title: Depression-Related Increases and Decreases in Appetite: Dissociable Patterns of Aberrant Activity in Reward and Interoceptive Neurocircuitry.
abstract: OBJECTIVE
  Appetite and weight changes are common but variable diagnostic markers in major depressive disorder: some depressed individuals manifest increased appetite, while others lose their appetite. Many of the brain regions implicated in appetitive responses to food have also been implicated in depression. It is thus remarkable that there exists no published research comparing the neural responses to food stimuli of depressed patients with increased versus decreased appetites.
  
  
  METHODS
  Using functional MRI, brain activity was compared in unmedicated depressed patients with increased or decreased appetite and healthy control subjects while viewing photographs of food and nonfood objects. The authors also measured how resting-state functional connectivity related to subjects' food pleasantness ratings.
  
  
  RESULTS
  Within putative reward regions, depressed participants with increased appetites exhibited greater hemodynamic activity to food stimuli than both those reporting appetite decreases and healthy control subjects. In contrast, depressed subjects experiencing appetite loss exhibited hypoactivation within a region of the mid-insula implicated in interoception, with no difference observed in this region between healthy subjects and those with depression-related appetite increases. Mid-insula activity was negatively correlated with food pleasantness ratings of depressed participants with increased appetites, and its functional connectivity to reward circuitry was positively correlated with food pleasantness ratings.
  
  
  CONCLUSIONS
  Depression-related increases in appetite are associated with hyperactivation of putative mesocorticolimbic reward circuitry, while depression-related appetite loss is associated with hypoactivation of insular regions that support monitoring the body's physiological state. Importantly, the interactions among these regions also contribute to individual differences in the depression-related appetite changes.
authors.affiliation: From the Laureate Institute for Brain Research, Tulsa, Okla.; the Faculty of Community Medicine, The University of Tulsa, Tulsa, Okla.; the Department of Psychology, The University of Tulsa, Tulsa, Okla.; the College of Engineering, The University of Oklahoma, Tulsa, Okla.; the Center for Health Behavior Neuroscience, Kansas University Medical Center, Kansas City, Kans.; and Janssen Pharmaceuticals, LLC., of Johnson & Johnson, Inc., Titusville, N.J.
authors.forename: W Kyle
authors.initials: WK
authors.lastname: Simmons
authors.affiliation: From the Laureate Institute for Brain Research, Tulsa, Okla.; the Faculty of Community Medicine, The University of Tulsa, Tulsa, Okla.; the Department of Psychology, The University of Tulsa, Tulsa, Okla.; the College of Engineering, The University of Oklahoma, Tulsa, Okla.; the Center for Health Behavior Neuroscience, Kansas University Medical Center, Kansas City, Kans.; and Janssen Pharmaceuticals, LLC., of Johnson & Johnson, Inc., Titusville, N.J.
authors.forename: Kaiping
authors.initials: K
authors.lastname: Burrows
authors.affiliation: From the Laureate Institute for Brain Research, Tulsa, Okla.; the Faculty of Community Medicine, The University of Tulsa, Tulsa, Okla.; the Department of Psychology, The University of Tulsa, Tulsa, Okla.; the College of Engineering, The University of Oklahoma, Tulsa, Okla.; the Center for Health Behavior Neuroscience, Kansas University Medical Center, Kansas City, Kans.; and Janssen Pharmaceuticals, LLC., of Johnson & Johnson, Inc., Titusville, N.J.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Avery
authors.affiliation: From the Laureate Institute for Brain Research, Tulsa, Okla.; the Faculty of Community Medicine, The University of Tulsa, Tulsa, Okla.; the Department of Psychology, The University of Tulsa, Tulsa, Okla.; the College of Engineering, The University of Oklahoma, Tulsa, Okla.; the Center for Health Behavior Neuroscience, Kansas University Medical Center, Kansas City, Kans.; and Janssen Pharmaceuticals, LLC., of Johnson & Johnson, Inc., Titusville, N.J.
authors.forename: Kara L
authors.initials: KL
authors.lastname: Kerr
authors.affiliation: From the Laureate Institute for Brain Research, Tulsa, Okla.; the Faculty of Community Medicine, The University of Tulsa, Tulsa, Okla.; the Department of Psychology, The University of Tulsa, Tulsa, Okla.; the College of Engineering, The University of Oklahoma, Tulsa, Okla.; the Center for Health Behavior Neuroscience, Kansas University Medical Center, Kansas City, Kans.; and Janssen Pharmaceuticals, LLC., of Johnson & Johnson, Inc., Titusville, N.J.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Bodurka
authors.affiliation: From the Laureate Institute for Brain Research, Tulsa, Okla.; the Faculty of Community Medicine, The University of Tulsa, Tulsa, Okla.; the Department of Psychology, The University of Tulsa, Tulsa, Okla.; the College of Engineering, The University of Oklahoma, Tulsa, Okla.; the Center for Health Behavior Neuroscience, Kansas University Medical Center, Kansas City, Kans.; and Janssen Pharmaceuticals, LLC., of Johnson & Johnson, Inc., Titusville, N.J.
authors.forename: Cary R
authors.initials: CR
authors.lastname: Savage
authors.affiliation: From the Laureate Institute for Brain Research, Tulsa, Okla.; the Faculty of Community Medicine, The University of Tulsa, Tulsa, Okla.; the Department of Psychology, The University of Tulsa, Tulsa, Okla.; the College of Engineering, The University of Oklahoma, Tulsa, Okla.; the Center for Health Behavior Neuroscience, Kansas University Medical Center, Kansas City, Kans.; and Janssen Pharmaceuticals, LLC., of Johnson & Johnson, Inc., Titusville, N.J.
authors.forename: Wayne C
authors.initials: WC
authors.lastname: Drevets
mesh_terms: D000328:Adult; D000679:Amygdala / Q000503:physiopathology; D000855:Anorexia / Q000150:complications / Q000503:physiopathology*; D001066:Appetite / Q000502:physiology*; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000503:physiopathology; D003865:Major Depressive Disorder / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005502:Food; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology; D010775:Photic Stimulation; D017397:Prefrontal Cortex / Q000503:physiopathology; D012201:Reward; D055815:Young Adult