Zoon H F A, de Bruijn S E M, Jager G, Smeets P A M, de Graaf C, Janssen I M C, Schijns W, Deden L, Boesveldt S
Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands; Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
Biol Psychol. 2018 Sep;137:34-41. doi: 10.1016/j.biopsycho.2018.06.005. Epub 2018 Jun 23.
Roux-en-Y gastric bypass (RYGB) surgery is a highly effective weight-loss intervention that often reduces preference and intake of high-energy foods. Research into the neural mechanisms behind this shift has mainly focused on reward processing of food cues. However, the ability to successfully control food intake and thereby weight-loss also depends on inhibitory control capacity. We investigated whether RYGB leads to alterations in neural inhibitory control in response to food cues.
A food-specific go/no-go task with pictures of high-energy (desserts) and low-energy foods (vegetables), was used to assess neural inhibition responses before and after RYGB with functional magnetic resonance imaging. Data from 18 morbidly obese patients (15 females; age 41 ± 11 years; BMI 42 ± 4 kg/m before; BMI 36 ± 4 kg/m after) were analysed. Pre- and post-RYGB BOLD fMRI responses were compared for response inhibition towards high- and low-energy foods. Participants were tested in a satiated state.
Response inhibition to high-energy foods was associated with increased activation of the right lateral prefrontal cortex (PFC), right medial PFC, dorsolateral PFC, right middle cingulate cortex and the right inferior frontal operculum (involved in inhibitory control), after compared to before surgery. Response inhibition to low-energy foods elicited diminished post- compared to pre-surgery responses in the left superior temporal pole, right parahippocampal gyrus and right hypothalamus (involved in metabolic control).
Neural changes indicate improved response inhibition towards high-energy food cues, altered influence of metabolic control during response inhibition towards low-energy food cues and a more positive attitude to both high-energy and low-energy food after RYGB. Alterations in neural circuits involved in inhibitory control, satiety signalling and reward processing may contribute to effective weight-loss after RYGB.
Roux-en-Y胃旁路术（RYGB）是一种高效的减肥干预措施，通常会降低对高能量食物的偏好和摄入量。对这种转变背后神经机制的研究主要集中在食物线索的奖赏处理上。然而，成功控制食物摄入量从而实现减肥的能力也取决于抑制控制能力。我们研究了RYGB是否会导致对食物线索的神经抑制控制发生改变。
采用一项针对高能量（甜点）和低能量食物（蔬菜）图片的特定食物“去/不去”任务，通过功能磁共振成像评估RYGB手术前后的神经抑制反应。分析了18例病态肥胖患者（15名女性；年龄41±11岁；术前BMI 42±4kg/m²；术后BMI 36±4kg/m²）的数据。比较了RYGB手术前后对高能量和低能量食物的反应抑制的血氧水平依赖性功能磁共振成像反应。参与者在饱腹状态下接受测试。
与手术前相比，手术后对高能量食物的反应抑制与右侧外侧前额叶皮质（PFC）、右侧内侧PFC、背外侧PFC、右侧中央扣带回皮质和右侧额下回盖部（参与抑制控制）的激活增加有关。与手术前相比，手术后对低能量食物的反应抑制在左侧颞上极、右侧海马旁回和右侧下丘脑（参与代谢控制）的反应减弱。
神经变化表明，RYGB术后对高能量食物线索的反应抑制得到改善，对低能量食物线索的反应抑制过程中代谢控制的影响发生改变，并且对高能量和低能量食物的态度更为积极。参与抑制控制、饱腹感信号和奖赏处理的神经回路改变可能有助于RYGB术后有效减肥。
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