Neural correlates of stress- and food cue-induced food craving in obesity: association with insulin levels.
Neural correlates of stress- and food cue-induced food craving in obesity: association with insulin levels.
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DOI：
10.2337/dc12-1112
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发表时间：
2013-02
期刊：
影响因子：
16.2
通讯作者：
Potenza MN
中科院分区：
文献类型：
--
作者：
Jastreboff AM;Sinha R;Lacadie C;Small DM;Sherwin RS;Potenza MN
肥胖与大脑皮质边缘-纹状体区域的改变有关，这些区域涉及食物的动机和奖励。压力和食物暗示的存在都可能刺激进食，并参与皮质边缘-纹状体神经回路。目前尚不清楚这些因素如何相互作用来影响大脑反应，以及这些相互作用是否受到肥胖、胰岛素水平和胰岛素敏感性的影响。我们假设，肥胖个体在暴露于压力和食物暗示后，会在皮质边缘-纹状体神经回路中表现出更大的反应，大脑激活将与主观的食物渴望、胰岛素水平和HOMA-IR相关。在功能磁共振成像中，对暴露在个性化压力和最喜欢的食物提示下的肥胖和消瘦受试者的空腹胰岛素水平进行了评估。肥胖但不瘦的个体在接触喜爱的食物和压力线索时，纹状体、岛状核和下丘脑区域的激活增加。在肥胖但不瘦的个体中，食物渴望、胰岛素和HOMA-IR水平与大脑皮质边缘-纹状体区域的神经活动在最喜欢的食物和压力提示期间呈正相关。肥胖个体的胰岛素抵抗和食物渴望之间的关系是通过纹状体、脑岛和丘脑等动机-奖励区域的活动来调节的。这些发现表明，肥胖而不是瘦的个体表现出对喜爱的食物和压力线索的反应增加了皮质边缘纹状体的激活，并且这些大脑反应在HOMA-IR和食物渴望之间的关系中起中介作用。改善胰岛素敏感性，进而降低皮质边缘-纹状体对食物暗示和压力的反应性，可能会减少对食物的渴望，并影响肥胖患者的饮食行为。
Obesity is associated with alterations in corticolimbic-striatal brain regions involved in food motivation and reward. Stress and the presence of food cues may each motivate eating and engage corticolimibic-striatal neurocircuitry. It is unknown how these factors interact to influence brain responses and whether these interactions are influenced by obesity, insulin levels, and insulin sensitivity. We hypothesized that obese individuals would show greater responses in corticolimbic-striatal neurocircuitry after exposure to stress and food cues and that brain activations would correlate with subjective food craving, insulin levels, and HOMA-IR. Fasting insulin levels were assessed in obese and lean subjects who were exposed to individualized stress and favorite-food cues during functional MRI. Obese, but not lean, individuals exhibited increased activation in striatal, insular, and hypothalamic regions during exposure to favorite-food and stress cues. In obese but not lean individuals, food craving, insulin, and HOMA-IR levels correlated positively with neural activity in corticolimbic-striatal brain regions during favorite-food and stress cues. The relationship between insulin resistance and food craving in obese individuals was mediated by activity in motivation-reward regions including the striatum, insula, and thalamus. These findings demonstrate that obese, but not lean, individuals exhibit increased corticolimbic-striatal activation in response to favorite-food and stress cues and that these brain responses mediate the relationship between HOMA-IR and food craving. Improving insulin sensitivity and in turn reducing corticolimbic-striatal reactivity to food cues and stress may diminish food craving and affect eating behavior in obesity.
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