Impact of cognitive function on weight management outcomes in adolescents (I-CAN)

 描述（由申请人提供）：儿童期超重和肥胖是一种流行病，影响超过30%的儿童和青少年，对中枢和自主神经系统产生病理影响。儿童期肥胖与成年期心血管疾病（CVD）的风险因素相关，包括血压升高、血脂异常、代谢综合征和2型糖尿病。尽管对心血管健康有潜在的益处，但在体重管理试验的背景下，谁采取行为改变仍然存在显着的异质性。神经认知功能认知功能和功能和结构脑形态是一个关键因素有关的减肥成果。在5年的时间里，将从匹兹堡大学招募176名肥胖且无并发症的青少年和88名体重正常的青少年，参加为期6个月的最佳实践，基于证据的干预-健康习惯4生活。本研究的总体目标是：（1）证明单纯性肥胖青少年表现出认知、任务诱发的功能性脑活动，以及大脑中灰质和白色物质结构缺陷。 与对照组相比，额叶-纹状体系统支持抑制和奖励;（2）测试干预期间基线认知功能与体重减轻之间的关系;（3）为接受体重减轻干预的青少年制定从基线到6个月和12个月的基于组的脑功能轨迹，以描绘大脑轮廓以及这些轮廓如何影响体重管理结果。这些关于认知功能对体重管理结果影响的信息可能是定制干预措施的重要一步（例如，治疗靶点、功能磁共振成像生物反馈、药物治疗）以及改善儿童肥胖和心血管疾病的护理。

 DESCRIPTION (provided by applicant): Childhood overweight and obesity is at epidemic proportions affecting over 30% of children and adolescents with pathologic effects on the central and autonomic nervous systems. Childhood obesity is associated with risk factors into adulthood for cardiovascular disease (CVD), including elevated blood pressure, dyslipidemia, metabolic syndrome, and type 2 diabetes mellitus. Despite the potential benefit for cardiovascular health, there remains significant heterogeneity in who adopts behavior changes in the context of a weight management trial. Neurocognitive functioning-cognitive function and functional and structural brain morphology-is a key factor related to weight loss outcomes. Over a 5 year period, 176 youth who are obese with no co-occurring medical conditions and 88 youth who are normal weight will be recruited from The University of Pittsburgh to participate in a best practice, 6-month, evidence based intervention-Healthy Habits 4 Life. The overarching goals of this study are to: (1) Document that adolescents with uncomplicated obesity exhibit cognitive, task- evoked functional brain activity, and gray and white matter structural deficits in frontal-striatal systems supporting inhibition and reward compared to a control group; (2) Test the relationship between baseline cognitive function and weight loss during an intervention; and (3) Develop group-based trajectories of brain function from baseline to 6- and 12-months for youth who underwent the weight loss intervention to delineate brain profiles and how these profiles affect weight management outcomes. Such information about the impact of cognitive function on weight management outcomes could be a significant step in tailoring interventions (e.g., therapeutic targets, fMRI biofeedback, pharmacotherapy) and improving care for childhood obesity and cardiovascular disease.