title: Prolonged fasting impairs neural reactivity to visual stimulation.
abstract: Previous literature has shown that hypoglycemia influences the intensity of the BOLD signal. A similar but smaller effect may also be elicited by low normal blood glucose levels in healthy individuals. This may not only confound the BOLD signal measured in fMRI, but also more generally interact with cognitive processing, and thus indirectly influence fMRI results. Here we show in a placebo-controlled, crossover, double-blind study on 40 healthy subjects, that overnight fasting and low normal levels of glucose contrasted to an activated, elevated glucose condition have an impact on brain activation during basal visual stimulation. Additionally, functional connectivity of the visual cortex shows a strengthened association with higher-order attention-related brain areas in an elevated blood glucose condition compared to the fasting condition. In a fasting state visual brain areas show stronger coupling to the inferior temporal gyrus. Results demonstrate that prolonged overnight fasting leads to a diminished BOLD signal in higher-order occipital processing areas when compared to an elevated blood glucose condition. Additionally, functional connectivity patterns underscore the modulatory influence of fasting on visual brain networks. Patterns of brain activation and functional connectivity associated with a broad range of attentional processes are affected by maturation and aging and associated with psychiatric disease and intoxication. Thus, we conclude that prolonged fasting may decrease fMRI design sensitivity in any task involving attentional processes when fasting status or blood glucose is not controlled.
authors.affiliation: JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany. nils.kohn@gmx.net.|Institute of Neuroscience and Medicine (INM-6), Jülich Research Centre, 52425, Jülich, Germany. nils.kohn@gmx.net.
authors.forename: N
authors.initials: N
authors.lastname: Kohn
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Wassenberg
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|Department of Biology, RWTH Aachen University, 52074, Aachen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Toygar
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Kellermann
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Weidenfeld
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Berthold-Losleben
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Chechko
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Orfanos
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Vocke
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|Department of Psychiatry and Psychotherapy, University of Düsseldorf, Bergische Landstrasse 2, 40629, Düsseldorf, Germany.
authors.forename: Z G
authors.initials: ZG
authors.lastname: Laoutidis
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Schneider
authors.affiliation: Division of Endocrinology and Diabetes, Medical Faculty, RWTH Aachen University, 52074, Aachen, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Karges
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, 52074, Aachen, Germany.|JARA Brain, Translational Brain Medicine, Julich, Aachen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Habel
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001921:Brain / Q000502:physiology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004837:Epinephrine / Q000097:blood; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D008297:Male; D009638:Norepinephrine / Q000097:blood; D010775:Photic Stimulation; D013702:Temporal Lobe / Q000502:physiology; D014793:Visual Cortex / Q000502:physiology; D014796:Visual Perception / Q000502:physiology*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine
keywords: Adrenaline; Arousal; Blood glucose; Checker board; fMRI