Frank S, Wilms B, Veit R, Ernst B, Thurnheer M, Kullmann S, Fritsche A, Birbaumer N, Preissl H, Schultes B
1] Institute of Medical Psychology and Behavioural Neurobiology, University of Tübingen, Tübingen, Germany [2] fMEG Center, University of Tübingen, Tübingen, Germany.
Department of Surgery, Cantonal Hospital St Gallen, St Gallen, Switzerland.
Int J Obes (Lond). 2014 Mar;38(3):341-8. doi: 10.1038/ijo.2013.60. Epub 2013 Apr 29.
Neuroimaging studies have demonstrated alterations in brain activity in obese (OB) subjects that might be causally linked to their disorder. Roux-en Y gastric bypass (RYGB) surgery induces a marked and sustained weight loss and may affect brain activity. The aim of this study was to compare brain activity pattern between severely OB women (n=11), normal-weight women (NW, n=11) and previously severely OB women who had undergone RYGB surgery (RYGB, n=9) on average 3.4±0.8 years (all >1 year) before the experiment.
Brain activity was assessed by functional magnetic resonance imaging during a one-back task containing food- and non-food-related pictures and during resting state. Hunger and satiety were repeatedly rated on a visual analog scale during the experiment.
As compared with NW and also with RYGB women, OB women showed (1) a higher cerebellar and a lower fusiform gyrus activity during the visual stimulation independently of the picture category, (2) a higher hypothalamic activation during the presentation of low- vs high-caloric food pictures, (3) a higher hippocampal and cerebellar activity during the working memory task and (4) a stronger functional connectivity in frontal regions of the default mode network during resting state. There were no differences in brain activity between the NW and RYGB women, both during picture presentation and during resting state. RYGB women generally rated lower on hunger and higher on satiety, whereas there were no differences in these ratings between the OB and NW women.
Data provide evidence for an altered brain activity pattern in severely OB women and suggest that RYGB surgery and/or the surgically induced weight loss reverses the obesity-associated alterations.
神经影像学研究表明，肥胖（OB）受试者的大脑活动存在改变，这可能与其疾病存在因果关系。Roux-en Y胃旁路手术（RYGB）可导致显著且持续的体重减轻，并可能影响大脑活动。本研究的目的是比较严重肥胖女性（n = 11）、正常体重女性（NW，n = 11）以及曾接受RYGB手术的肥胖女性（RYGB，n = 9）之间的大脑活动模式，这些曾接受手术的肥胖女性在实验前平均3.4±0.8年（均>1年）接受了RYGB手术。
在一项包含食物和非食物相关图片的单样本任务以及静息状态期间，通过功能磁共振成像评估大脑活动。在实验过程中，使用视觉模拟量表反复评估饥饿感和饱腹感。
与NW女性以及RYGB女性相比，OB女性表现出：（1）在视觉刺激期间，无论图片类别如何，小脑活动较高，梭状回活动较低；（2）在呈现低热量与高热量食物图片期间，下丘脑激活较高；（3）在工作记忆任务期间，海马体和小脑活动较高；（4）在静息状态下，默认模式网络额叶区域的功能连接更强。在图片呈现和静息状态期间，NW女性和RYGB女性的大脑活动均无差异。RYGB女性的饥饿感评分普遍较低，饱腹感评分较高，而OB女性和NW女性在这些评分上没有差异。
数据为严重肥胖女性大脑活动模式改变提供了证据，并表明RYGB手术和/或手术引起的体重减轻可逆转与肥胖相关的改变。
