Karaivazoglou Katerina, Aggeletopoulou Ioanna, Triantos Christos
Department of Psychiatry, University Hospital of Patras, 26504 Patras, Greece.
Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, 26504 Patras, Greece.
Biomedicines. 2024 Aug 15;12(8):1861. doi: 10.3390/biomedicines12081861.
The human reward network consists of interconnected brain regions that process stimuli associated with satisfaction and modulate pleasure-seeking behaviors. Impairments in reward processing have been implicated in several medical and psychiatric conditions, and there is a growing interest in disentangling the underlying pathophysiological mechanisms. The brain-gut axis plays a regulatory role in several higher-order neurophysiological pathways, including reward processing. In this context, the aim of the current review was to critically appraise research findings on the contribution of the brain-gut axis to the human reward system. Enteric neuropeptides, which are implicated in the regulation of hunger and satiety, such as ghrelin, PYY, and glucagon-like peptide 1 (GLP-1), have been associated with the processing of food-related, alcohol-related, and other non-food-related rewards, maintaining a delicate balance between the body's homeostatic and hedonic needs. Furthermore, intestinal microbiota and their metabolites have been linked to differences in the architecture and activation of brain reward areas in obese patients and patients with attention deficit and hyperactivity disorder. Likewise, bariatric surgery reduces hedonic eating by altering the composition of gut microbiota. Although existing findings need further corroboration, they provide valuable information on the pathophysiology of reward-processing impairments and delineate a novel framework for potential therapeutic interventions.
人类奖赏网络由相互连接的脑区组成，这些脑区处理与满足感相关的刺激并调节寻求愉悦的行为。奖赏处理受损与多种医学和精神疾病有关，人们对厘清其潜在的病理生理机制的兴趣日益浓厚。脑-肠轴在包括奖赏处理在内的多种高阶神经生理通路中发挥调节作用。在此背景下，本综述的目的是批判性地评估关于脑-肠轴对人类奖赏系统贡献的研究结果。参与饥饿和饱腹感调节的肠神经肽，如胃饥饿素、肽YY和胰高血糖素样肽1（GLP-1），已与食物相关、酒精相关及其他非食物相关奖赏的处理相关联，维持着身体稳态需求和享乐需求之间的微妙平衡。此外，肠道微生物群及其代谢产物与肥胖患者以及注意力缺陷多动障碍患者脑奖赏区域的结构和激活差异有关。同样，减肥手术通过改变肠道微生物群的组成来减少享乐性进食。尽管现有研究结果需要进一步证实，但它们为奖赏处理受损的病理生理学提供了有价值的信息，并勾勒出一个潜在治疗干预的新框架。
