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Int J Obes (Lond). 2019 Apr;43(4):842-851. doi: 10.1038/s41366-018-0126-x. Epub 2018 Jun 18.

Ghrelin reductions following bariatric surgery were associated with decreased resting state activity in the hippocampus.

Author information

1
Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China. yizhang@xidian.edu.cn.
2
Xijing Gastrointestinal Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China. yongznie@fmmu.edu.cn.
3
Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China.
4
College of Mechanical and Electronic Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China.
5
Department of Psychology, Southwest University, Chongqing, 400715, China.
6
Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, 710038, China.
7
Depart of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
8
Xijing Gastrointestinal Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
9
Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.
10
Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA.
11
Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA. gene-jack.wang@nih.gov.

Abstract

BACKGROUND/OBJECTIVE:

Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric surgery to treat obesity, and involves removal of the gastric fundus where ghrelin is mainly produced. Ghrelin stimulates appetite and regulates food intake through its effect on the hypothalamus and hippocampus (HIPP). While ghrelin's role on the hypothalamus has been explored, little is known about its role on HIPP. We tested the hypothesis that LSG-induced reductions in ghrelin levels would be associated with changes in HIPP activity.

SUBJECTS/METHODS:

Brain activity was measured with amplitude of low-frequency fluctuations (ALFF) captured with resting-state functional magnetic resonance imaging (fMRI) in 30 obese participants, both before and after 1-month of LSG, and in 26 obese controls without surgery that were studied at baseline and 1-month later. A two-way analysis of variance (ANOVA) was performed to model the group and time effects on ALFF and resting-state functional connectivity.

RESULTS:

One-month post-LSG there were significant decreases in appetite, body mass index (BMI), fasting plasma ghrelin and leptin levels, anxiety, and ALFF in HIPP and ALFF increases in posterior cingulate cortex (PCC, PFWE < 0.05). Decreases in HIPP ALFF correlated positively with decreases in fasting ghrelin and anxiety, and increases in PCC ALFF correlated positively with decreases in anxiety. Seed-voxel correlation analysis showed stronger connectivity between HIPP and insula, and between PCC and dorsolateral prefrontal cortex (DLPFC) post-LSG.

CONCLUSIONS:

These findings suggest that ghrelin effects in HIPP modulate connectivity with the insula, which processes interoception and might be relevant to LSG-induced reductions in appetite/anxiety. Role of LSG in PCC and its enhanced connectivity with DLPFC in improving self-regulation following LSG requires further investigation.

PMID:
29915363
DOI:
10.1038/s41366-018-0126-x

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