Importance of Brain Reward Regions in Adults with Acquired Structural Hypothalamic Damage: A Functional Neuroimaging Study
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Importance of Brain Reward Regions in Adults with Acquired Structural Hypothalamic Damage:
A Functional Neuroimaging Study
CA Steele1, J Powell2, IA Macfarlane1, JCG Halford3, JPH Wilding1, JA Harrold3, DJ Cuthbertson1, K Das4, M Javadpour4, GJ Kemp2, AStancak3 & C Daousi1
1Department of Obesity & Endocrinology, University Hospital Aintree, Liverpool, 2Magnetic Resonance and Image Analysis Research Centre (MARIARC), University of Liverpool, 3Department of Experimental Psychology, University of Liverpool, 4Departments of Neuroradiology and Neurosurgery, The Walton Centre for Neurology & Neurosurgery, Liverpool.
Introduction: The hypothalamus is the critical brain region processing internal (homeostatic) appetitive signals. Tumours damaging it often result in hypothalamic obesity (HO).
Objective: Using functional MRI scanning we assessed the influence of non-homeostatic (e.g./ reward, emotional) brain-regions in HO and hypothalamic weight-stable (HWS) patients and non-obese (NOC) and
obese controls (OC).
Results: Viewing high-
calorie food photographs
resulted in significantly
lower activation in the
insula and lingual gyrus in
HWS than all other groups.
activation in these reward-
related regions may protect
HWS patients from weight-
gain. These may be
important regions in the
pathophysiology of obesity
in the general population.
Weight gain and obesity are common, distressing
long-term sequelae of hypothalamic damage secondary to tumours
affecting this brain region.
The hypothalamus is the critical centre regulating internal (homeostatic)
factors affecting appetite and eating. Other areas (e.g./ cortical brain regions) process
non-homeostatic environmental, rewarding effects of food. The interactions between
them remain poorly understood.
fMRI (functional MRI) has been used to explore brain regions involved in regulating
appetite and eating in other groups (e.g./ obese, anorexia).
By studying patients with damage to the hypothalamus (homeostatic regulator), we
could explore the influence of reward-related non-homeostatic areas working in it’s absence.
We hypothesised that reward-related brain regions may assume a more dominant role
in appetite control in hypothalamic obesity (HO) than in those
with hypothalamic damage remaining
Figure 1. fMRI photo protocol.