University of Granada, Spain.
Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM-17), Barcelona, Spain.
J Am Acad Child Adolesc Psychiatry. 2019 Feb;58(2):211-220.e5. doi: 10.1016/j.jaac.2018.06.039. Epub 2018 Nov 26.
Adolescents with excess weight are particularly sensitive to stress, which may contribute to the presence of emotional eating behaviors. It is proposed that this may be due to alterations in the connectivity between hypothalamic networks and regions of the "emotional nervous system," involved in the regulation of energy balance and stress processing. However, this remains to be clarified in adolescents with excess weight.
We investigated whole-brain differences in the functional connectivity of the medial and lateral hypothalamus (MH and LH) between adolescents with excess weight (EW, n = 53; mean age = 14.64 years, SD = 1.78) and normal weight (NW, n = 51; mean age = 15.29 years, SD = 1.75) using seed-based resting-state analyses. Then, in a subset of 22 adolescents with EW (mean age = 15.75 years, SD = 1.70) and 32 with NW (mean age = 15.27, SD = 2.03), we explored for group interactions between the MH/LH networks and stress response in the Trier Social Stress Task (TSST) and emotional eating, assessed with the Dutch Eating Behavior Questionnaire (DEB-Q).
Compared to NW, EW showed higher functional connectivity in the LH-orbitofrontal cortex, ventral striatum, anterior insula, and in the MH-middle temporal cortex networks. EW also showed lower connectivity in the LH-cerebellum, and in the MH-middle prefrontal, pre-, and postcentral gyri networks. In EW, higher connectivity of the LH-nucleus accumbens and LH-midbrain networks were associated with stress response. Higher connectivity in the LH-midbrain was also associated with a greater presence of emotional eating behaviors in EW.
Adolescents with EW showed functional connectivity alterations within both MH/LH networks. Alterations in the LH network were linked with higher levels of stress response and emotional-driven eating patterns.
超重青少年对压力特别敏感，这可能导致情绪性进食行为的出现。据推测，这可能是由于下丘脑网络与“情绪神经系统”区域之间的连接发生改变所致，这些区域参与了能量平衡和压力处理的调节。然而，这在超重青少年中仍有待阐明。
我们使用基于种子的静息态分析，研究了超重青少年（EW，n=53；平均年龄=14.64 岁，SD=1.78）和正常体重青少年（NW，n=51；平均年龄=15.29 岁，SD=1.75）的内侧和外侧下丘脑（MH 和 LH）之间全脑功能连接的差异。然后，在 22 名 EW 青少年（平均年龄=15.75 岁，SD=1.70）和 32 名 NW 青少年（平均年龄=15.27 岁，SD=2.03）中，我们在 Trier 社会应激测试（TSST）和情绪性进食（使用荷兰饮食行为问卷（DEB-Q）评估）中，探索了 MH/LH 网络与应激反应之间的组间相互作用。
与 NW 相比，EW 在 LH-眶额皮质、腹侧纹状体、前岛叶和 MH-中颞叶网络中的功能连接更高。EW 在 LH-小脑和 MH-中前额叶、额、后中央回网络中的功能连接也较低。在 EW 中，LH-伏隔核和 LH-中脑网络的连接越高，应激反应越大。LH-中脑的连接越高，EW 中情绪性进食行为的出现也越多。
超重青少年的 MH/LH 网络内存在功能连接改变。LH 网络的改变与更高水平的应激反应和情绪驱动的进食模式有关。
