Binge eating is associated with right orbitofrontal-insular-striatal atrophy in frontotemporal dementia
Binge eating is associated with right orbitofrontal-insular-striatal atrophy in frontotemporal dementia
复制标题
DOI：
10.1212/01.wnl.0000277461.06713.23
复制
发表时间：
2007-10-02
期刊：
影响因子：
9.9
通讯作者：
Miller, B. L.
中科院分区：
文献类型：
--
作者：
Woolley, J. D.;Gorno-Tempini, M.-L.;Miller, B. L.
背景：对人类和非人类灵长类动物的神经生理学研究表明，眶额-岛状-纹状体回路在进食的高水平调节中起作用。然而，这些区域在决定神经系统患者进食障碍中的作用仍不确定。目的和方法：为了确定控制饮食行为的关键大脑结构，我们对18名健康对照者和32名神经退行性疾病患者进行了前瞻性、实验室基础的自由喂养研究。基于体素的磁共振形态学（VBM）被用来识别与不进食的患者相比，进食过量的患者显著萎缩的区域。结果：尽管正常的味觉识别，32例患者中有6例强迫性暴食，在报告适当的饱腹感后食用大量食物。所有6名暴饮暴食的患者均被临床诊断为额颞叶痴呆（FTD），这是一种先前与饮食失调相关的疾病，而非暴饮暴食的患者被诊断为额颞叶痴呆、语义性痴呆、进行性失语、进行性核上性麻痹和阿尔茨海默病。VBM显示，暴饮暴食患者在右侧腹侧脑岛、纹状体和眶额皮质有明显更大的萎缩。结论：暴饮暴食可以在报告饱腹的情况下发生，并且与人类右侧眶额-岛状-纹状体回路的损伤有关。这些发现支持了一个模型，其中腹侧岛叶和眶额皮质作为高阶味觉区域，并与纹状体合作指导适当的进食反应。
Background: Neurophysiologic studies on human and nonhuman primates implicate an orbitofrontal- insular- striatal circuit in high- level regulation of feeding. However, the role of these areas in determining feeding disturbances in neurologic patients remains uncertain.Objective and Methods: To determine brain structures critical for control of eating behavior, we performed a prospective, laboratory- based, free- feeding study of 18 healthy control subjects and 32 patients with neurodegenerative disease. MR voxel- based morphometry ( VBM) was used to identify regions of significant atrophy in patients who overate compared with those who did not.Results: Despite normal taste recognition, 6 of 32 patients compulsively binged, consuming large quantities of food after reporting appropriate satiety. All six patients who overate were clinically diagnosed with frontotemporal dementia ( FTD), a disorder previously associated with disordered eating, while the nonovereaters were diagnosed with FTD, semantic dementia, progressive aphasia, progressive supranuclear palsy, and Alzheimer disease. VBM revealed that binge- eating patients had significantly greater atrophy in the right ventral insula, striatum, and orbitofrontal cortex.Conclusion: Binge eating can occur despite reported satiety and is associated with damage to a right- sided orbitofrontal- insular- striatal circuit in humans. These findings support a model in which ventral insular and orbitofrontal cortices serve as higher- order gustatory regions and cooperate with the striatum to guide appropriate feeding responses.