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Barba L, Carrubba C, Spindler K, Weise CM, Sachs T, Foschi M, D'Anna L, Sehm B, Ibe R, Elolf E, Strauss C, Otto M, Mensch A, Abu-Rumeileh S. Posterior reversible encephalopathy syndrome associated with antibiotic therapy: a case report and systematic review. Neurol Sci 2024:10.1007/s10072-024-07545-1. [PMID: 38679625 DOI: 10.1007/s10072-024-07545-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/20/2024] [Indexed: 05/01/2024]
Abstract
Posterior reversible encephalopathy syndrome (PRES) is an acute neurological condition associated with different etiologies, including antibiotic therapy. To date, most data regarding antibiotic-related PRES are limited to case reports and small case series. Here, we report a novel case description and provide a systematic review of the clinico-radiological characteristics and prognosis of available cases of PRES associated with antibiotic therapy. We performed a systematic literature search in PubMed and Scopus from inception to 10 January 2024, following PRISMA guidelines and a predefined protocol. The database search yielded 12 subjects (including our case). We described the case of a 55-year-old female patient with PRES occurring one day after administration of metronidazole and showing elevated serum neurofilament light chain protein levels and favorable outcome. In our systematic review, antibiotic-associated PRES was more frequent in female patients (83.3%). Metronidazole and fluoroquinolones were the most reported antibiotics (33.3% each). Clinical and radiological features were comparable to those of PRES due to other causes. Regarding the prognosis, about one third of the cases were admitted to the intensive care unit, but almost all subjects (90.0%) had a complete or almost complete clinical and radiological recovery after prompt cessation of the causative drug. Antibiotic-associated PRES appears to share most of the characteristics of classic PRES. Given the overall good prognosis of the disease, it is important to promptly diagnose antibiotic-associated PRES and discontinue the causative drug.
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Affiliation(s)
- Lorenzo Barba
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Carmelo Carrubba
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Kai Spindler
- Department of Neurosurgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Christopher M Weise
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Torben Sachs
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Matteo Foschi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Lucio D'Anna
- Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College London NHS Healthcare Trust, London, UK
- Division of Brain Sciences, Department of Medicine, Hammersmith Campus, Imperial College London, London, UK
| | - Bernhard Sehm
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Richard Ibe
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Erck Elolf
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Christian Strauss
- Department of Neurosurgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Markus Otto
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Alexander Mensch
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Samir Abu-Rumeileh
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
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Abu-Rumeileh S, Burow P, Strube D, Barba L, Ibe R, Weise CM, Otto M. Clinical and biochemical profile of a patient with acute metonitazene intoxication. J Neurol Sci 2024; 458:122942. [PMID: 38395731 DOI: 10.1016/j.jns.2024.122942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 02/25/2024]
Affiliation(s)
- Samir Abu-Rumeileh
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 06120, Germany.
| | - Philipp Burow
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 06120, Germany
| | - David Strube
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 06120, Germany
| | - Lorenzo Barba
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 06120, Germany
| | - Richard Ibe
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 06120, Germany
| | - Christopher M Weise
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 06120, Germany
| | - Markus Otto
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 06120, Germany
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Bachmann T, Schroeter ML, Chen K, Reiman EM, Weise CM. Longitudinal changes in surface based brain morphometry measures in amnestic mild cognitive impairment and Alzheimer's Disease. Neuroimage Clin 2023; 38:103371. [PMID: 36924681 PMCID: PMC10025277 DOI: 10.1016/j.nicl.2023.103371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/14/2022] [Accepted: 03/06/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is associated with marked brain atrophy. While commonly used structural MRI imaging methods do not account for the complexity of human brain morphology, little is known about the longitudinal changes of cortical geometry and their relationship with cognitive decline in subjects with AD. METHODS Data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were used to perform two-sample t-tests to investigate longitudinal changes of cortical thickness (CTh) and three surface-based morphometry measures: fractal dimension (i.e. cortical complexity; FD), gyrification index (GI), and sulcal depth (SD) in subjects with AD, amnestic mild cognitive impairment (aMCI) in comparison to cognitively unimpaired controls (CU) in baseline and 2-year follow-up sMRI scans. In addition, correlations of the morphological measures with two-year cognitive decline as assessed by the modified AD Assessment Scale-Cognitive Subscale (ADAS-Cog 11) were calculated via regression analyses. RESULTS Compared to CU, both AD and aMCI showed marked decreases in CTh. In contrast, analyses of FD and GI yielded a more nuanced decline of the respective measures with some areas showing increases in FD and GI. Overall changes in FD and GI were more pronounced in AD as compared to aMCI. Analyses of SD yielded widespread decreases. Interestingly, cognitive decline corresponded well with CTh declines in aMCI but not AD, whereas changes in FD corresponded with AD only but not aMCI, whereas GI and SD were associated with cognitive decline in aMCI and AD. CONCLUSION Patterns of longitudinal changes in FD, GI and SD were only partially overlapping with CTh reductions. In AD, surface-based morphometry measures for brain-surface complexity showed better correspondence than CTh with cognitive decline over a two-year period of time. Being drawn from measures reflecting changes in more intricate aspects of human brain morphology, these data provide new insight into the complexity of AD-related brain atrophy and its relationship with cognitive decline.
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Affiliation(s)
- Tobias Bachmann
- University of Leipzig Medical Center, Department of Neurology, Germany.
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurology, Leipzig, Germany; Clinic of Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA; School of Mathematics and Statistics (KC), Neurodegenerative Disease Research Center (EMR), Arizona State University, USA; Department of Neurology, College of Medicine - Phoenix (KC), Department of Psychiatry (EMR), University of Arizona, USA
| | - Eric M Reiman
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA; Department of Neurology, College of Medicine - Phoenix (KC), Department of Psychiatry (EMR), University of Arizona, USA; Neurogenomics Division, Translational Genomics Research Institute, University of Arizona, and Arizona State University, Phoenix, AZ, USA; Banner-Arizona State University Neurodegenerative Disease Research Center, BioDesign Institute, Arizona State, University, Tempe, AZ, USA
| | - Christopher M Weise
- University of Leipzig Medical Center, Department of Neurology, Germany; University of Halle Medical Center, Department of Neurology, Germany
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Weise CM, Chen K, Chen Y, Devadas V, Su Y, Reiman EM. Differential impact of body mass index and leptin on baseline and longitudinal positron emission tomography measurements of the cerebral metabolic rate for glucose in amnestic mild cognitive impairment. Front Aging Neurosci 2022; 14:1031189. [PMID: 36570534 PMCID: PMC9782536 DOI: 10.3389/fnagi.2022.1031189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/19/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Several studies have suggested that greater adiposity in older adults is associated with a lower risk of Alzheimer's disease (AD) related cognitive decline, some investigators have postulated that this association may be due to the protective effects of the adipose tissue-derived hormone leptin. In this study we sought to demonstrate that higher body mass indices (BMIs) are associated with greater baseline FDG PET measurements of the regional cerebral metabolic rate for glucose (rCMRgl), a marker of local neuronal activity, slower rCMRgl declines in research participants with amnestic mild cognitive impairment (aMCI). We then sought to clarify the extent to which those relationships are attributable to cerebrospinal fluid (CSF) or plasma leptin concentrations. Materials and methods We used baseline PET images from 716 73 ± 8 years-old aMCI participants from the AD Neuroimaging Initiative (ADNI) of whom 453 had follow up images (≥6 months; mean follow up time 3.3 years). For the leptin analyses, we used baseline CSF samples from 81 of the participants and plasma samples from 212 of the participants. Results As predicted, higher baseline BMI was associated with greater baseline CMRgl measurements and slower declines within brain regions preferentially affected by AD. In contrast and independently of BMI, CSF, and plasma leptin concentrations were mainly related to less baseline CMRgl within mesocorticolimbic brain regions implicated in energy homeostasis. Discussion While higher BMIs are associated with greater baseline CMRgl and slower declines in persons with aMCI, these associations appear not to be primarily attributable to leptin concentrations.
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Affiliation(s)
- Christopher M. Weise
- Department of Neurology, Marti-Luther-University of Halle-Wittenberg, Halle, Germany,Department of Neurology, University of Leipzig, Leipzig, Germany,*Correspondence: Christopher M. Weise,
| | - Kewei Chen
- Banner Alzheimer’s Institute, Phoenix, AZ, United States,School of Mathematics and Statistics, Arizona State University, Tempe, AZ, United States,Department of Neurology, College of Medicine, University of Arizona, Phoenix, AZ, United States,Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Yinghua Chen
- Banner Alzheimer’s Institute, Phoenix, AZ, United States
| | - Vivek Devadas
- Banner Alzheimer’s Institute, Phoenix, AZ, United States
| | - Yi Su
- Banner Alzheimer’s Institute, Phoenix, AZ, United States,Department of Neurology, College of Medicine, University of Arizona, Phoenix, AZ, United States,Arizona Alzheimer’s Consortium, Phoenix, AZ, United States,School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ, United States
| | - Eric M. Reiman
- Banner Alzheimer’s Institute, Phoenix, AZ, United States,Arizona Alzheimer’s Consortium, Phoenix, AZ, United States,Department of Psychiatry, College of Medicine, University of Arizona, Phoenix, AZ, United States,Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, United States,Arizona State University-Banner Health Neurodegenerative Disease Research Center, Arizona State University, Tempe, AZ, United States
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Aghakhanyan G, Saur D, Rullmann M, Weise CM, Schroeter ML, Marek K, Jamra RA, Tiepolt S, Strauss M, Scherlach C, Hoffmann KT, Sabri O, Classen J, Barthel H. PET/MRI Delivers Multimodal Brain Signature in Alzheimer's Disease with De Novo PSEN1 Mutation. Curr Alzheimer Res 2021; 18:178-184. [PMID: 33855944 DOI: 10.2174/1567205018666210414111536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/27/2021] [Accepted: 03/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Little is known so far about the brain phenotype and the spatial interplay of different Alzheimer's disease (AD) biomarkers with structural and functional brain connectivity in the early phase of autosomal-dominant AD (ADAD). Multimodal PET/MRI might be suitable to fill this gap. MATERIAL AND METHODS We presented a 31-year-old male patient without a family history of dementia with progressive worsening of memory and motor function. Two separate sessions of 3T PET/MRI acquisitions were arranged with the ß-amyloid tracer [18F]Florbetaben and the secondgeneration tau tracer [18F]PI-2620. Simultaneously acquired MRI consisted of high-resolution 3D T1, diffusion-tensor imaging (DTI), and resting-state fMRI. PET/MRI data were compared with ten age-matched healthy controls. RESULTS Widespread β-amyloid depositions were found in cortical regions, and striatum (Thal stage III) along with tau pathology restricted to the mesial-temporal structures (Braak stage III/IV). Volumetric/shape analysis of subcortical structures revealed atrophy of the hippocampal-amygdala complex. In addition, cortical thinning was detected in the right middle temporal pole. Alterations of multiple DTI indices were noted in the major white matter fiber bundles, together with disruption of default mode and sensory-motor network functional connectivity. Molecular genetic analysis by next-generation sequencing revealed a heterozygote missense pathogenic variant of the PSEN1 (Met233Val). CONCLUSION Multimodal PET/MR imaging is able to deliver, in a one-stop-shop approach, an array of molecular, structural and functional brain information in AD due to de novo pathogenic variant, which can be studied for spatial interplay and might provide a rationale for initiating anti- amyloid/tau therapeutic approaches.
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Affiliation(s)
| | - Dorothee Saur
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Michael Rullmann
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | | | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - Ken Marek
- Invicro, New Haven, CT, United States
| | - Rami Abou Jamra
- Institute for Human Genetics, University Hospital Leipzig, Leipzig, Germany
| | - Solveig Tiepolt
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Maria Strauss
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Cordula Scherlach
- Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | | | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
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Pirlich M, Höfer C, Weise CM, Stockert A, Thöne-Otto A, Garthe A, Schob S, Classen J, Hoffmann KT, Saur D. Hippocampal gray matter volume in the long-term course after transient global amnesia. Neuroimage Clin 2021; 30:102586. [PMID: 33621769 PMCID: PMC7907892 DOI: 10.1016/j.nicl.2021.102586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/03/2022]
Abstract
No substantial hippocampus-dependent memory deficits in the long-term course after transient global amnesia. Greater hippocampal gray matter volume in patients with transient global amnesia compared to healthy controls in the long-term course. Transient global amnesia might trigger neuronal and/or non-neuronal mechanisms in the hippocampus resulting in an increase of grey matter rather than atrophy.
Objective In this retrospective, cross-sectional study we aimed to examine long-term memory deficits and gray matter volumes (GMV) in the hippocampus after transient global amnesia (TGA). Methods 20 patients with a history of TGA (TGA+, mean 6.5 years after TGA) and 20 age-matched healthy controls (TGA-) underwent neurocognitive assessment (i.e. Mini-Mental State Examination (MMSE), visuospatial, verbal and episodic autobiographical memory and visuospatial learning/navigation [“human water maze”]) in combination with structural cerebral MRI. Voxel-based morphometry (VBM) was used to detect GMV in the hippocampus in TGA+ versus TGA-. Results Besides slight differences in MMSE and visuo-spatial learning/navigation measured with a human water maze in TGA+ vs. TGA-, no other tests of visuo-spatial, verbal and autobiographical long-term memory differed between groups. VBM analyses yielded a statistically significant difference in bilateral hippocampal GMV with TGA+ compared to TGA- showing greater GMV in a region corresponding to bilateral CA1. However, none of the hippocampus-dependent cognitive measures correlated with hippocampal GMV. Conclusion In the long-term course after TGA, only subtle neurocognitive deficits without microstructural damage of the hippocampus could be detected. Greater GMV in bilateral hippocampus in TGA+ vs. TGA- may indicate that TGA triggers hippocampal GMV increase rather than atrophy.
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Affiliation(s)
- Mandy Pirlich
- Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany
| | - Cathleen Höfer
- Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany
| | - Christopher M Weise
- Department of Neurology, University of Halle Medical Center, Halle, Germany; Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany
| | - Anika Stockert
- Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany
| | - Angelika Thöne-Otto
- Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany
| | - Alexander Garthe
- Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany
| | - Stefan Schob
- Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany
| | - Joseph Classen
- Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany
| | - Karl-Titus Hoffmann
- Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany
| | - Dorothee Saur
- Department of Neurology (M.P., C.H., C.M.W., A.S., J.C., D.S.), Department of Neuroradiology (S.S., K.T.H.) and Department of Cognitive Neurology (A.T.O.), University of Leipzig Medical Center, Leipzig, Germany, German Center for Neurodegenerative Diseases, Dresden (A.G.), Germany.
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Weise CM, Bachmann T, Schroeter ML, Saur D. When less is more: Structural correlates of core executive functions in young adults - A VBM and cortical thickness study. Neuroimage 2019; 189:896-903. [PMID: 30716455 DOI: 10.1016/j.neuroimage.2019.01.070] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 12/30/2018] [Accepted: 01/28/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The term executive functions (EF) describes a set of higher cognitive abilities/skills needed for goal-oriented and flexible behavior. In contrast to a multitude of functional neuroimaging studies of EF performance, only limited and partially inconclusive data is available for the structural-neuroanatomical underpinnings of EFs, particularly in healthy adults. METHODS Here, we applied voxel-based morphometry (VBM) and additional analyses of cortical thickness (CTH; via surface-based morphometry) to a large sample of healthy young adults from the Human Connectome Project (N = 1110; Age 28.8 ± 3.7 years) with structural MRI data and test data reflective of three core EFs [i.e. cognitive flexibility (CF), inhibitory control (IC) and working memory (WM)]. RESULTS For CF and IC, VBM analyses yielded a distinct and largely overlapping pattern of exclusively negative associations (CF>IC), most prominently within the medial prefrontal cortex, the insular cortex, central/precentral regions, subcortical and mesotemporal structures. A similar, yet less pronounced pattern of negative associations was found in analyses of CTH. In contrast, both VBM and CTH analyses yielded no significant associations with WM performance. CONCLUSIONS Brain regions we found negatively associated with measures of CF and IC have been repeatedly highlighted by functional imaging studies of EF performance. The here observed inverse relationship with brain structural parameters may be related to the young age of our study population and well established neurobiological mechanisms of cortical maturation (i.e. cortical thinning via synaptic pruning and cortical myelination).
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Affiliation(s)
| | | | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Germany; Day Clinic for Cognitive Neurology, University of Leipzig, Germany
| | - Dorothee Saur
- Department of Neurology, University of Leipzig, Germany
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Weise CM, Chen K, Chen Y, Kuang X, Savage CR, Reiman EM. Left lateralized cerebral glucose metabolism declines in amyloid-β positive persons with mild cognitive impairment. Neuroimage Clin 2018; 20:286-296. [PMID: 30101060 PMCID: PMC6084012 DOI: 10.1016/j.nicl.2018.07.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/10/2018] [Accepted: 07/16/2018] [Indexed: 01/18/2023]
Abstract
Background Previous publications indicate that Alzheimer's Disease (AD) related cortical atrophy may develop in asymmetric patterns, with accentuation of the left hemisphere. Since fluorodeoxyglucose positron emission tomography (FDG PET) measurements of the regional cerebral metabolic rate of glucose (rCMRgl) provide a sensitive and specific marker of neurodegenerative disease progression, we sought to investigate the longitudinal pattern of rCMRgl in amyloid-positive persons with mild cognitive impairment (MCI) and dementia, hypothesizing asymmetric declines of cerebral glucose metabolism. Methods Using florbetapir PET and cerebrospinal fluid (CSF) measures to define amyloid-β (Aβ) positivity, 40 Aβ negative (Aβ-) cognitively unimpaired controls (CU; 76 ± 5y), 76 Aβ positive (Aβ+) persons with MCI (76 ± 7y) and 51 Aβ + persons with probable AD dementia (75 ± 7y) from the AD Neuroimaging Initiative (ADNI) were included in this study with baseline and 2-year follow-up FDG PET scans. The degree of lateralization of longitudinal rCMRgl declines in subjects with Aβ + MCI and AD in comparison with Aβ- CU were statistically quantified via bootstrapped lateralization indices [(LI); range − 1 (right) to 1 (left)]. Results Compared to Aβ- CU, Aβ + MCI patients showed marked left hemispheric lateralization (LI: 0.78). In contrast, modest right hemispheric lateralization (LI: −0.33) of rCMRgl declines was found in Aβ + persons with probable AD dementia. Additional comparisons of Aβ + groups (i.e. MCI and probable AD dementia) consequently indicated right hemispheric lateralization (LI: −0.79) of stronger rCMRgl declines in dementia stages of AD. For all comparisons, voxel-based analyses confirmed significant (pFWE<0.05) declines of rCMRgl within AD-typical brain regions. Analyses of cognitive data yielded predominant decline of memory functions in both MCI and dementia stages of AD. Conclusions These data indicate that in early stages, AD may be characterized by a more lateralized pattern of left hemispheric rCMRgl declines. However, metabolic differences between hemispheres appear to diminish with further progression of the disease. Lateralized cerebral glucose metabolism declines in Alzheimer's Disease. Early stages show strong left-hemispheric lateralization. Advanced stages show weak right-hemispheric lateralization.
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Affiliation(s)
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Neurogenomics Division, Translational Genomics Research Institute, University of Arizona, Arizona State University, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Yinghua Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Xiaoying Kuang
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Cary R Savage
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Center for Brain, Biology and Behavior, Department of Psychology, University of Nebraska, Lincoln, NE, USA
| | - Eric M Reiman
- Banner Alzheimer's Institute, Phoenix, AZ, USA; School of Mathematics and Statistics (KC), Neurodegenerative Disease Research Center (EMR), Arizona State University, USA; Department of Neurology, College of Medicine - Phoenix (KC), Department of Psychiatry (EMR), University of Arizona, USA; Neurogenomics Division, Translational Genomics Research Institute, University of Arizona, Arizona State University, Phoenix, AZ, USA; Banner-Arizona State University, Neurodegenerative Disease Research Center, BioDesign Institute, Arizona State University, Tempe, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
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Heinitz S, Reinhardt M, Piaggi P, Weise CM, Diaz E, Stinson EJ, Venti C, Votruba SB, Wassermann EM, Alonso-Alonso M, Krakoff J, Gluck ME. Neuromodulation directed at the prefrontal cortex of subjects with obesity reduces snack food intake and hunger in a randomized trial. Am J Clin Nutr 2017; 106:1347-1357. [PMID: 29046305 PMCID: PMC5698839 DOI: 10.3945/ajcn.117.158089] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 09/12/2017] [Indexed: 01/08/2023] Open
Abstract
Background: Obesity is associated with reduced activation in the left dorsolateral prefrontal cortex (DLPFC), a region of the brain that plays a key role in the support of self-regulatory aspects of eating behavior and inhibitory control. Transcranial direct current stimulation (tDCS) is a noninvasive technique used to modulate brain activity.Objectives: We tested whether repeated anodal tDCS targeted at the left DLPFC (compared with sham tDCS) has an immediate effect on eating behavior during ad libitum food intake, resulting in weight change, and whether it might influence longer-term food intake-related appetite ratings in individuals with obesity.Design: In a randomized parallel-design study combining inpatient and outpatient assessments over 31 d, 23 individuals with obesity [12 men; mean ± SD body mass index (BMI; in kg/m2): 39.3 ± 8.42] received 15 sessions of anodal (i.e., enhancing cortical activity) or sham tDCS aimed at the left DLPFC. Ad libitum food intake was assessed through the use of a vending machine paradigm and snack food taste tests (SFTTs). Appetite was evaluated with a visual analog scale (VAS). Body weight was measured. We examined the effect of short-term (i.e., 3 sessions) and long-term (i.e., 15 sessions) tDCS on these variables.Results: Relative to sham tDCS, short-term anodal tDCS did not influence ad libitum intake of food from the vending machines. Accordingly, no effect on short-term or 4-wk weight change was observed. In the anodal tDCS group, compared with the sham group, VAS ratings for hunger and the urge to eat declined significantly more (P = 0.01 and P = 0.05, respectively), and total energy intake during an SFTT was relatively lower in satiated individuals (P = 0.01), after long-term tDCS.Conclusions: Short-term anodal tDCS of the left DLPFC did not have an immediate effect on ad libitum food intake or thereby weight change, relative to sham tDCS. Hunger and snack food intake were reduced only after a longer period of anodal tDCS in individuals with obesity. This trial was registered at clinicaltrials.gov as NCT00739362.
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Affiliation(s)
- Sascha Heinitz
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | | | - Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | | | - Enrique Diaz
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | - Emma J Stinson
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | - Colleen Venti
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | - Susanne B Votruba
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | - Eric M Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and
| | - Miguel Alonso-Alonso
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | - Marci E Gluck
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ;
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10
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Weise CM, Chen K, Kuang X, Savage C, Reiman EM. [IC‐P‐210]: LEFT LATERALIZED CEREBRAL GLUCOSE METABOLISM DECLINES IN AMYLOID‐β– POSITIVE SUBJECTS WITH MILD COGNITIVE IMPAIRMENT. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Kewei Chen
- Banner Alzheimer's InstitutePhoenixAZUSA
- University of ArizonaTucsonAZUSA
- Arizona State UniversityTempeAZUSA
- Arizona Alzheimer's ConsortiumPhoenixAZUSA
| | - Xiaoying Kuang
- Banner Alzheimer's InstitutePhoenixAZUSA
- Arizona Alzheimer's ConsortiumPhoenixAZUSA
| | | | - Eric M. Reiman
- Banner Alzheimer's InstitutePhoenixAZUSA
- University of ArizonaTucsonAZUSA
- Arizona State UniversityTempeAZUSA
- Translational Genomics Research InstitutePhoenixAZUSA
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11
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Weise CM, Chen K, Kuang X, Savage C, Reiman EM. [P4–247]: LEFT LATERALIZED CEREBRAL GLUCOSE METABOLISM DECLINES IN AMYLOID‐β‐POSITIVE SUBJECTS WITH MILD COGNITIVE IMPAIRMENT. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Kewei Chen
- Banner Alzheimer's InstitutePhoenixAZUSA
- University of ArizonaTucsonAZUSA
- Arizona State UniversityTempeAZUSA
- Arizona Alzheimer's ConsortiumPhoenixAZUSA
| | - Xiaoying Kuang
- Banner Alzheimer's InstitutePhoenixAZUSA
- Arizona Alzheimer's ConsortiumPhoenixAZUSA
| | | | - Eric M. Reiman
- Banner Alzheimer's InstitutePhoenixAZUSA
- University of ArizonaTucsonAZUSA
- Arizona State UniversityTempeAZUSA
- Arizona Alzheimer's ConsortiumPhoenixAZUSA
- Translational Genomics Research InstitutePhoenixAZUSA
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12
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Weise CM, Piaggi P, Reinhardt M, Chen K, Savage CR, Krakoff J, Pleger B. The obese brain as a heritable phenotype: a combined morphometry and twin study. Int J Obes (Lond) 2016; 41:458-466. [PMID: 27916985 PMCID: PMC5402354 DOI: 10.1038/ijo.2016.222] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 11/01/2016] [Accepted: 11/22/2016] [Indexed: 12/17/2022]
Abstract
Background Body weight and adiposity are heritable traits. To date it remains unknown whether obesity-associated brain structural alterations are under a similar level of genetic control. Methods For this study we utilized magnetic resonance imaging (MRI) data from the Human Connectome Project. Voxel based morphometry (VBM) was used to investigate associations between body mass index (BMI) and regional gray matter volume (GMV) in a sample of 875 young adults with a wide BMI range (386m/489f; age 28.8 ± 3.7y; BMI 26.6 ± 5.3 kg*m-2), that included 86 pairs of monozygotic twins and 82 pairs of dizygotic twins. Twin data were analyzed by applying the additive genetic, common environmental and residual effects (ACE) model to determine heritability of brain regions that were associated with BMI. Results We observed positive associations between BMI and GMV in the ventromedial prefrontal cortex and the right cerebellum and widespread negative associations within the prefrontal cortex, cerebellum, temporal lobes and distinct subcortical structures. Varying degrees of heritability were found for BMI-associated brain regions, with highest heritability estimates for cerebellar GMV and subcortical structures. Conclusions These data indicate that brain regions associated with obesity are subject to differing levels of genetic control and environmental influences. Specific brain regions with high heritability might represent an inherent vulnerability factor for obesity.
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Affiliation(s)
- C M Weise
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - P Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - M Reinhardt
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - K Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - C R Savage
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - J Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - B Pleger
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Department of Neurology, BG University Clinic Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
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13
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Weise CM, Chen K, Chen Y, Goradia D, Savage C, Caselli RJ, Krakoff J, Reiman EM. P2‐243: Higher BMI is Associated with Greater Cerebral Glucose Metabolism in Late Middle‐Aged and Elderly Subjects Regardless of
APOE
ε4 Genotype. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Kewei Chen
- Banner Alzheimer's InstitutePhoenixAZ USA
- Arizona State UniversityTempeAZ USA
- Arizona Alzheimer's ConsortiumPhoenixAZ USA
| | - Yinghua Chen
- Banner Alzheimer's InstitutePhoenixAZ USA
- Arizona Alzheimer's ConsortiumPhoenixAZ USA
| | | | | | | | | | - Eric M. Reiman
- Banner Alzheimer's InstitutePhoenixAZ USA
- Arizona Alzheimer's ConsortiumPhoenixAZ USA
- University of ArizonaTucsonAZ USA
- Translational Genomics Research InstitutePhoenixAZ USA
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14
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Reinhardt M, Parigi AD, Chen K, Reiman EM, Thiyyagura P, Krakoff J, Hohenadel MG, Le DSNT, Weise CM. Deactivation of the left dorsolateral prefrontal cortex in Prader-Willi syndrome after meal consumption. Int J Obes (Lond) 2016; 40:1360-8. [PMID: 27121248 PMCID: PMC5014561 DOI: 10.1038/ijo.2016.75] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 02/29/2016] [Accepted: 04/08/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Prader-Willi syndrome (PWS) is a type of human genetic obesity that may give us information regarding the physiology of non-syndromic obesity. The objective of this study was to investigate the functional correlates of hunger and satiety in individuals with PWS in comparison with healthy controls with obesity, hypothesizing that we would see significant differences in activation in the left dorsolateral prefrontal cortex (DLPFC) based on prior findings. SUBJECTS/METHODS This study compared the central effects of food consumption in nine individuals with PWS (7 men, 2 women; body fat 35.3±10.0%) and seven controls (7 men; body fat 28.8±7.6%), matched for percentage body fat. H2(15)O-PET (positron emission tomography) scans were performed before and after consumption of a standardized liquid meal to obtain quantitative measures of regional cerebral blood flow (rCBF), a marker of neuronal activity. RESULTS Compared with obese controls, PWS showed altered (P<0.05 family-wise error cluster-level corrected; voxelwise P<0.001) rCBF before and after meal consumption in multiple brain regions. There was a significant differential rCBF response within the left DLPFC after meal ingestion with decreases in DLPFC rCBF in PWS; in controls, DLPFC rCBF tended to remain unchanged. In more liberal analyses (P<0.05 family-wise error cluster-level corrected; voxelwise P<0.005), rCBF of the right orbitofrontal cortex (OFC) increased in PWS and decreased in controls. In PWS, ΔrCBF of the right OFC was associated with changes in appetite ratings. CONCLUSIONS The pathophysiology of eating behavior in PWS is characterized by a paradoxical meal-induced deactivation of the left DLPFC and activation in the right OFC, brain regions implicated in the central regulation of eating behavior.
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Affiliation(s)
- M Reinhardt
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA.,Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - A D Parigi
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA, USA.,Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, USA
| | - K Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - E M Reiman
- Banner Alzheimer's Institute, Phoenix, AZ, USA.,Neurogenomics Division, Translational Genomics Research Institute, University of Arizona, and Arizona State University, Phoenix, AZ, USA
| | | | - J Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA
| | - M G Hohenadel
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA
| | - D S N T Le
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA
| | - C M Weise
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Phoenix, AZ, USA.,Department of Neurology, University of Leipzig, Leipzig, Germany
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15
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Gluck ME, Alonso-Alonso M, Piaggi P, Weise CM, Schwartzenberg RJV, Reinhardt M, Wassermann EM, Venti CA, Votruba SB, Krakoff J. Neuromodulation targeted to the prefrontal cortex induces changes in energy intake and weight loss in obesity. Obesity (Silver Spring) 2015; 23:2149-56. [PMID: 26530931 PMCID: PMC4636021 DOI: 10.1002/oby.21313] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/11/2015] [Accepted: 08/11/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Obesity is associated with decreased activity in the prefrontal cortex. Transcranial direct current stimulation (tDCS) modifies cortical excitability and may facilitate improved control of eating. The energy intake (EI) and body weight in subjects who received cathodal versus sham (study 1) and subsequent anodal versus sham (study 2) tDCS aimed at the left dorsolateral prefrontal cortex (LDLPFC) were measured. METHODS Nine (3m, 6f) healthy volunteers with obesity (94 ± 15 kg [M ± SD]; 42 ± 8 y) were admitted as inpatients for 9 days to participate in a double-blind, randomized, placebo-controlled crossover experiment. Study 1: following 5 days of a weight-maintaining diet, participants received cathodal or sham tDCS (2 mA, 40 min) on three consecutive mornings and then ate ad libitum from a computerized vending machine, which recorded EI. Weight was measured daily. Study 2: participants repeated the study, maintaining original assignment to active (this time anodal) and sham. RESULTS Participants tended to consume fewer kilocalories per day (P = 0.07), significantly fewer kilocalories from soda (P = 0.02) and fat (P = 0.03), and had a greater % weight loss (P = 0.009) during anodal versus cathodal tDCS. CONCLUSIONS The results indicated a role for the LDLPFC in obesity and food intake. This proof of concept study suggested, for the first time, the potential application of anodal tDCS to facilitate weight loss.
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Affiliation(s)
- Marci E. Gluck
- Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Miguel Alonso-Alonso
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Paolo Piaggi
- Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Christopher M. Weise
- Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Reiner Jumpertz-von Schwartzenberg
- Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Martin Reinhardt
- Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Eric M. Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health,, Bethesda, MD, USA
| | - Colleen A. Venti
- Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Susanne B. Votruba
- Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Jonathan Krakoff
- Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
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Weise CM, Thiyyagura P, Reiman EM, Chen K, Krakoff J. A potential role for the midbrain in integrating fat-free mass determined energy needs: An H2 (15) O PET study. Hum Brain Mapp 2015; 36:2406-15. [PMID: 25766283 DOI: 10.1002/hbm.22780] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 02/21/2015] [Accepted: 02/24/2015] [Indexed: 12/30/2022] Open
Abstract
Little is known on how sensing of energy needs is centrally represented, integrated, and translated into the behavioral aspects of energy homeostasis. Fat free mass (FFM) is the major determinant of energy expenditure. We investigated how interindividual variances in FFM relate to neuronal activity in humans. Healthy adults (n = 64, 21F/43M; age 31.3 ± 9.1y; percentage of body fat [PFAT] 25.6 ± 10.7%; BMI 30.4 ± 9) underwent a 36h fast and subsequent H(2) (15) O positron emission tomographic (PET) measurement of regional cerebral blood flow (rCBF). Multiple variable regression analysis revealed significant associations of FFM with rCBF within the midbrain [including parts of the periaqueductal gray (PAG), ventral tegmental area (VTA), thalamic and hypothalamic regions], the bilateral parahippocampal region, left anterior cingulate, left insular cortex, right cerebellum, and distinct regions within the temporal and occipital cortex. In contrast, no significant associations were found for fat mass (FM). We investigated the potential functional-anatomical link between FFM and central regulation of food intake by performing a conjunction analysis of FFM and the perceived hunger feelings. This showed a significant overlap within the midbrain PAG. Mediation analysis demonstrated a significant indirect effect of FFM on hunger with PAG rCBF as mediator. Most regions we found to be associated with FFM form part in ascending homeostatic pathways and cortical circuitries implicated in the regulation of basic bodily functions indicating a potential role of these central networks in the integration of FFM determined energy needs.
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Affiliation(s)
- Christopher M Weise
- Obesity and Diabetes Clinical Research Section, NIDDK-NIH, DHHS, Phoenix, Arizona; Department of Neurology, University of Leipzig, Germany
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17
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Weise CM, Mouton PR, Eschbacher J, Coons SW, Krakoff J. A post-mortem stereological study of striatal cell number in human obesity. Obesity (Silver Spring) 2015; 23:100-4. [PMID: 25234737 PMCID: PMC4276484 DOI: 10.1002/oby.20897] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 08/18/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Neuroimaging studies have revealed abnormalities in brain structure, including the striatum, in obese people. In this study, the cellular and parenchymal basis for these findings in post-mortem brain tissue was investigated. METHODS Design-based (unbiased) stereology combined with histochemical and immunocytochemical staining was used to quantify total number of neurons and astrocytes in post-mortem striatal brain samples from nine obese (BMI 40.2 ± 6.1 kg/m(2) ) and eight lean (BMI 24.4 ± 1.0 kg/m(2) ) donors. Total numbers of Nissl-stained neurons and glial fibrillary acidic protein-immunopositive astrocytes were counted in 10 systematic-random sections starting from the frontal pole of the striatum. RESULTS There were no differences in mean total numbers of neurons (obese: 7.60 E+06; SD 2.50 E+06; lean: 7.85 E+06; SD 8.26 E+05; P < 0.78) or astrocytes (obese: 7.42 E+06; SD 2.27 E+06; lean: 7.43 E+06; SD 2.50 E+06; P < 0.99). A higher variance was found for number of neurons (P < 0.007) but not astrocytes (P < 0.72) in the obese group. Neuron/glia ratios were similar in both groups (obese: 1.07, SD 0.39; lean: 1.15, SD 0.37; P < 0.70) with an overall striatal neuron/glia ratio of 1.11 (SD 0.37) across the entire study population (n = 17). CONCLUSIONS No difference was found in the average numbers of neurons and astrocytes in the anterior striatum between lean and obese people. The morphological basis for structural brain changes in obesity requires further investigation.
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Affiliation(s)
- Christopher M. Weise
- Obesity and Diabetes Clinical Research Section, NIDDK-NIH, DHHS, Phoenix, AZ, USA
- University of Leipzig, Department of Neurology, Leipzig, Germany
| | - Peter R Mouton
- Department of Pathology & Cell Biology, University of South Florida School of Medicine, Byrd Alzheimer’s Institute and Research Center and the Stereology Resource Center, Tampa, FL, USA
| | - Jennifer Eschbacher
- Department of Neuropathology/Pathology, Barrows Neurological Institute, St. Josephs Hospital and Medical Center, Phoenix, AZ
| | - Stephen W. Coons
- Department of Neuropathology/Pathology, Barrows Neurological Institute, St. Josephs Hospital and Medical Center, Phoenix, AZ
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, NIDDK-NIH, DHHS, Phoenix, AZ, USA
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18
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Weise CM, Hohenadel MG, Krakoff J, Votruba SB. Body composition and energy expenditure predict ad-libitum food and macronutrient intake in humans. Int J Obes (Lond) 2014; 38:243-51. [PMID: 23736368 PMCID: PMC3909024 DOI: 10.1038/ijo.2013.85] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 04/15/2013] [Accepted: 05/08/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Obesity is the result of chronic positive energy balance. The mechanisms underlying the regulation of energy homeostasis and food intake are not understood. Despite large increases in fat mass (FM), recent evidence indicates that fat-free mass (FFM) rather than FM is positively associated with intake in humans. METHODS In 184 humans (73 females/111 males; age 34.5±8.8 years; percentage body fat: 31.6±8.1%), we investigated the relationship of FFM index (FFMI, kg m(-2)), FM index (FMI, kg m(-2)); and 24-h energy expenditure (EE, n=127) with ad-libitum food intake using a 3-day vending machine paradigm. Mean daily calories (CAL) and macronutrient intake (PRO, CHO, FAT) were determined and used to calculate the relative caloric contribution of each (%PRO, %CHO, %FAT) and percent of caloric intake over weight maintaining energy needs (%WMENs). RESULTS FFMI was positively associated with CAL (P<0.0001), PRO (P=0.0001), CHO (P=0.0075) and FAT (P<0.0001). This remained significant after adjusting for FMI. Total EE predicted CAL and macronutrient intake (all P<0.0001). FMI was positively associated with CAL (P=0.019), PRO (P=0.025) and FAT (P=0.0008). In models with both FFMI and FMI, FMI was negatively associated with CAL (P=0.019) and PRO (P=0.033). Both FFMI and FMI were negatively associated with %CHO and positively associated with %FAT (all P<0.001). EE and FFMI (adjusted for FMI) were positively (EE P=0.0085; FFMI P=0.0018) and FMI negatively (P=0.0018; adjusted for FFMI) associated with %WMEN. CONCLUSION Food and macronutrient intake are predicted by FFMI and to a lesser degree by FMI. FFM and FM may have opposing effects on energy homeostasis.
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Affiliation(s)
- Christopher M Weise
- Obesity and Diabetes Clinical Research Section, NIDDK-NIH, DHHS, Phoenix, AZ, USA
| | | | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, NIDDK-NIH, DHHS, Phoenix, AZ, USA
| | - Susanne B Votruba
- Obesity and Diabetes Clinical Research Section, NIDDK-NIH, DHHS, Phoenix, AZ, USA
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Weise CM, Thiyyagura P, Reiman EM, Chen K, Krakoff J. Fat-free body mass but not fat mass is associated with reduced gray matter volume of cortical brain regions implicated in autonomic and homeostatic regulation. Neuroimage 2012; 64:712-21. [PMID: 22974975 DOI: 10.1016/j.neuroimage.2012.09.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 09/01/2012] [Accepted: 09/03/2012] [Indexed: 12/30/2022] Open
Abstract
Obesity has been associated with alterations of both functional and structural aspects of the human central nervous system. In obese individuals both fat mass (FM; primarily consisting of adipose tissue) and fat-free mass (FFM; all non-adipose tissues) are increased and it remains unknown whether these compartments have separate effects on human brain morphology. We used voxel-based morphometry to investigate the relationships between measures of body composition and regional gray matter volume (GMV) in 76 healthy adults with a wide range of adiposity (24 F/52 M; age 32.1 ± 8.8 years; percentage of body fat [PFAT%] 25.5 ± 10.9%; BMI 29.8 ± 8.9). Fat-free mass index (FFMI kg × m(-2)) showed negative associations in bilateral temporal regions, the bilateral medial and caudolateral OFC, and the left insula. Fat mass index (FMI kg × m(-2)) showed similar, but less extensive negative associations within temporal cortical regions and the left caudolateral orbitofrontal cortex (OFC). In addition, negative associations were seen for FMI with GMV of the cerebellum. Associations of FFMI with temporal and medial orbitofrontal GMV appeared to be independent of adiposity. No associations were seen between measures of adiposity (i.e. FM and PFAT) and GMV when adjusted for FFM. The majority of regions that we find associated with FFM have been implicated in the regulation of eating behavior and show extensive projections to central autonomic and homeostatic core structures. These data indicate that not adipose tissue or relative adiposity itself, but obesity related increases in absolute tissue mass and particularly FFM may have a more predominant effect on the human brain. This might be explained by the high metabolic demand of FFM and related increases in total energy needs.
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Affiliation(s)
- Christopher M Weise
- Obesity and Diabetes Clinical Research Section, NIDDK-NIH, DHHS, Phoenix, AZ 85016, USA.
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Weise CM, Thiyyagura P, Reiman EM, Chen K, Krakoff J. Postprandial plasma PYY concentrations are associated with increased regional gray matter volume and rCBF declines in caudate nuclei--a combined MRI and H2(15)O PET study. Neuroimage 2011; 60:592-600. [PMID: 22206963 DOI: 10.1016/j.neuroimage.2011.12.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 11/28/2011] [Accepted: 12/13/2011] [Indexed: 01/01/2023] Open
Abstract
The anorexigenic gastrointestinal hormone Peptide YY plays an important role in the communication between the gastrointestinal tract and the central nervous system. PYY has been shown to modulate brain activity in regions implicated in reward and food related behavior. Its effects on brain structure however, remain unknown. Voxel-based morphometry was used to investigate the relationship between fasting and postprandial plasma PYY concentrations and regional gray matter volume (GMV). For this analysis twenty adult, non diabetic Caucasians were included (18F/2M, age 31±9 y, percentage of body fat [PFAT] 32±8%) who had volumetric brain magnetic resonance images and underwent H(2)(15)O positron emission tomographic (PET) measurements of regional cerebral blood flow (rCBF), a marker of local neuronal activity, and measurements of plasma total PYY, prior to (fasting) and following a satiating liquid meal. Voxel-wise analysis revealed a regional positive association between postprandial PYY and gray matter volume bilaterally in the caudate nuclei. These associations remained significant (p<0.05) after small volume correction for multiple comparisons. Based on these findings we investigated whether postprandial PYY is associated with PET measured rCBF of the caudate nucleus. We found a significant negative association between average postprandial caudate rCBF and postprandial plasma PYY concentrations (r=-0.60, p<0.02, age, sex and PFAT adjusted). Average postprandial caudate rCBF was also negatively associated with rCBF in the right medial orbitofrontal cortex and the right hippocampal formation (p<0.05, corrected for multiple comparisons). Total PYY is positively associated with gray matter but negatively with postprandial activity in the caudate nuclei while caudate activity is negatively associated with rCBF in prefrontal and paralimbic regions implicated in reward behavior. Thus, PYY may act centrally to modulate eating behavior via striatal networks.
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Affiliation(s)
- Christopher M Weise
- Obesity and Diabetes Clinical Research Section, NIDDK-NIH, DHHS, Phoenix, AZ 85016, USA.
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