title: Decreased insular and increased midbrain activations during decision-making under risk in adolescents with excess weight.
abstract: OBJECTIVE
  Functional magnetic resonance imaging (fMRI) was used to explore the brain substrates of decisions under risk in excess weight adolescents. Decreased activations of the brain regions signaling risk (orbitofrontal cortex [OFC], insula) were expected during anticipation of higher rewards and increased activations of the brain regions involved in reward processing (OFC, striatum) were expected after reward receipt in excess weight adolescents compared to normal weight controls.
  
  
  METHODS
  Fifty-two adolescents (age range 12-17), classified in three groups as a function of BMI: obese (n = 21), overweight (n = 15), or normal weight (n = 16) performed the Risky-Gains task as described by Paulus et al. in the fMRI scanner.
  
  
  RESULTS
  Excess weight adolescents, compared to normal weight controls, showed decreased left insular and increased midbrain activations during anticipation of risky choices. In addition, excess weight adolescents showed increased activations of the inferior frontal gyrus, parahippocampus, thalamus, and posterior brain regions after reward receipt.
  
  
  CONCLUSIONS
  Adolescents with excess weight showed reduced activations in brain regions signaling risk and increased activations in regions signaling reward during anticipation of decisions involving risk and reward. In addition, post-decision reward outcomes produced increased activations of regions involved in emotional salience in excess weight adolescents versus controls.
authors.affiliation: Department of Personality, Evaluation and Psychological Treatment, University of Granada, Granada, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Delgado-Rico
authors.forename: Carles
authors.initials: C
authors.lastname: Soriano-Mas
authors.forename: Juan
authors.initials: J
authors.lastname: Verdejo-Román
authors.forename: Jacqueline S
authors.initials: JS
authors.lastname: Río-Valle
authors.forename: Antonio
authors.initials: A
authors.lastname: Verdejo-García
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002540:Cerebral Cortex / Q000502:physiology*; D002648:Child; D003342:Corpus Striatum / Q000502:physiology; D003657:Decision Making / Q000502:physiology*; D005260:Female; D005625:Frontal Lobe / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000502:physiology*; D009765:Obesity / Q000503:physiopathology*; D050177:Overweight / Q000503:physiopathology*; D012201:Reward; D012309:Risk-Taking