title: Lorcaserin Administration Decreases Activation of Brain Centers in Response to Food Cues and These Emotion- and Salience-Related Changes Correlate With Weight Loss Effects: A 4-Week-Long Randomized, Placebo-Controlled, Double-Blind Clinical Trial.
abstract: Lorcaserin is a serotonin 5-hydroxytryptamine 2c receptor agonist effective in treating obesity. Studies in rodents have shown that lorcaserin acts in the brain to exert its weight-reducing effects, but this has not yet been studied in humans. We performed a randomized, placebo-controlled, double-blind trial with 48 obese participants and used functional MRI to study the effects of lorcaserin on the brain. Subjects taking lorcaserin had decreased brain activations in the attention-related parietal and visual cortices in response to highly palatable food cues at 1 week in the fasting state and in the parietal cortex in response to any food cues at 4 weeks in the fed state. Decreases in emotion- and salience-related limbic activity, including the insula and amygdala, were attenuated at 4 weeks. Decreases in caloric intake, weight, and BMI correlated with activations in the amygdala, parietal, and visual cortices at baseline. These data suggest that lorcaserin exerts its weight-reducing effects by decreasing attention-related brain activations to food cues (parietal and visual cortices) and emotional and limbic activity (insula, amygdala). Results indicating that baseline activation of the amygdala relates to increased efficacy suggest that lorcaserin would be of particular benefit to emotional eaters.
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Olivia M
authors.initials: OM
authors.lastname: Farr
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Jagriti
authors.initials: J
authors.lastname: Upadhyay
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Anna
authors.initials: A
authors.lastname: Gavrieli
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Camp
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Spyrou
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Harper
authors.initials: H
authors.lastname: Kaye
authors.affiliation: Boston University Medical Center, Boston, MA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Mathew
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Maria
authors.initials: M
authors.lastname: Vamvini
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Koniaris
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Holly
authors.initials: H
authors.lastname: Kilim
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Srnka
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Migdal
authors.affiliation: Division of Endocrinology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA ofarr@bidmc.harvard.edu.
authors.forename: Christos S
authors.initials: CS
authors.lastname: Mantzoros
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D001921:Brain / Q000187:drug effects* / Q000502:physiology*; D003463:Cues; D004311:Double-Blind Method; D004644:Emotions / Q000502:physiology; D002149:Energy Intake; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy / Q000503:physiopathology; D015431:Weight Loss / Q000187:drug effects
chemical_list: D019440:Anti-Obesity Agents; D001552:Benzazepines; C506658:lorcaserin