Functional neuroimaging in craniopharyngioma: a useful tool to better understand hypothalamic obesity?
OBJECTIVE
To use functional magnetic resonance imaging (fMRI) in craniopharyngioma (CP) patients to examine the hypothesis that hypothalamic damage due to CP and its treatment results in enhanced perception of food reward and/or impaired central satiety processing.


METHODS
Pre- and post-meal responses to visual food cues in brain regions of interest (ROI; bilateral nucleus accumbens, bilateral insula, and medial orbitofrontal cortex) were assessed in 4 CP patients versus 4 age- and weight-matched controls. Stimuli consisted of images of high- ('fattening') and low-calorie ('non-fattening') foods in blocks, alternating with non-food object blocks. After the first fMRI scan, subjects drank a high-calorie test meal to suppress appetite, then completed a second fMRI scan. Within each ROI, we calculated mean z-scores for activation by fattening as compared to non-fattening food images.


RESULTS
Following the test meal, controls showed suppression of activation by food cues while CP patients showed trends towards higher activation.


CONCLUSIONS
These data, albeit in a small group of patients, support our hypothesis that perception of food cues may be altered in hypothalamic obesity (HO), especially after eating, i.e. in the satiated state. The fMRI approach is encouraging for performing future mechanistic studies of the brain response to food cues and satiety in patients with hypothalamic or other forms of childhood obesity.
Seattle Children's Research Institute, Center of Integrative Brain Research, University of Washington, Seattle, WA, USA.
Christian L
CL
Roth
Elizabeth
E
Aylward
Olivia
O
Liang
Natalia M
NM
Kleinhans
Gregory
G
Pauley
Ellen A
EA
Schur
D000293:Adolescent; D001069:Appetite Regulation / Q000502:physiology; D016022:Case-Control Studies; D003397:Craniopharyngioma / Q000503:physiopathology / Q000523:psychology*; D003463:Cues; D004032:Diet / Q000523:psychology*; D002149:Energy Intake / Q000502:physiology; D005260:Female; D059907:Functional Neuroimaging / Q000379:methods; D006801:Humans; D008297:Male; D062407:Meals / Q000502:physiology; D009765:Obesity / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D010465:Perception / Q000502:physiology*; D010911:Pituitary Neoplasms / Q000503:physiopathology / Q000523:psychology*; D012201:Reward; D012527:Satiation / Q000502:physiology*