Striatal dopamine tone is positively associated with body mass index in humans as determined by PET using dual dopamine type-2 receptor antagonist tracers

Brain dopamine responses to ultra-processed milkshakes are highly variable and not significantly related to adiposity in humans

Ultra-processed foods high in fat and sugar may be addictive, in part, due to their purported ability to induce an exaggerated postingestive brain dopamine response akin to drugs of abuse. Using standard [11C]raclopride positron emission tomography (PET) displacement methods used to measure brain dopamine responses to addictive drugs, we measured postingestive striatal dopamine responses to an ultra-processed milkshake high in fat and sugar in 50 young, healthy adults over a wide body mass index range (BMI 20-45 kg/m2). Surprisingly, milkshake consumption did not result in significant postingestive dopamine response in the striatum (p=0.62) nor any striatal subregion (p>0.33) and the highly variable interindividual responses were not significantly related to adiposity (BMI: r=0.076, p=0.51; %body fat: r=0.16, p=0.28). Thus, postingestive striatal dopamine responses to an ultra-processed milkshake were likely substantially smaller than many addictive drugs and below the limits of detection using standard PET methods.

The association between obesity severity and food reward in adolescents with obesity: a one-stage individual participant data meta-analysis

BACKGROUND

Food reward and cue reactivity have been linked prospectively to problematic eating behaviours and excess weight gain in adults and children. However, evidence to date in support of an association between degree of adiposity and food reward is tenuous. A non-linear relationship between reward sensitivity and obesity degree has been previously proposed, suggesting a peak is reached in mild obesity and decreases in more severe obesity in a quadratic fashion.

OBJECTIVE

To investigate and characterise in detail the relationship between obesity severity, body composition, and explicit and implicit food reward in adolescents with obesity.

METHODS

Data from seven clinical trials in adolescents with obesity were aggregated and analysed in an independent participant data meta-analysis. Linear and curvilinear relationships between the degree of obesity and explicit and implicit reward for sweet and high fat foods were tested in fasted and fed states with BMI-z score as a continuous and discrete predictor using clinically recognised partitions.

RESULTS

Although positive associations between obesity severity and preference for high-fat (i.e. energy dense) foods were observed when fasted, none reached significance in either analysis. Conversely, adiposity was reliably associated with lower reward for sweet, particularly when measured as implicit wanting (p = 0.012, ηp2 = 0.06), independent of metabolic state. However, this significant association was only observed in the linear model. Fat distribution was consistently associated with explicit and implicit preference for high-fat foods.

CONCLUSIONS

A limited relationship was demonstrated between obesity severity and food reward in adolescents, although a lower preference for sweet could be a signal of severe obesity in a linear trend. Obesity is likely a heterogenous condition associated with multiple potential phenotypes, which metrics of body composition may help define.

CLINICAL TRIAL REGISTRATIONS

NCT02925572: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT02925572 . NCT03807609: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT03807609 . NCT03742622: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT03742622 . NCT03967782: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT03967782 . NCT03968458: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT03968458 . NCT04739189: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT04739189 . NCT05365685: https://www.

CLINICALTRIALS

gov/study/NCT05365685?tab=history .

Portuguese observational cross-sectional clinical imaging study protocol to investigate central dopaminergic mechanisms of successful weight loss through bariatric surgery

INTRODUCTION

Bariatric surgery (BS) is the treatment of choice for refractory obesity. Although weight loss (WL) reduces the prevalence of obesity-related comorbidities, not all patients maintain it. It has been suggested that central mechanisms involving dopamine receptors may play a role in successful WL. This protocol describes an observational cross-sectional study to test if the binding of central dopamine receptors is similar in individuals who responded successfully to BS and age- and gender-matched normal-weight healthy individuals (controls). As secondary goals, the protocol will investigate if this binding correlates with key parameters such as age, hormonal status, anthropometric metrics and neurobehavioural scores. Finally, as exploratory goals, we will include a cohort of individuals with obesity before and after BS to explore whether obesity and type of BS (sleeve gastrectomy and Roux-en-Y gastric bypass) yield distinct binding values and track central dopaminergic changes resulting from BS.

METHODS AND ANALYSIS

To address the major research question of this observational study, positron emission tomography (PET) with [11C]raclopride will be used to map brain dopamine type 2 and 3 receptors (D2/3R) non-displaceable binding potential (BPND) of individuals who have successfully responded to BS. Mean regional D2/3R BPND values will be compared with control individuals by two one-sided test approaches. The sample size (23 per group) was estimated to demonstrate the equivalence between two independent group means. In addition, these binding values will be correlated with key parameters to address secondary goals. Finally, for exploratory analysis, these values will be compared within the same individuals (before and after BS) and between individuals with obesity and controls and types of BS.

ETHICS AND DISSEMINATION

The project and informed consent received ethical approval from the Faculty of Medicine and the Coimbra University Hospital ethics committees. Results will be disseminated in international peer-reviewed journals and conferences.

Alterations in type 2 dopamine receptors across neuropsychiatric conditions: A large-scale PET cohort

PURPOSE

Aberrant dopaminergic function is linked with motor, psychotic, and affective symptoms, but studies have typically compared a single patient group with healthy controls.

METHODS

Here, we investigated the variation in striatal (caudate nucleus, nucleus accumbens, and putamen) and thalamic type 2 dopamine receptor (D2R) availability using [11C]raclopride positron emission tomography (PET) data from a large sample of 437 humans including healthy controls, and subjects with Parkinson's disease (PD), antipsychotic-naïve schizophrenia, severe violent behavior, pathological gambling, depression, and overweight. We analyzed regional group differences in D2R availability. We also analyzed the interregional correlation in D2R availability within each group.

RESULTS

Subjects with PD showed the clearest decline in D2R availability. Overall, the groups showed high interregional correlation in D2R availability, while this pattern was weaker in violent offenders. Subjects with schizophrenia, pathological gambling, depression, or overweight did not show clear changes in either the regional receptor availability or the interregional correlation.

CONCLUSION

We conclude that the dopaminergic changes in neuropsychiatric conditions might not only affect the overall receptor availability but also how coupled regions are across people. The region-specific receptor availability more profoundly links to the motor symptoms, while the between-region coupling might be disrupted in violence.