Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK.
School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
Brain Behav. 2023 Dec;13(12):e3286. doi: 10.1002/brb3.3286. Epub 2023 Oct 13.
Dysregulated appetite control is characteristic of anorexia nervosa (AN), bulimia nervosa (BN), and obesity (OB). Studies using a broad range of methods suggest the cerebellum plays an important role in aspects of weight and appetite control, and is implicated in both AN and OB by reports of aberrant gray matter volume (GMV) compared to nonclinical populations. As functions of the cerebellum are anatomically segregated, specific localization of aberrant anatomy may indicate the mechanisms of its relationship with weight and appetite in different states. We sought to determine if there were consistencies in regions of cerebellar GMV changes in AN/BN and OB, as well as across normative (NOR) variation.
Systematic review and meta-analysis using GingerALE.
Twenty-six publications were identified as either case-control studies (n = 277; n = 510) or regressed weight from NOR data against brain volume (total n = 3830). AN/BN and OB analyses both showed consistently decreased GMV within Crus I and Lobule VI, but volume reduction was bilateral for AN/BN and unilateral for OB. Analysis of the NOR data set identified a cluster in right posterior lobe that overlapped with AN/BN cerebellar reduction. Sensitivity analyses indicated robust repeatability for NOR and AN/BN cohorts, but found OB-specific heterogeneity.
Findings suggest that more than one area of the cerebellum is involved in control of eating behavior and may be differentially affected in normal variation and pathological conditions. Specifically, we hypothesize an association with sensorimotor and emotional learning via Lobule VI in AN/BN, and executive function via Crus I in OB.
食欲调节紊乱是厌食症（AN）、贪食症（BN）和肥胖症（OB）的特征。使用广泛方法的研究表明，小脑在体重和食欲控制的各个方面都起着重要作用，并且与 AN 和 OB 有关，因为与非临床人群相比，其灰质体积（GMV）存在异常。由于小脑的功能在解剖上是分离的，异常解剖结构的特定定位可能表明其与不同状态下体重和食欲的关系的机制。我们试图确定在 AN/BN 和 OB 中，以及在正常（NOR）变异中，小脑 GMV 变化的区域是否存在一致性。
使用 GingerALE 进行系统评价和荟萃分析。
确定了 26 篇出版物，要么是病例对照研究（n = 277；n = 510），要么是将体重从 NOR 数据回归到大脑体积（总 n = 3830）。AN/BN 和 OB 分析均显示 Crus I 和 Lobule VI 内 GMV 持续减少，但 AN/BN 为双侧体积减少，OB 为单侧体积减少。对 NOR 数据集的分析确定了右后叶的一个簇，与 AN/BN 小脑减少重叠。敏感性分析表明 NOR 和 AN/BN 队列的可重复性很强，但发现 OB 具有特异性异质性。
研究结果表明，小脑的不止一个区域参与了进食行为的控制，并且在正常变异和病理条件下可能受到不同的影响。具体来说，我们假设 AN/BN 中通过 Lobule VI 与感觉运动和情绪学习有关，而 OB 中通过 Crus I 与执行功能有关。
