title: Diabetes dietary management alters responses to food pictures in brain regions associated with motivation and emotion: a functional magnetic resonance imaging study.
abstract: OBJECTIVE
  We hypothesised that living with type 2 diabetes would enhance responses to pictures of foods in brain regions known to be involved in learnt food sensory motivation and that these stronger activations would relate to scores for dietary adherence in diabetes and to measures of potential difficulties in adherence.
  
  
  METHODS
  We compared brain responses to food images of 11 people with type 2 diabetes and 12 healthy control participants, matched for age and weight, using functional magnetic resonance imaging (fMRI).
  
  
  RESULTS
  Having type 2 diabetes increased responses to pictured foods in the insula, orbitofrontal cortex (OFC) and basal ganglia and, within these regions, the effect of the fat content of the foods was larger in participants with type 2 diabetes than in healthy controls. Furthermore, increased activation to food within the insula and OFC positively correlated with external eating, dietary self-efficacy and dietary self-care. In contrast, responses within subcortical structures (amygdala and basal ganglia) were positively correlated with emotional eating and rated appetite for the food stimuli and negatively correlated with dietary self-care.
  
  
  CONCLUSIONS
  Type 2 diabetes is associated with changes in brain responses to food that are modulated by dietary self-care. We propose that this is linked to the need to follow a life-long restrictive diet.
authors.affiliation: School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
authors.forename: M
authors.initials: M
authors.lastname: Chechlacz
authors.forename: P
authors.initials: P
authors.lastname: Rotshtein
authors.forename: S
authors.initials: S
authors.lastname: Klamer
authors.forename: K
authors.initials: K
authors.lastname: Porubská
authors.forename: S
authors.initials: S
authors.lastname: Higgs
authors.forename: D
authors.initials: D
authors.lastname: Booth
authors.forename: A
authors.initials: A
authors.lastname: Fritsche
authors.forename: H
authors.initials: H
authors.lastname: Preissl
authors.forename: H
authors.initials: H
authors.lastname: Abele
authors.forename: N
authors.initials: N
authors.lastname: Birbaumer
authors.forename: A
authors.initials: A
authors.lastname: Nouwen
mesh_terms: D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000033:anatomy & histology; D015992:Body Mass Index; D001921:Brain / Q000033:anatomy & histology* / Q000502:physiology*; D001931:Brain Mapping; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000523:psychology* / Q000534:rehabilitation; D003927:Diet, Diabetic / Q000523:psychology*; D004644:Emotions; D005502:Food; D005625:Frontal Lobe / Q000033:anatomy & histology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009042:Motivation; D010775:Photic Stimulation; D012016:Reference Values; D012648:Self Care; D011795:Surveys and Questionnaires
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin