Faulconbridge Lucy F, Ruparel Kosha, Loughead James, Allison Kelly C, Hesson Louise A, Fabricatore Anthony N, Rochette Amber, Ritter Scott, Hopson Ryan D, Sarwer David B, Williams Noel N, Geliebter Allan, Gur Ruben C, Wadden Thomas A
Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Center for Neuroimaging, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Obesity (Silver Spring). 2016 May;24(5):1054-60. doi: 10.1002/oby.21464.
This prospective, observational fMRI study examined changes over time in blood oxygen level dependent (BOLD) response to high- and low-calorie foods (HCF and LCF) in bariatric surgery candidates and weight-stable controls.
Twenty-two Roux-en-Y gastric bypass (RYGB) participants, 18 vertical sleeve gastrectomy (VSG) participants, and 19 weight-stable controls with severe obesity underwent fMRI before and 6 months after surgery/baseline. BOLD signal change in response to images of HCF vs. LCF was examined in a priori regions of interest.
RYGB and VSG participants lost 23.6% and 21.1% of initial weight, respectively, at 6 months, and controls gained 1.0%. Liking ratings for HCF decreased significantly in the RYGB and VSG groups but remained stable in the control group. BOLD response in the ventral tegmental area (VTA) to HCF (vs. LCF) declined significantly more at 6 months in RYGB compared to control participants but not in VSG participants. Changes in fasting ghrelin correlated positively with changes in VTA BOLD signal in both RYGB and VSG but not in control participants.
Results implicate the VTA as a critical site for modulating postsurgical changes in liking of highly palatable foods and suggest ghrelin as a potential substrate requiring further investigation.
这项前瞻性观察性功能磁共振成像（fMRI）研究，考察了肥胖症手术候选者和体重稳定的对照组对高热量和低热量食物（HCF和LCF）的血氧水平依赖（BOLD）反应随时间的变化。
22名接受Roux-en-Y胃旁路术（RYGB）的参与者、18名接受垂直袖状胃切除术（VSG）的参与者以及19名患有严重肥胖症的体重稳定的对照组在手术/基线前及术后6个月接受了fMRI检查。在预先设定的感兴趣区域检查对HCF与LCF图像的BOLD信号变化。
在6个月时，RYGB和VSG参与者的初始体重分别减轻了23.6%和21.1%，而对照组体重增加了1.0%。RYGB组和VSG组对HCF的喜爱评分显著下降，而对照组保持稳定。与对照组参与者相比，RYGB参与者在6个月时腹侧被盖区（VTA）对HCF（相对于LCF）的BOLD反应下降更为显著，而VSG参与者则不然。空腹胃饥饿素的变化在RYGB组和VSG组中均与VTA的BOLD信号变化呈正相关，而在对照组参与者中则不然。
结果表明VTA是调节术后对高度可口食物喜好变化的关键部位，并提示胃饥饿素是一个需要进一步研究的潜在因素。
