Sewaybricker LE, Melhorn SJ, Rosenbaum JL, Askren MK, Tyagi V, Webb MF, De Leon MRB, Grabowski TJ, Schur EA. Reassessing relationships between appetite and adiposity in people at risk of obesity: A twin study using fMRI. Physiol Behav 2021; 239:113504. [PMID: 34147511 DOI: 10.1016/j.physbeh.2021.113504] [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: 03/05/2021] [Revised: 06/03/2021] [Accepted: 06/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Neuroimaging studies suggest that appetitive drive is enhanced in obesity. OBJECTIVE To test if appetitive drive varies in direct proportion to the level of body adiposity after accounting for genetic factors that contribute to both brain response and obesity risk. SUBJECTS/METHODS Participants were adult monozygotic (n = 54) and dizygotic (n = 30) twins with at least one member of the pair with obesity. Body composition was assessed by dual-energy X-ray absorptiometry. Hormonal and appetite measures were obtained in response to a standardized meal that provided 20% of estimated daily caloric needs and to an ad libitum buffet meal. Pre- and post-meal functional magnetic resonance imaging (fMRI) assessed brain response to visual food cues in a set of a priori appetite-regulating regions. Exploratory voxelwise analyses outside a priori regions were performed with correction for multiple comparisons. RESULTS In a group of 84 adults, the majority with obesity (75%), body fat mass was not associated with hormonal responses to a meal (glucose, insulin, glucagon-like peptide-1 and ghrelin, all P>0.40), subjective feelings of hunger (β=-0.01 mm [95% CI -0.35, 0.34] P = 0.97) and fullness (β=0.15 mm [-0.15, 0.44] P = 0.33), or buffet meal intake in relation to estimated daily caloric needs (β=0.28% [-0.05, 0.60] P = 0.10). Body fat mass was also not associated with brain response to high-calorie food cues in appetite-regulating regions (Pre-meal β=-0.12 [-0.32, 0.09] P = 0.26; Post-meal β=0.18 [-0.02, 0.37] P = 0.09; Change by a meal β=0.29 [-0.02, 0.61] P = 0.07). Conversely, lower fat mass was associated with being weight reduced (β=-0.05% [-0.07, -0.03] P<0.001) and greater pre-meal activation to high-calorie food cues in the dorsolateral prefrontal cortex (Z = 3.63 P = 0.017). CONCLUSIONS In a large study of adult twins, the majority with overweight or obesity, the level of adiposity was not associated with excess appetitive drive as assessed by behavioral, hormonal, or fMRI measures.
Collapse
Affiliation(s)
- Leticia E Sewaybricker
- Department of Medicine, University of Washington, 1959 NE Pacific St. Box 356420, Seattle, WA, 98195 USA
| | - Susan J Melhorn
- Department of Medicine, University of Washington, 1959 NE Pacific St. Box 356420, Seattle, WA, 98195 USA
| | - Jennifer L Rosenbaum
- Department of Medicine, University of Washington, 1959 NE Pacific St. Box 356420, Seattle, WA, 98195 USA
| | - Mary K Askren
- Departments of Radiology and Neurology, University of Washington, 1959 NE Pacific St. Seattle, WA, 98195 USA
| | - Vidhi Tyagi
- Department of Medicine, University of Washington, 1959 NE Pacific St. Box 356420, Seattle, WA, 98195 USA
| | - Mary F Webb
- Department of Medicine, University of Washington, 1959 NE Pacific St. Box 356420, Seattle, WA, 98195 USA
| | - Mary Rosalynn B De Leon
- Department of Medicine, University of Washington, 1959 NE Pacific St. Box 356420, Seattle, WA, 98195 USA
| | - Thomas J Grabowski
- Departments of Radiology and Neurology, University of Washington, 1959 NE Pacific St. Seattle, WA, 98195 USA
| | - Ellen A Schur
- Department of Medicine, University of Washington, 1959 NE Pacific St. Box 356420, Seattle, WA, 98195 USA.
| |
Collapse
|
22
|
Saruco E, Pleger B. A Systematic Review of Obesity and Binge Eating Associated Impairment of the Cognitive Inhibition System. Front Nutr 2021; 8:609012. [PMID: 33996871 PMCID: PMC8116510 DOI: 10.3389/fnut.2021.609012] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/09/2021] [Indexed: 02/04/2023] Open
Abstract
Altered functioning of the inhibition system and the resulting higher impulsivity are known to play a major role in overeating. Considering the great impact of disinhibited eating behavior on obesity onset and maintenance, this systematic review of the literature aims at identifying to what extent the brain inhibitory networks are impaired in individuals with obesity. It also aims at examining whether the presence of binge eating disorder leads to similar although steeper neural deterioration. We identified 12 studies that specifically assessed impulsivity during neuroimaging. We found a significant alteration of neural circuits primarily involving the frontal and limbic regions. Functional activity results show BMI-dependent hypoactivity of frontal regions during cognitive inhibition and either increased or decreased patterns of activity in several other brain regions, according to their respective role in inhibition processes. The presence of binge eating disorder results in further aggravation of those neural alterations. Connectivity results mainly report strengthened connectivity patterns across frontal, parietal, and limbic networks. Neuroimaging studies suggest significant impairment of various neural circuits involved in inhibition processes in individuals with obesity. The elaboration of accurate therapeutic neurocognitive interventions, however, requires further investigations, for a deeper identification and understanding of obesity-related alterations of the inhibition brain system.
Collapse
Affiliation(s)
- Elodie Saruco
- Department of Neurology, BG University Clinic Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Burkhard Pleger
- Department of Neurology, BG University Clinic Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| |
Collapse
|
23
|
Miranda-Olivos R, Steward T, Martínez-Zalacaín I, Mestre-Bach G, Juaneda-Seguí A, Jiménez-Murcia S, Fernández-Formoso JA, Vilarrasa N, Veciana de las Heras M, Custal N, Virgili N, Lopez-Urdiales R, Menchón JM, Granero R, Soriano-Mas C, Fernandez-Aranda F. The neural correlates of delay discounting in obesity and binge eating disorder. J Behav Addict 2021; 10:498-507. [PMID: 33950859 PMCID: PMC8997223 DOI: 10.1556/2006.2021.00023] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND AIMS Increased delay discounting is associated with obesity and binge eating disorder (BED). Although BED and obesity frequently co-occur, the neural mechanisms underlying delay discounting in these conditions remain poorly understood. METHODS Thirtyfive women with obesity, including 10 participants with obesity and BED and 31 controls completed a monetary delay discounting task during functional magnetic resonance imaging. RESULTS We identified that increased discounting rates were associated with decreased activity in the left anterior insula in participants with obesity compared to controls when choosing immediate rewards over delayed rewards (PFWE < 0.05). An exploratory analysis comparing the BED subsample to the other groups did not detect significant differences. DISCUSSION AND CONCLUSIONS Our findings suggest decreased activity in the anterior insula may underlie heightened delay discounting in individuals with obesity, contributing the probability of choosing immediate rewards over delayed rewards based on emotional states. Future studies including larger, more diverse samples are required to confirm these effects.
Collapse
Affiliation(s)
- Romina Miranda-Olivos
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - Trevor Steward
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | | | - Asier Juaneda-Seguí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - José A. Fernández-Formoso
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
| | - Nuria Vilarrasa
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
| | | | - Nuria Custal
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - Nuria Virgili
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - Rafael Lopez-Urdiales
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona,08193, Barcelona, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona,08193, Barcelona, Spain
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| |
Collapse
|
24
|
Veit R, Schag K, Schopf E, Borutta M, Kreutzer J, Ehlis AC, Zipfel S, Giel KE, Preissl H, Kullmann S. Diminished prefrontal cortex activation in patients with binge eating disorder associates with trait impulsivity and improves after impulsivity-focused treatment based on a randomized controlled IMPULS trial. NEUROIMAGE-CLINICAL 2021; 30:102679. [PMID: 34215149 PMCID: PMC8102655 DOI: 10.1016/j.nicl.2021.102679] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 01/18/2023]
Abstract
Persons with binge eating disorder show increased impulsivity. We investigated cognitive control to food cues using fNIRS. Compared to healthy controls, binge eaters show weaker activation of the prefrontal cortex. After behavioral therapy, binge eaters increase prefrontal cortex activation.
Background Behavioral and cognitive control are vital for healthy eating behavior. Patients with binge eating disorder (BED) suffer under recurrent binge eating episodes accompanied by subjective loss of control that results, among other factors, from increased impulsivity. Methods In the current study, we investigated the frontal network using functional near-infrared spectroscopy (fNIRS) during a food specific go/nogo task to assess response inhibition in 24 patients with BED (BMI range 22.6–59.7 kg/m2) compared to 12 healthy controls (HC) (BMI range 20.9–27 kg/m2). Patients with BED were invited to undergo fNIRS measurements before an impulsivity-focused cognitive behavioral group treatment, directly after this treatment and 3 months afterwards. As this was a planned subgroup analysis of the randomized controlled IMPULS trial, patients with BED were randomized either to the treatment group (n = 14) or to a control group (n = 10). The treatment group received 8 weekly sessions of the IMPULS treatment. Results We found a significant response inhibition effect (nogo minus go), in terms of an increased oxygenated hemoglobin response in the bilateral prefrontal cortex in both groups. The greatest response was observed when participants were instructed to go for healthy and withhold their response to unhealthy high caloric food cues. The healthy nogo condition failed to show a significant prefrontal inhibitory response, which was probably related to the task design, as the condition was considered more demanding. BED patients, especially those with higher trait impulsivity, showed a weaker activation of the prefrontal cortex during response inhibition, predominantly in the right hemisphere. Interestingly, three months after the treatment, patients of the treatment group increased their right prefrontal cortex activity during response inhibition. Likewise, increased prefrontal cortex activation correlated with decreased trait impulsivity after treatment. Conclusions Our results suggest that patients with BED have limited resources to activate the prefrontal cortex when asked to inhibit a reaction onto food-specific stimuli. However, this effect could be partly driven by differences in BMI between the HC and BED group. Cognitive-behavioral therapy targeting impulsive eating behavior may improve prefrontal cortex recruitment during response inhibition.
Collapse
Affiliation(s)
- Ralf Veit
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany
| | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Center of Excellence for Eating Disorders Tübingen (COMET), Tübingen, Germany
| | - Eric Schopf
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Maike Borutta
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany
| | - Jann Kreutzer
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Center of Excellence for Eating Disorders Tübingen (COMET), Tübingen, Germany
| | - Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Center of Excellence for Eating Disorders Tübingen (COMET), Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany; Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Institute of Pharmaceutical Sciences, Department of Pharmacy and Biochemistry, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany.
| |
Collapse
|
25
|
Ludwig M, Richter M, Goltermann J, Redlich R, Repple J, Flint C, Grotegerd D, Koch K, Leehr EJ, Meinert S, Hülsmann C, Enneking V, Kugel H, Hahn T, Baune BT, Dannlowski U, Opel N. Novelty seeking is associated with increased body weight and orbitofrontal grey matter volume reduction. Psychoneuroendocrinology 2021; 126:105148. [PMID: 33513455 DOI: 10.1016/j.psyneuen.2021.105148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
Novelty seeking (NS) has previously been identified as a personality trait that is associated with elevated body mass index (BMI) and obesity. Of note, both obesity and reduced impulse control - a core feature of NS - have previously been associated with grey matter volume (GMV) reductions in the orbitofrontal cortex (OFC). Yet, it remains unknown, if body weight-related grey matter decline in the OFC might be explained by higher levels of NS. To address this question, we studied associations between NS, BMI and brain structure in 355 healthy subjects. Brain images were pre-processed using voxel-based morphometry (VBM). BMI was calculated from self-reported height and weight. The Tridimensional Personality Questionnaire (TPQ) was used to assess NS. NS and BMI were associated positively (r = .137, p = .01) with NS being a significant predictor of BMI (B = 0.172; SE B = 0.05; ß = 0.184; p = 0.001). Significant associations between BMI and GMV specifically in the OFC (x = -44, y = 56, z = -2, t(350) = 4.34, k = 5, pFWE = 0.011) did not uphold when correcting for NS in the model. In turn, a significant negative association between NS and OFC GMV was found independent of BMI (x = -2, y = 48, z = -10, t(349) = 4.42, k = 88, pFWE = 0.008). Body mass-related grey matter decrease outside the OFC could not be attributed to NS. Our results suggest that body-weight-related orbitofrontal grey matter reduction can at least partly be linked to higher levels of NS. Given the pivotal role of the OFC in overweight as well as cognitive domains such as impulse inhibition, executive control and reward processing, its association with NS seems to provide a tenable neurobiological correlate for future research.
Collapse
Affiliation(s)
- Marius Ludwig
- Department of Psychiatry, University of Münster, Germany
| | - Maike Richter
- Department of Psychiatry, University of Münster, Germany
| | | | - Ronny Redlich
- Department of Psychiatry, University of Münster, Germany; Department of Psychology, University of Halle, Germany
| | | | - Claas Flint
- Department of Psychiatry, University of Münster, Germany; Department of Mathematics and Computer Science, University of Münster, Germany
| | | | - Katharina Koch
- Department of Psychiatry, University of Münster, Germany
| | | | | | | | | | - Harald Kugel
- Institute of Clinical Radiology, University of Münster, Germany
| | - Tim Hahn
- Department of Psychiatry, University of Münster, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Germany
| | - Nils Opel
- Department of Psychiatry, University of Münster, Germany.
| |
Collapse
|
26
|
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.
Collapse
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.
| |
Collapse
|
27
|
Donofry SD, Stillman CM, Erickson KI. A review of the relationship between eating behavior, obesity and functional brain network organization. Soc Cogn Affect Neurosci 2020; 15:1157-1181. [PMID: 31680149 PMCID: PMC7657447 DOI: 10.1093/scan/nsz085] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/24/2019] [Accepted: 10/02/2019] [Indexed: 12/21/2022] Open
Abstract
Obesity is a major public health issue affecting nearly 40% of American adults and is associated with increased mortality and elevated risk for a number of physical and psychological illnesses. Obesity is associated with impairments in executive functions such as decision making and inhibitory control, as well as in reward valuation, which is thought to contribute to difficulty sustaining healthy lifestyle behaviors, including adhering to a healthy diet. Growing evidence indicates that these impairments are accompanied by disruptions in functional brain networks, particularly those that support self-regulation, reward valuation, self-directed thinking and homeostatic control. Weight-related differences in task-evoked and resting-state connectivity have most frequently been noted in the executive control network (ECN), salience network (SN) and default mode network (DMN), with obesity generally being associated with weakened connectivity in the ECN and enhanced connectivity in the SN and DMN. Similar disruptions have been observed in the much smaller literature examining the relationship between diet and disordered eating behaviors on functional network organization. The purpose of this narrative review was to summarize what is currently known about how obesity and eating behavior relate to functional brain networks, describe common patterns and provide recommendations for future research based on the identified gaps in knowledge.
Collapse
Affiliation(s)
- Shannon D Donofry
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, 15260, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, 15213, PA, USA
| | - Chelsea M Stillman
- Department of Psychology, University of Pittsburgh, Pittsburgh, 15213, PA, USA
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, 15213, PA, USA
- The Center for the Neural Basis of Cognition, Pittsburgh, 15213, PA, USA
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, Western Australia, 6150, Australia
| |
Collapse
|
28
|
Wakonig K, Eitel F, Ritter K, Hetzer S, Schmitz-Hübsch T, Bellmann-Strobl J, Haynes JD, Brandt AU, Gold SM, Paul F, Weygandt M. Altered Coupling of Psychological Relaxation and Regional Volume of Brain Reward Areas in Multiple Sclerosis. Front Neurol 2020; 11:568850. [PMID: 33117263 PMCID: PMC7574404 DOI: 10.3389/fneur.2020.568850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/19/2020] [Indexed: 12/19/2022] Open
Abstract
Background: Psychological stress can influence the severity of multiple sclerosis (MS), but little is known about neurobiological factors potentially counteracting these effects. Objective: To identify gray matter (GM) brain regions related to relaxation after stress exposure in persons with MS (PwMS). Methods: 36 PwMS and 21 healthy controls (HCs) reported their feeling of relaxation during a mild stress task. These markers were related to regional GM volumes, heart rate, and depressive symptoms. Results: Relaxation was differentially linked to heart rate in both groups (t = 2.20, p = 0.017), i.e., both markers were only related in HCs. Relaxation was positively linked to depressive symptoms across all participants (t = 1.99, p = 0.045) although this link differed weakly between groups (t = 1.62, p = 0.108). Primarily, the volume in medial temporal gyrus was negatively linked to relaxation in PwMS (t = -5.55, pfamily-wise-error(FWE)corrected = 0.018). A group-specific coupling of relaxation and GM volume was found in ventromedial prefrontal cortex (VMPFC) (t = -4.89, pFWE = 0.039). Conclusion: PwMS appear unable to integrate peripheral stress signals into their perception of relaxation. Together with the group-specific coupling of relaxation and VMPFC volume, a key area of the brain reward system for valuation of affectively relevant stimuli, this finding suggests a clinically relevant misinterpretation of stress-related affective stimuli in MS.
Collapse
Affiliation(s)
- Katharina Wakonig
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany
| | - Fabian Eitel
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Department of Psychiatry and Psychotherapy, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Advanced Neuroimaging, Berlin, Germany
| | - Kerstin Ritter
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Department of Psychiatry and Psychotherapy, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Advanced Neuroimaging, Berlin, Germany
| | - Stefan Hetzer
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Advanced Neuroimaging, Berlin, Germany
| | - Tanja Schmitz-Hübsch
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine and Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Experimental and Clinical Research Center, Berlin, Germany
| | - Judith Bellmann-Strobl
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine and Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Experimental and Clinical Research Center, Berlin, Germany
| | - John-Dylan Haynes
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Advanced Neuroimaging, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Alexander U. Brandt
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany
- Department of Neurology, University of California, Irvine, CA, United States
| | - Stefan M. Gold
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg Eppendorf, Hamburg, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychosomatic Medicine, Berlin, Germany
| | - Friedemann Paul
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine and Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Experimental and Clinical Research Center, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Neurology, Berlin, Germany
| | - Martin Weygandt
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine and Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Experimental and Clinical Research Center, Berlin, Germany
| |
Collapse
|
29
|
Neural correlates of future weight loss reveal a possible role for brain-gastric interactions. Neuroimage 2020; 224:117403. [PMID: 32979521 DOI: 10.1016/j.neuroimage.2020.117403] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/19/2020] [Accepted: 08/25/2020] [Indexed: 12/19/2022] Open
Abstract
Lifestyle dietary interventions are an essential practice in treating obesity, hence neural factors that may assist in predicting individual treatment success are of great significance. Here, in a prospective, open-label, three arms study, we examined the correlation between brain resting-state functional connectivity measured at baseline and weight loss following 6 months of lifestyle intervention in 92 overweight participants. We report a robust subnetwork composed mainly of sensory and motor cortical regions, whose edges correlated with future weight loss. This effect was found regardless of intervention group. Importantly, this main finding was further corroborated using a stringent connectivity-based prediction model assessed with cross-validation thus attesting to its robustness. The engagement of senso-motor regions in this subnetwork is consistent with the over-sensitivity to food cues theory of weight regulation. Finally, we tested an additional hypothesis regarding the role of brain-gastric interaction in this subnetwork, considering recent findings of a cortical network synchronized with gastric activity. Accordingly, we found a significant spatial overlap with the subnetwork reported in the present study. Moreover, power in the gastric basal electric frequency within our reported subnetwork negatively correlated with future weight loss. This finding was specific to the weight loss related subnetwork and to the gastric basal frequency. These findings should be further corroborated by combining direct recordings of gastric activity in future studies. Taken together, these intriguing results may have important implications for our understanding of the etiology of obesity and the mechanism of response to dietary intervention.
Collapse
|
30
|
Chen EY, Eickhoff SB, Giovannetti T, Smith DV. Obesity is associated with reduced orbitofrontal cortex volume: A coordinate-based meta-analysis. Neuroimage Clin 2020; 28:102420. [PMID: 32961404 PMCID: PMC7509458 DOI: 10.1016/j.nicl.2020.102420] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 01/01/2023]
Abstract
Neural models of obesity vary in their focus upon prefrontal and striatal differences. Animal and human studies suggest that differential functioning of the orbitofrontal cortex is associated with obesity. However, meta-analyses of functional neuroimaging studies have not found a clear relationship between the orbitofrontal cortex and obesity. Meta-analyses of structural imaging studies of obesity have shown mixed findings with regards to an association with reduced orbitofrontal cortex gray matter volume. To clarify these findings, we conducted a meta-analysis of 25 voxel-based morphometry studies, and found that greater body mass index is associated with decreased gray matter volume in the right orbitofrontal cortex (Brodmanns' areas 10 and 11), where family-wise corrected p < .05, N = 7,612. Use of the right orbitofrontal cortex as a seed in a Neurosynth Network Coactivation analysis showed that this region is associated with activity in the left frontal medial cortex, left temporal lobe, right precuneus cortex, posterior division of the left middle temporal gyrus, and right frontal pole. When Neurosynth Network Coactivation results were submitted as regions of interest in the Human Connectome Project data, we found that greater body mass index was associated with greater activity in left frontal medial cortex response to the Gambling Task, where p < .05, although this did not survive Bonferroni-correction. Our findings highlight the importance of the orbitofrontal cortex structure and functioning in neural models of obesity. Exploratory analyses suggest more studies are needed that examine the functional significance of reduced orbitofrontal cortex gray matter volume in obesity, and the effect of age and weight changes on this relationship using longitudinal designs.
Collapse
Affiliation(s)
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Germany
| | | | | |
Collapse
|
31
|
Schur EA, Melhorn SJ, Scholz K, De Leon MRB, Elfers CT, Rowland MG, Saelens BE, Roth CL. Child neurobiology impacts success in family-based behavioral treatment for children with obesity. Int J Obes (Lond) 2020; 44:2011-2022. [PMID: 32713944 PMCID: PMC7530004 DOI: 10.1038/s41366-020-0644-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 06/08/2020] [Accepted: 07/16/2020] [Indexed: 11/30/2022]
Abstract
Background and Objectives: Family-based behavioral treatment (FBT) is the recommended treatment for children with common obesity. However, there is a large variability in short- and long-term treatment response and mechanisms for unsuccessful treatment outcomes are not fully understood. In this study, we tested if brain response to visual food cues among children with obesity before treatment predicted weight or behavioral outcomes during a 6-mo. behavioral weight management program and/or long-term relative weight maintenance over a 1-year follow-up period. Subjects and Methods: Thirty-seven children with obesity (age 9–11y, 62% male) who entered active FBT (attended 2 or more sessions) and had outcome data. Brain activation was assessed at pre-treatment by functional magnetic resonance imaging across an a priori set of appetite-processing brain regions that included the ventral and dorsal striatum, medial orbitofrontal cortex, amygdala, substantia nigra/ventral tegmental area and insula in response to viewing food images before and after a standardized meal. Results: Children with more robust reductions in brain activation to high-calorie food cue images following a meal had greater declines in BMI z-score during FBT (r= 0.42; 95% CI: 0.09, 0.66; P=0.02) and greater improvements in Healthy Eating Index scores (r= −0.41; 95% CI: −0.67, −0.06; P=0.02). In whole-brain analyses, greater activation in the ventromedial prefrontal cortex, specifically by high-calorie food cues, was predictive of better treatment outcomes (whole-brain cluster corrected P=0.02). There were no significant predictors of relative weight maintenance and initial behavioral or hormonal measures did not predict FBT outcomes. Conclusions: Children’s brain responses to a meal prior to obesity treatment were related to treatment-based weight outcomes, suggesting that neurophysiologic factors and appetitive drive, more so than initial hormone status or behavioral characteristics, limit intervention success.
Collapse
Affiliation(s)
- Ellen A Schur
- Division of General Internal Medicine, Department of Medicine, University of Washington, 750 Republican St, Box 358062, Seattle, WA, 98109, USA.
| | - Susan J Melhorn
- Division of General Internal Medicine, Department of Medicine, University of Washington, 750 Republican St, Box 358062, Seattle, WA, 98109, USA
| | - Kelley Scholz
- Seattle Children's Research Institute, 1900 Ninth Ave, Seattle, WA, 98101, USA
| | - Mary Rosalynn B De Leon
- Division of General Internal Medicine, Department of Medicine, University of Washington, 750 Republican St, Box 358062, Seattle, WA, 98109, USA
| | - Clinton T Elfers
- Seattle Children's Research Institute, 1900 Ninth Ave, Seattle, WA, 98101, USA
| | - Maya G Rowland
- Seattle Children's Research Institute, 1900 Ninth Ave, Seattle, WA, 98101, USA
| | - Brian E Saelens
- Seattle Children's Research Institute, 1900 Ninth Ave, Seattle, WA, 98101, USA.,Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Christian L Roth
- Seattle Children's Research Institute, 1900 Ninth Ave, Seattle, WA, 98101, USA.,Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA
| |
Collapse
|
32
|
Fassini PG, Das SK, Magerowski G, Marchini JS, da Silva Junior WA, da Silva IR, de Souza Ribeiro Salgueiro R, Machado CD, Suen VMM, Alonso-Alonso M. Noninvasive neuromodulation of the prefrontal cortex in young women with obesity: a randomized clinical trial. Int J Obes (Lond) 2020; 44:1279-1290. [PMID: 32076105 DOI: 10.1038/s41366-020-0545-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 01/09/2020] [Accepted: 02/03/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND/OBJECTIVES Obesity is associated with reduced neurocognitive performance. Individuals with obesity show decreased activation in the left dorsolateral prefrontal cortex (DLPFC), a key brain region relevant to the regulation of eating behavior. Transcranial direct current stimulation (tDCS) has emerged as a potential technique to correct these abnormalities. However, there is limited information to date, particularly in clinical settings and regarding long-term effects of tDCS. This study aimed to investigate the effects of DLPFC-targeted tDCS in young women with obesity. SUBJECT/METHODS Randomized, double-blind, sham-controlled parallel-design clinical trial conducted in 38 women, aged 20-40 years, with BMI 30-35 kg/m2. STUDY DESIGN Phase I: target engagement (immediate effects of tDCS on working memory performance), Phase II: tDCS only (ten sessions, 2 weeks), Phase III: tDCS + hypocaloric diet (six sessions, 30% energy intake reduction, 2 weeks, inpatient), Phase IV: follow-up at 1, 3, and 6 months. PRIMARY OUTCOME change in body weight. SECONDARY OUTCOMES change in eating behavior and appetite. Additional analyses: effect of Catechol-O-methyl transferase (COMT) gene variability. Data were analyzed as linear mixed models. RESULTS There was no group difference in change in body weight during the tDCS intervention. At follow-up, the active group lost less weight than the sham group. In addition, the active group regained weight at 6-month follow-up, compared with sham. Genetic analysis indicated that COMT Met noncarriers were the subgroup that accounted for this paradoxical response in the active group. CONCLUSION Our results suggest that in young women with class I obesity, tDCS targeted to the DLPFC does not facilitate weight loss. Indeed, we found indications that tDCS could have a paradoxical effect in this population, possibly connected with individual differences in dopamine availability. Future studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Priscila Giacomo Fassini
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Bairro Monte Alegre, CEP, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Sai Krupa Das
- Energy Metabolism Laboratory, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111-1524, USA
| | - Greta Magerowski
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Júlio Sérgio Marchini
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Bairro Monte Alegre, CEP, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Wilson Araújo da Silva Junior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Bairro Monte Alegre, CEP, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Isabela Rozatte da Silva
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Bairro Monte Alegre, CEP, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Rafaella de Souza Ribeiro Salgueiro
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Bairro Monte Alegre, CEP, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Cássia Dias Machado
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Bairro Monte Alegre, CEP, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Vivian Marques Miguel Suen
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Bairro Monte Alegre, CEP, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Miguel Alonso-Alonso
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
| |
Collapse
|
33
|
Naets T, Vervoort L, Tanghe A, De Guchtenaere A, Braet C. Maladaptive Eating in Children and Adolescents With Obesity: Scrutinizing Differences in Inhibition. Front Psychiatry 2020; 11:309. [PMID: 32425824 PMCID: PMC7212434 DOI: 10.3389/fpsyt.2020.00309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/27/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION In order to grasp the complex etiology of childhood obesity, we aim to clarify the relationship between external eating and weight. Based on theory and empirical evidence, we claim that inhibition is an important moderator in this association. In our first research question we expected that high external eating would be related to a higher weight status, especially for those with high inhibition problems. Secondly, we explored the moderating role of inhibition in the association between external eating and weight change after a multidisciplinary obesity treatment. METHOD We investigated n=572 participants (51% boys, aged 7-19) with moderate to extreme obesity recruited in a Belgian inpatient treatment center. At intake, parents reported on inhibition (BRIEF), while the children and adolescents reported on their eating behavior (DEBQ). Weight and length were objectively measured pre and post treatment (ADJUSTED BMI). Two hierarchical linear regression models were built to scrutinize the influence of inhibition on the association between external eating and both baseline weight and weight change. RESULTS First, predicting baseline weight, we found no significant moderating effect of inhibition problems. Second, predicting weight loss, inhibition turned out to be a substantial moderator, specifically in adolescents. Some unexpected gender differences occurred in favor of adolescent boys, in a way that those with high external eating and low inhibition problems lost most weight. CONCLUSION Inhibition problems act as a moderator explaining weight loss, but this only holds for adolescents. This suggests that external eating and inhibition play a complex role in weight loss in certain age and gender categories, and stresses the importance of identifying subgroups for tailoring interventions. For those with high inhibition problems, interventions aimed at increasing inhibition skills might be needed to optimize treatment outcomes.
Collapse
Affiliation(s)
- Tiffany Naets
- Clinical Child and Adolescent Psychology (CCAP) Lab, Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Leentje Vervoort
- Clinical Child and Adolescent Psychology (CCAP) Lab, Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Ann Tanghe
- Obesity Department, Zeepreventorium vzw, De Haan, Belgium
| | | | - Caroline Braet
- Clinical Child and Adolescent Psychology (CCAP) Lab, Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| |
Collapse
|
34
|
Donofry SD, Jakicic JM, Rogers RJ, Watt JC, Roecklein KA, Erickson KI. Comparison of Food Cue-Evoked and Resting-State Functional Connectivity in Obesity. Psychosom Med 2020; 82:261-271. [PMID: 32267660 PMCID: PMC8057093 DOI: 10.1097/psy.0000000000000769] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Obesity is associated with differences in task-evoked and resting-state functional brain connectivity (FC). However, no studies have compared obesity-related differences in FC evoked by high-calorie food cues from that observed at rest. Such a comparison could improve our understanding of the neural mechanisms of reward valuation and decision making in the context of obesity. METHODS The sample included 122 adults (78% female; mean age = 44.43 [8.67] years) with body mass index (BMI) in the overweight or obese range (mean = 31.28 [3.92] kg/m). Participants completed a functional magnetic resonance imaging scan that included a resting period followed by a visual food cue task. Whole-brain FC analyses examined seed-to-voxel signal covariation during the presentation of high-calorie food and at rest using seeds located in the left and right orbitofrontal cortex, left hippocampus, and left dorsomedial prefrontal cortex. RESULTS For all seeds examined, BMI was associated with stronger FC during the presentation of high-calorie food, but weaker FC at rest. Regions exhibiting BMI-related modulation of signal coherence in the presence of palatable food cues were largely located within the default mode network (z range = 2.34-4.91), whereas regions exhibiting BMI-related modulation of signal coherence at rest were located within the frontostriatal and default mode networks (z range = 3.05-4.11). All FC results exceeded a voxelwise threshold of p < .01 and cluster-defining familywise error threshold of p < .05. CONCLUSIONS These dissociable patterns of FC may suggest separate neural mechanisms contributing to variation in distinct cognitive, psychological, or behavioral domains that may be related to individual differences in risk for obesity.
Collapse
Affiliation(s)
- Shannon D Donofry
- From the Department of Psychiatry (Donofry), University of Pittsburgh School of Medicine; Departments of Psychology (Donofry, Watt, Roecklein, Erickson) and Health and Physical Activity (Jakicic, Rogers), and Healthy Lifestyle Institute (Jakicic, Rogers), University of Pittsburgh; and The Center for the Neural Basis of Cognition (Roecklein, Erickson), Pittsburgh, Pennsylvania
| | | | | | | | | | | |
Collapse
|
35
|
Kemps E, Goossens L, Petersen J, Verbeken S, Vervoort L, Braet C. Evidence for enhancing childhood obesity treatment from a dual-process perspective: A systematic literature review. Clin Psychol Rev 2020; 77:101840. [DOI: 10.1016/j.cpr.2020.101840] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 10/08/2019] [Accepted: 02/08/2020] [Indexed: 12/16/2022]
|
36
|
Food cue recruits increased reward processing and decreased inhibitory control processing in the obese/overweight: An activation likelihood estimation meta-analysis of fMRI studies. Obes Res Clin Pract 2020; 14:127-135. [DOI: 10.1016/j.orcp.2020.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/13/2019] [Accepted: 02/17/2020] [Indexed: 12/22/2022]
|
37
|
Kekic M, McClelland J, Bartholdy S, Chamali R, Campbell IC, Schmidt U. Bad Things Come to Those Who Do Not Wait: Temporal Discounting Is Associated With Compulsive Overeating, Eating Disorder Psychopathology and Food Addiction. Front Psychiatry 2020; 10:978. [PMID: 32038324 PMCID: PMC6987464 DOI: 10.3389/fpsyt.2019.00978] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/10/2019] [Indexed: 12/29/2022] Open
Abstract
The tendency to act on immediate pleasure-driven desires, due to the devaluation of future rewards [a process known as temporal discounting (TD)], has been associated with substance use disorders (SUD) and with conditions characterised by compulsive overeating. The study involved a large inclusive participant sample (i.e., no diagnostic or exclusion criteria were applied). They were recruited/assessed online and we investigated whether TD was related to compulsive overeating and associated problems. Participants [N = 432, (48 males)] completed an online survey, which included a hypothetical monetary TD task, the Eating Disorder Examination-Questionnaire (EDE-Q), the Yale Food Addiction Scale (YFAS) and the Depression Anxiety and Stress Scales (DASS). TD correlated with frequency of compulsive overeating and compensatory behaviours, with eating disorder psychopathology, with scores on the YFAS, and with body mass index (BMI). As our study shows that elevated rates of TD are associated with a range of behaviours/measures, we propose that it is more likely that elevated TD rates are a predisposing factor rather than a consequence of the behaviour, i.e., elevated rates of TD contribute to pathological eating-related behaviours; however, a bi-directional explanation is also possible. Future research should investigate whether interventions aimed at reducing TD have clinical potential for treating problematic eating behaviours.
Collapse
Affiliation(s)
| | | | | | | | | | - Ulrike Schmidt
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| |
Collapse
|
38
|
Goldschmidt AB, Dickstein DP, MacNamara AE, Phan KL, O'Brien S, Le Grange D, Fisher JO, Keedy S. A Pilot Study of Neural Correlates of Loss of Control Eating in Children With Overweight/Obesity: Probing Intermittent Access to Food as a Means of Eliciting Disinhibited Eating. J Pediatr Psychol 2019; 43:846-855. [PMID: 29462339 DOI: 10.1093/jpepsy/jsy009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 02/01/2018] [Indexed: 11/12/2022] Open
Abstract
Objective Neural substrates of loss of control (LOC) eating are undercharacterized. We aimed to model intermittent access to food to elicit disinhibited eating in youth undergoing neuroimaging, given evidence that restricted food access may increase subsequent food intake via enhancing reward value of food and diminishing eating-related self-control. Methods Participants were 18 preadolescents (aged 9-12 years) who were overweight/obese with recent LOC eating (OW-LOC; n = 6); overweight/obese with no history of LOC eating (OW-CON; n = 5); or non-overweight with no history of LOC eating (NW-CON; n = 7). Participants underwent functional magnetic resonance imaging during a simulated food restriction paradigm in which they were alternately given restricted or unrestricted access to milkshake solutions. Results There were no significant main effects of restricted versus unrestricted access to milkshake flavors. Group main effects revealed increased activation for OW-LOC relative to OW-CON in areas related to attentional processes (right middle frontal gyrus), inhibitory control/attentional shifts (right and left cuneus), and emotion regulation (left cingulate gyrus); and for OW-LOC relative to NW-CON in areas related to response inhibition (right inferior frontal gyrus). Significant block type × group interaction effects were found for the right middle frontal gyrus, left cingulate gyrus, and left cuneus, but these appeared to be accounted for primarily by group. Discussion There were clear group differences in neural activity in brain regions related to self-regulation during a food restriction paradigm. Elevations in these regions among OW-LOC relative to OW-CON and NW-CON, respectively, may suggest that youth with LOC eating expended more cognitive effort to regulate ingestive behavior.
Collapse
Affiliation(s)
| | | | | | - K Luan Phan
- Departments of Psychiatry, Psychology, Anatomy, & Cell Biology, and Graduate Program in Neuroscience, University of Illinois at Chicago
| | | | | | | | - Sarah Keedy
- Psychiatry & Behavioral Neuroscience, University of Chicago
| |
Collapse
|
39
|
Maurer L, Mai K, Krude H, Haynes JD, Weygandt M, Spranger J. Interaction of circulating GLP-1 and the response of the dorsolateral prefrontal cortex to food-cues predicts body weight development. Mol Metab 2019; 29:136-144. [PMID: 31668385 PMCID: PMC6812034 DOI: 10.1016/j.molmet.2019.08.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/14/2019] [Accepted: 08/19/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES This study evaluated the impact of the interaction between the anorexigenic incretin hormone glucagon-like peptide-1 (GLP-1) and reward-related brain activity in the dorsolateral prefrontal cortex (DLPFC), a key area of behavioral control, on future weight loss in obese individuals. METHODS We performed a weight loss-weight maintenance intervention study over 27 months. We applied an fMRI food-cue reactivity paradigm during which the participants were passively exposed to food pictures to evaluate neuronal activity in the DLPFC. Additionally, we measured concentrations of circulating GLP-1 levels during a standard oral glucose tolerance test. Phenotyping was performed consecutively before and after a 3-month low-calorie diet as well as after a randomized 12-month trial, investigating the effect of a combined behavioral intervention on body weight maintenance. Participants were then followed-up for another 12 months without further intervention. RESULTS Using voxel-wise linear mixed-effects regression analyses, we evaluated 56 measurements and identified a strong interaction between circulating, endogenous GLP-1 levels and DLPFC activity predicting body weight change over the total observation period (t = -6.17, p = 1.6 · 10-7). While neither the GLP-1 nor the DLPFC response individually predicted the subsequent weight change, participants achieved body weight loss when the GLP-1 and the DLPFC responses occurred concurrently. CONCLUSIONS Our data demonstrate an interaction between a peripheral hormonal signal and central nervous activity as robust predictor of body weight change throughout the different periods of a long-term life-style intervention. The preeminent role of their interdependency compared to the partly ambivalent effects of the single components argues for integrative approaches to improve sensitivity and reliability of weight prediction conventionally based on individual biomarkers.
Collapse
Affiliation(s)
- Lukas Maurer
- Charité - Universitätsmedizin Berlin, Clinic of Endocrinology, Diabetes and Metabolism, Berlin, Germany; Charité - Universitätsmedizin Berlin, Charité Center for Cardiovascular Research, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
| | - Knut Mai
- Charité - Universitätsmedizin Berlin, Clinic of Endocrinology, Diabetes and Metabolism, Berlin, Germany; Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Heiko Krude
- Charité - Universitätsmedizin Berlin, Clinic of Pediatric Endocrinology and Diabetology, Berlin, Germany
| | - John-Dylan Haynes
- Charité - Universitätsmedizin Berlin, Excellence Cluster NeuroCure, Berlin, Germany; Charité - Universitätsmedizin Berlin, Berlin Center for Advanced Neuroimaging, Department of Neurology, Berlin, Germany
| | - Martin Weygandt
- Charité - Universitätsmedizin Berlin, Excellence Cluster NeuroCure, Berlin, Germany; Charité - Universitätsmedizin Berlin, Berlin Center for Advanced Neuroimaging, Department of Neurology, Berlin, Germany
| | - Joachim Spranger
- Charité - Universitätsmedizin Berlin, Clinic of Endocrinology, Diabetes and Metabolism, Berlin, Germany; Charité - Universitätsmedizin Berlin, Charité Center for Cardiovascular Research, Berlin, Germany; Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| |
Collapse
|
40
|
Wang Y, Qin Y, Li H, Yao D, Sun B, Li Z, Li X, Dai Y, Wen C, Zhang L, Zhang C, Zhu T, Luo C. Abnormal Functional Connectivity in Cognitive Control Network, Default Mode Network, and Visual Attention Network in Internet Addiction: A Resting-State fMRI Study. Front Neurol 2019; 10:1006. [PMID: 31620077 PMCID: PMC6759465 DOI: 10.3389/fneur.2019.01006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 09/03/2019] [Indexed: 01/01/2023] Open
Abstract
Internet addiction (IA) has become a global mental and social problem, which may lead to a series of psychiatric symptoms including uncontrolled use of internet, and lack of concentration. However, the exact pathophysiology of IA remains unclear. Most of functional connectivity studies were based on pre-selected regions of interest (ROI), which could not provide a comprehensive picture of the communication abnormalities in IA, and might lead to limited or bias observations. Using local functional connectivity density (lFCD), this study aimed to explore the whole-brain abnormalities of functional connectivity in IA. We evaluated the whole-brain lFCD resulting from resting-state fMRI data in 28 IA individuals and 30 demographically matched healthy control subjects (HCs). The correlations between clinical characteristics and aberrant lFCD were also assessed. Compared with HCs, subjects with IA exhibited heightened lFCD values in the right dorsolateral prefrontal cortex (DLPFC), left parahippocampal gyrus (PHG), and cerebellum, and the bilateral middle cingulate cortex (MCC) and superior temporal pole (STP), as well as decreased lFCD values in the right inferior parietal lobe (IPL), and bilateral calcarine and lingual gyrus. Voxel-based correlation analysis revealed the significant correlations between the Young's Internet Addiction Test (IAT) score and altered lFCD values in the left PHG and bilateral STP. These findings revealed the hyper-connectivity in cognitive control network and default mode network as well as the hypo-connectivity in visual attention network, verifying the common mechanism in IA and substance addiction, and the underlying association between IA, and attention deficit/hyperactivity disorder in terms of neurobiology.
Collapse
Affiliation(s)
- Yang Wang
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Department of Rehabilitation, Shuangliu Maternal and Child Health Care Hospital, Chengdu, China
| | - Yun Qin
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Hui Li
- School of Medicine, Chengdu University, Chengdu, China
| | - Dezhong Yao
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Bo Sun
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiliang Li
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xin Li
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yu Dai
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chao Wen
- Department of Rehabilitation, Zigong Fifth People's Hospital, Zigong, China
| | - Lingrui Zhang
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chenchen Zhang
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tianmin Zhu
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Cheng Luo
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
41
|
Viscoelasticity of striatal brain areas reflects variations in body mass index of lean to overweight male adults. Brain Imaging Behav 2019; 14:2477-2487. [PMID: 31512097 DOI: 10.1007/s11682-019-00200-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although a variety of MRI studies investigated the link between body mass index (BMI) and parameters of neural gray matter (GM), the technique applied in most of these studies, voxel-based morphometry (VBM), focusses on the regional GM volume, a macroscopic tissue property. Thus, the studies were not able to exploit the BMI-related information contained in the GM microstructure although PET studies suggest that these factors are important. Here, we used cerebral MR Elastography (MRE) to characterize features of tissue microstructure by evaluating the propagation of shear waves applied to the skull and to assess local tissue viscoelasticity to test the link between this parameter and BMI in 22 lean to overweight males. Unlike the majority of existing MRE studies investigating neural viscoelasticity signals averaged across large brain regions, we used the viscoelasticity of individual voxels for our experiment. Our technique revealed a negative link between BMI and viscoelasticity of two areas of the striatal reward system, i.e., right putamen (t = -8.2; pFWE-corrected = 0.005) and left globus pallidus (t = -7.1; pFWE = 0.037) which was independent of GM volume at these coordinates. Finally, comparison of BMI models based on individual voxels vs. on signals averaged across brain atlas regions demonstrates that voxel-based models explain a significantly higher proportion of variance. Consequently, our findings show that cerebral MRE is suitable to identify medically relevant microstructural tissue properties. Using a voxel-wise analysis approach, we were able to utilize the high spatial resolution of MRE for mapping BMI-related information in the brain.
Collapse
|
42
|
Adams RC, Sedgmond J, Maizey L, Chambers CD, Lawrence NS. Food Addiction: Implications for the Diagnosis and Treatment of Overeating. Nutrients 2019; 11:E2086. [PMID: 31487791 PMCID: PMC6770567 DOI: 10.3390/nu11092086] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/14/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
Abstract
With the obesity epidemic being largely attributed to overeating, much research has been aimed at understanding the psychological causes of overeating and using this knowledge to develop targeted interventions. Here, we review this literature under a model of food addiction and present evidence according to the fifth edition of the Diagnostic and Statistical Manual (DSM-5) criteria for substance use disorders. We review several innovative treatments related to a food addiction model ranging from cognitive intervention tasks to neuromodulation techniques. We conclude that there is evidence to suggest that, for some individuals, food can induce addictive-type behaviours similar to those seen with other addictive substances. However, with several DSM-5 criteria having limited application to overeating, the term 'food addiction' is likely to apply only in a minority of cases. Nevertheless, research investigating the underlying psychological causes of overeating within the context of food addiction has led to some novel and potentially effective interventions. Understanding the similarities and differences between the addictive characteristics of food and illicit substances should prove fruitful in further developing these interventions.
Collapse
Affiliation(s)
- Rachel C Adams
- CUBRIC, School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UK.
| | - Jemma Sedgmond
- CUBRIC, School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UK
| | - Leah Maizey
- CUBRIC, School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UK
| | | | - Natalia S Lawrence
- School of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter EX4 4QG, UK
| |
Collapse
|
43
|
Steward T, Miranda-Olivos R, Soriano-Mas C, Fernández-Aranda F. Neuroendocrinological mechanisms underlying impulsive and compulsive behaviors in obesity: a narrative review of fMRI studies. Rev Endocr Metab Disord 2019; 20:263-272. [PMID: 31654260 DOI: 10.1007/s11154-019-09515-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Impulsivity and compulsivity are multidimensional constructs that are increasingly considered determinants of obesity. Studies using functional magnetic resonance imaging (fMRI) have provided insight on how differences in brain response during tasks exploring facets of impulsivity and compulsivity relate to the ingestive behaviors that support the etiology and maintenance of obesity. In this narrative review, we provide an overview of neuroimaging studies exploring impulsivity and compulsivity factors as they relate to weight status. Special focus will be placed on studies examining the impulsivity-related dimensions of attentional bias, delayed gratification and emotion regulation. Discussions of compulsivity within the context of obesity will be restricted to fMRI studies investigating habit formation and response flexibility under shifting contingencies. Further, we will highlight neuroimaging research demonstrating how alterations in neuroendocrine functioning are linked to excessive food intake and may serve as a driver of the impulsive and compulsive behaviors observed in obesity. Research on the associations between brain response with neuroendocrine factors, such as insulin, peptide YY (PYY), leptin, ghrelin and glucagon-like peptide 1 (GLP-1), will be reviewed.
Collapse
Affiliation(s)
- Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Romina Miranda-Olivos
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Bellaterra, Spain.
- Ciber de Salud Mental (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain.
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
- Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| |
Collapse
|
44
|
Liu Y, Zhao J, Zhang X, Gao X, Xu W, Chen H. Overweight adults are more impulsive than normal weight adults: Evidence from ERPs during a chocolate-related delayed discounting task. Neuropsychologia 2019; 133:107181. [PMID: 31476320 DOI: 10.1016/j.neuropsychologia.2019.107181] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 02/03/2023]
Abstract
Overweight or obesity can be accompanied by abnormalities in executive function and related neural markers. The aim of the present study was to investigate the behavioral and neural correlates of food-related decision-making in overweight and normal-weight adults. We used a delayed discounting task (DDT), which requires participants to choose between smaller immediate rewards and larger delayed rewards. In total, 24 overweight adults and 24 normal-weight adults participated; all participants engaged with a food-related DDT, and their responses were measured using event-related potentials (ERPs). In the current study, we take the area under the curve (AUC), number of smaller immediate rewards, and reaction times (RTs) as behavioral indicators of DDT. AUC is an individual's discounting rate, with smaller AUC reflecting more impulsive decision-making. Number of smaller immediate rewards also reflects impulsivity. For ERPs, N2, reward-related positivity, P3, and late positive component (LPC) were investigated. Behavioral results showed smaller AUC, more choice of smaller immediate rewards, and longer RTs in overweight adults than in normal-weight adults. Neural markers showed that overweight adults elicited greater N2 in larger delayed rewards than in smaller immediate rewards and also elicited greater reward-related positivity than normal-weight adults. Moreover, the P3 and LPC mean amplitudes of overweight adults were greater than those of normal-weight adults. Pearson correlation analysis showed that body mass index (BMI) was positively related to P3 and LPC, while AUC was negatively related to P3. The findings thus suggest that overweight adults are more impulsive than normal-weight adults. Moreover, overweight adults might experience more cognitive conflict before their reaction, and they might allocate more cognitive resources to food-related stimuli and might have higher-order cognitive processes more involved in motivation or emotion regarding food-related stimuli. This is the first study investigating ERP correlates of food-related decision-making in overweight adults, and it enriches the theoretical models by providing neural markers for future study.
Collapse
Affiliation(s)
- Yong Liu
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China; School of Psychology, Southwest University, Chongqing, China
| | - Jia Zhao
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China; School of Psychology, Southwest University, Chongqing, China
| | - Xuemeng Zhang
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China; School of Psychology, Southwest University, Chongqing, China
| | - Xiao Gao
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China; School of Psychology, Southwest University, Chongqing, China
| | - Wenjian Xu
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China; School of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China; School of Psychology, Southwest University, Chongqing, China.
| |
Collapse
|
45
|
Steward T, Picó-Pérez M, Mestre-Bach G, Martínez-Zalacaín I, Suñol M, Jiménez-Murcia S, Fernández-Formoso JA, Vilarrasa N, García-Ruiz-de-Gordejuela A, Veciana de las Heras M, Custal N, Virgili N, Lopez-Urdiales R, Menchón JM, Granero R, Soriano-Mas C, Fernandez-Aranda F. A multimodal MRI study of the neural mechanisms of emotion regulation impairment in women with obesity. Transl Psychiatry 2019; 9:194. [PMID: 31431608 PMCID: PMC6702163 DOI: 10.1038/s41398-019-0533-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 05/16/2019] [Accepted: 05/31/2019] [Indexed: 02/07/2023] Open
Abstract
Maladaptive emotion regulation contributes to overeating and impedes weight loss. Our study aimed to compare the voluntary downregulation of negative emotions by means of cognitive reappraisal in adult women with obesity (OB) and female healthy controls (HC) using a data-driven, multimodal magnetic resonance imaging (MRI) approach. Women with OB (n = 24) and HC (n = 25) carried out an emotion regulation task during functional MRI scanning. Seed-to-voxel resting-state connectivity patterns derived from activation peaks identified by this task were compared between groups. Diffusion tensor imaging (DTI) was used to examine white matter microstructure integrity between regions exhibiting group differences in resting-state functional connectivity. Participants in the OB group presented reduced activation in the ventromedial prefrontal (vmPFC) cortex in comparison to the HC group when downregulating negative emotions, along with heightened activation in the extrastriate visual cortex (p < 0.05, AlphaSim-corrected). Moreover, vmPFC peak activity levels during cognitive reappraisal were negatively correlated with self-reported difficulties in emotion regulation. OB patients exhibited decreased functional connectivity between the vmPFC and the temporal pole during rest (peak-pFWE = 0.039). Decreased fractional white-matter track volume in the uncinate fasciculus, which links these two regions, was also found in participants with OB. Taken together, our findings are indicative of emotion regulation deficits in OB being underpinned by dysfunctional hypoactivity in the vmPFC and hyperactivity in the extrastriate visual cortex. Our results provide a potential target circuit for neuromodulatory interventions to improve emotion regulation skills and weight-loss intervention outcomes.
Collapse
Affiliation(s)
- Trevor Steward
- 0000 0000 8836 0780grid.411129.eDepartment of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0000 9314 1427grid.413448.eCiber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0001 2179 088Xgrid.1008.9Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010 Australia
| | - Maria Picó-Pérez
- 0000 0000 8836 0780grid.411129.eDepartment of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0001 2159 175Xgrid.10328.38Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal ,ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Gemma Mestre-Bach
- 0000 0000 8836 0780grid.411129.eDepartment of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0000 9314 1427grid.413448.eCiber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Ignacio Martínez-Zalacaín
- 0000 0000 8836 0780grid.411129.eDepartment of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0004 1937 0247grid.5841.8Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Maria Suñol
- 0000 0000 8836 0780grid.411129.eDepartment of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0004 1937 0247grid.5841.8Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0000 9314 1427grid.413448.eCiber Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Susana Jiménez-Murcia
- 0000 0000 8836 0780grid.411129.eDepartment of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0000 9314 1427grid.413448.eCiber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0004 1937 0247grid.5841.8Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Jose A. Fernández-Formoso
- 0000 0000 9314 1427grid.413448.eCiber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Nuria Vilarrasa
- 0000 0000 8836 0780grid.411129.eDepartment of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0000 9314 1427grid.413448.eCIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Amador García-Ruiz-de-Gordejuela
- 0000 0000 8836 0780grid.411129.eBariatric and Metabolic Surgery Unit, Service of General and Gastrointestinal Surgery, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Misericordia Veciana de las Heras
- 0000 0000 8836 0780grid.411129.eNeurology Department, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Nuria Custal
- 0000 0000 8836 0780grid.411129.eDepartment of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Nuria Virgili
- 0000 0000 8836 0780grid.411129.eDepartment of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Rafael Lopez-Urdiales
- 0000 0000 8836 0780grid.411129.eDepartment of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - José M. Menchón
- 0000 0000 8836 0780grid.411129.eDepartment of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0004 1937 0247grid.5841.8Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,0000 0000 9314 1427grid.413448.eCiber Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain
| | - Roser Granero
- 0000 0000 9314 1427grid.413448.eCiber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Feixa Llarga s/n, 08907 Barcelona, Spain ,grid.7080.fDepartament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain. .,Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Feixa Llarga s/n, 08907, Barcelona, Spain. .,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain.
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain. .,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Feixa Llarga s/n, 08907, Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain.
| |
Collapse
|
46
|
Kim SH, Park BY, Byeon K, Park H, Kim Y, Eun YM, Chung JH. The effects of high-frequency repetitive transcranial magnetic stimulation on resting-state functional connectivity in obese adults. Diabetes Obes Metab 2019; 21:1956-1966. [PMID: 31050167 DOI: 10.1111/dom.13763] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/22/2019] [Accepted: 04/30/2019] [Indexed: 12/14/2022]
Abstract
AIMS We conducted a 4-week randomized, sham-controlled, single-blind, parallel-group trial to examine the effect of repetitive transcranial magnetic stimulation (rTMS) delivered to the left dorsolateral prefrontal cortex (DLPFC) on functional brain connectivity and body weight in adults with obesity. MATERIALS AND METHODS Of the 45 volunteers with obesity, aged between 18 and 70 years (body mass index [BMI] ≥25 kg/m2 according to the obesity criterion for an Asian population), 36 participants (54.1 ± 11.0 years, BMI 30.2 ± 3.5 kg/m2 , 77.8% female) completed the 4 weeks of follow-up, undergoing two resting state fMRI scans (20 in the real stimulation group and 16 in the sham stimulation group). A total of eight sessions of high-frequency rTMS targeting the left DLPFC were provided over a period of 4 weeks (5-second trains with 25-second inter-train intervals, 10 Hz, 110% motor threshold; 2000 pulses over 20 minutes). RESULTS Participants in the real stimulation group showed significantly greater weight loss from baseline following the eight session of rTMS (-2.53 ± 2.41 kg vs 0.38 ± 1.13 kg, P < 0.01). For intrinsic brain connectivity comparisons, the between-ness centrality values within the right frontoparietal network tended to increase with rTMS, and a significant interaction effect was identified for time (pre vs post) × rTMS (real vs sham) in the right frontoparietal network (P = 0.031, FDR corrected). CONCLUSIONS We observed that rTMS selectively increased resting state functional connectivity within the right frontoparietal network. Our findings suggest that high-frequency rTMS to the left DLPFC might strengthen the frontoparietal network that orchestrates top-down inhibitory control to reduce food intake.
Collapse
Affiliation(s)
- Se-Hong Kim
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bo-Yong Park
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, Republic of Korea
| | - Kyoungseob Byeon
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, Republic of Korea
| | - Hyunjin Park
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, Republic of Korea
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Youngkook Kim
- Department of Rehabilitation Medicine, College of Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Mi Eun
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ju-Hye Chung
- Department of Family Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
47
|
Kure Liu C, Joseph PV, Feldman DE, Kroll DS, Burns JA, Manza P, Volkow ND, Wang GJ. Brain Imaging of Taste Perception in Obesity: a Review. Curr Nutr Rep 2019; 8:108-119. [PMID: 30945140 PMCID: PMC6486899 DOI: 10.1007/s13668-019-0269-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW We summarize neuroimaging findings related to processing of taste (fat, salt, umami, bitter, and sour) in the brain and how they influence hedonic responses and eating behaviors and their role in obesity. RECENT FINDINGS Neuroimaging studies in obese individuals have revealed alterations in reward/motivation, executive control/self-regulation, and limbic/affective circuits that are implicated in food and drug addiction. Psychophysical studies show that sensory properties of food ingredients may be associated with anthropometric and neurocognitive outcomes in obesity. However, few studies have examined the neural correlates of taste and processing of calories and nutrient content in obesity. The literature of neural correlated of bitter, sour, and salty tastes remains sparse in obesity. Most published studies have focused on sweet, followed by fat and umami taste. Studies on calorie processing and its conditioning by preceding taste sensations have started to delineate a dynamic pattern of brain activation associated with appetition. Our expanded understanding of taste processing in the brain from neuroimaging studies is poised to reveal novel prevention and treatment targets to help address overeating and obesity.
Collapse
Affiliation(s)
- Christopher Kure Liu
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013 USA
| | - Paule Valery Joseph
- Sensory Science and Metabolism Unit, Biobehavioral Branch, National Institute of Nursing Research, National Institutes of Health, 31 Center Drive, Rm 5B03, Bethesda, MD 20892-2178 USA
| | - Dana E. Feldman
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013 USA
| | - Danielle S. Kroll
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013 USA
| | - Jamie A. Burns
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013 USA
| | - Peter Manza
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013 USA
| | - Nora D. Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013 USA
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Suite 5274, Bethesda, MD 20892-9581 USA
| | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013 USA
| |
Collapse
|
48
|
Galindo Muñoz JS, Morillas-Ruiz JM, Gómez Gallego M, Díaz Soler I, Barberá Ortega MDC, Martínez CM, Hernández Morante JJ. Cognitive Training Therapy Improves the Effect of Hypocaloric Treatment on Subjects with Overweight/Obesity: A Randomised Clinical Trial. Nutrients 2019; 11:E925. [PMID: 31022980 PMCID: PMC6521325 DOI: 10.3390/nu11040925] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/16/2019] [Accepted: 04/23/2019] [Indexed: 02/01/2023] Open
Abstract
Obesity has been associated with impaired cognitive performance. This study aimed to determine whether improvements in cognitive function may contribute to higher weight loss in patients with obesity. In this randomised, 12-week trial, participants with overweight/obesity were randomised into a cognitive training intervention (Cognitive) group or a cognitive-behavioural (Control) group. In addition, both groups followed a hypocaloric dietary treatment. Cognitive functioning measurements and anthropometrical parameters were evaluated. All cognitive measures improved in the intervention group (p < 0.005 in all contrasts). In controls, significant improvements in attention, flexibility and task planning were also observed. Regarding anthropometrical parameters, the effect of the intervention in the cognitive group was higher for the total percentage of weight loss, body mass index (BMI), body fat and waist circumference. Biochemical parameters improved in both groups. Attending to our data, cognitive training was more effective that the hypocaloric intervention alone, partly related to an improvement in the working memory. Despite the shortage of training interventions for executive functions in the context of weight control, this type of combined intervention could establish the first steps towards a more appropriate intervention for patients with obesity.
Collapse
Affiliation(s)
| | | | | | | | | | - Carlos M Martínez
- Biomedical Research Institute (IMIB), Arrixaca University Hospital, 30120 Murcia, Spain.
| | | |
Collapse
|
49
|
Stice E, Burger K. Neural vulnerability factors for obesity. Clin Psychol Rev 2019; 68:38-53. [PMID: 30587407 PMCID: PMC6397091 DOI: 10.1016/j.cpr.2018.12.002] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/05/2018] [Accepted: 12/17/2018] [Indexed: 01/09/2023]
Abstract
Multiple theories identify neural vulnerability factors that may increase risk for overeating and weight gain. Early cross-sectional neuroimaging studies were unable to determine whether aberrant neural responsivity was a risk factor for or a consequence of overeating. More recent obesity risk, prospective, repeated-measures, and experimental neuroimaging studies with humans have advanced knowledge of etiologic processes and neural plasticity resulting from overeating. Herein, we review evidence from these more rigorous human neuroimaging studies, in conjunction with behavioral measures reflecting neural function, as well as experiments with animals that investigated neural vulnerability theories for overeating. Findings provide support for the reward surfeit theory that posits that individuals at risk for obesity initially show hyper-responsivity of reward circuitry to high-calorie food tastes, which theoretically drives elevated intake of such foods. However, findings provide little support for the reward deficit theory that postulates that individuals at risk for obesity show an initial hypo-responsivity of reward circuitry that motives overeating. Further, results provide support for the incentive sensitization and dynamic vulnerability theories that propose that overconsumption of high-calorie foods results in increased reward and attention region responsivity to cues that are associated with hedonic reward from intake of these high-calorie foods via conditioning, as well as a simultaneous decrease in reward region responsivity to high-calorie food tastes. However, there is little evidence that this induced reduction in reward region response to high-calorie food tastes drives an escalation in overeating. Finally, results provide support for the theory that an initial deficit in inhibitory control and a bias for immediate reward contribute to overconsumption of high-calorie foods. Findings imply that interventions that reduce reward and attention region responsivity to food cues and increase inhibitory control should reduce overeating and excessive weight gain, an intervention theory that is receiving support in randomized trials.
Collapse
Affiliation(s)
- Eric Stice
- Oregon Research Institute, Eugene, OR, USA.
| | - Kyle Burger
- University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
50
|
Kohl SH, Veit R, Spetter MS, Günther A, Rina A, Lührs M, Birbaumer N, Preissl H, Hallschmid M. Real-time fMRI neurofeedback training to improve eating behavior by self-regulation of the dorsolateral prefrontal cortex: A randomized controlled trial in overweight and obese subjects. Neuroimage 2019; 191:596-609. [PMID: 30798010 DOI: 10.1016/j.neuroimage.2019.02.033] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/30/2019] [Accepted: 02/13/2019] [Indexed: 01/17/2023] Open
Abstract
Obesity is associated with altered responses to food stimuli in prefrontal brain networks that mediate inhibitory control of ingestive behavior. In particular, activity of the dorsolateral prefrontal cortex (dlPFC) is reduced in obese compared to normal-weight subjects and has been linked to the success of weight-loss dietary interventions. In a randomized controlled trial in overweight/obese subjects, we investigated the effect on eating behavior of volitional up-regulation of dlPFC activity via real-time functional magnetic resonance imaging (fMRI) neurofeedback training. Thirty-eight overweight or obese subjects (BMI 25-40 kg/m2) took part in fMRI neurofeedback training with the aim of increasing activity of the left dlPFC (dlPFC group; n = 17) or of the visual cortex (VC/control group; n = 21). Participants were blinded to group assignment. The training session took place on a single day and included three training runs of six trials of up-regulation and passive viewing. Food appraisal and snack intake were assessed at screening, after training, and in a follow-up session four weeks later. Participants of both groups succeeded in up-regulating activity of the targeted brain area. However, participants of the control group also showed increased left dlPFC activity during up-regulation. Functional connectivity between dlPFC and ventromedial PFC, an area that processes food value, was generally increased during up-regulation compared to passive viewing. At follow-up compared to baseline, both groups rated pictures of high-, but not low-calorie foods as less palatable and chose them less frequently. Actual snack intake remained unchanged but palatability and choice ratings for chocolate cookies decreased after training. We demonstrate that one session of fMRI neurofeedback training enables individuals with increased body weight to up-regulate activity of the left dlPFC. Behavioral effects were observed in both groups, which might have been due to dlPFC co-activation in the control group and, in addition, unspecific training effects. Improved dlPFC-vmPFC functional connectivity furthermore suggested enhanced food intake-related control mechanisms. Neurofeedback training might support therapeutic strategies aiming at improved self-control in obesity, although the respective contributions of area-specific mechanisms and general regulation effects are in need of further investigation.
Collapse
Affiliation(s)
- Simon H Kohl
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Jülich Research Center, Jülich, Germany
| | - Ralf Veit
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen; German Center for Diabetes Research (DZD), Tübingen, Germany; High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Maartje S Spetter
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Astrid Günther
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany
| | - Andriani Rina
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael Lührs
- Brain Innovation B.V, Research Department, Maastricht, Netherlands; Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, Netherlands
| | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Wyss Center for Bio and Neuroengineering, Geneva, 1202, Switzerland
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen; German Center for Diabetes Research (DZD), Tübingen, Germany; Institute of Pharmaceutical Sciences, Interfaculty Centre for Pharmacogenomics and Pharma Research, Department of Pharmacy and Biochemistry, University of Tübingen, Tübingen, Germany.
| | - Manfred Hallschmid
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen; German Center for Diabetes Research (DZD), Tübingen, Germany
| |
Collapse
|