Abstract
Obesity is one of the most challenging problems in human health and is recognized as an important risk factor for many chronic diseases. It remains unclear how the neural systems (e.g., the mesolimbic “reward” and the prefrontal “control” neural systems) are correlated with patients’ executive function (EF), conceptualized as the integration of “cool” EF and “hot” EF. “Cool” EF refers to relatively abstract, non-affective operations such as inhibitory control and mental flexibility. “Hot” EF refers to motivationally significant affective operations such as affective decision-making. We tried to find the correlation between structural and functional neuroimaging indices and EF in obese patients. The study population comprised seventeen patients with obesity (seven males and 10 females, BMI = 37.99 ± 5.40, age = 31.82 ± 8.75 year-old) preparing to undergo bariatric surgery. We used noninvasive diffusion tensor imaging, generalized q-sampling imaging, and resting-state functional magnetic resonance imaging to examine the neural correlations between structural and functional neuroimaging indices and EF performances in patients with obesity. We reported that many brain areas are correlated to the patients’ EF performances. More interestingly, some correlations may implicate the possible associations of EF and the incentive motivational effects of food. The neural correlation between the left precuneus and middle occipital gyrus and inhibitory control may suggest that patients with a better ability to detect appetitive food may have worse inhibitory control. Also, the neural correlation between the superior frontal blade and affective decision-making may suggest that patients’ affective decision-making may be associated with the incentive motivational effects of food. Our results provide evidence suggesting neural correlates of EF in patients with obesity.
Highlights
The prevalence of being overweight (BMI ! 25 kg/m2) and obesity (BMI ! 30 kg/m2) has more than doubled during the last three decades (WHO, 2016)
We examined the correlations between the indices of structural and functional neuroimaging and executive function (EF) performances in the patients with obesity
There were no significant correlations between the color trails test (CTT) score and the fractional anisotropy (FA), radial diffusivity (RD), and mean diffusivity (MD)
Summary
The prevalence of being overweight (BMI ! 25 kg/m2) and obesity (BMI ! 30 kg/m2) has more than doubled during the last three decades (WHO, 2016). The functional connectivity strength of the putamen in the reward network (Kenny, 2011) was increased in the obese patients (Garcıa-Garcıa et al, 2013; Machann et al, 2013), whereas the caudate nucleus showed elevated task-related (viewing appetizing foods) functional connectivity with the amygdala and insula (Nummenmaa et al, 2012). Patients with obesity show atrophy in the frontal lobes, anterior cingulate cortex (ACC), hippocampus, and thalamus, in comparison to people with normal-weights (Garcıa-Garcıa et al, 2015; Raji et al, 2010). A recent review study (Carnell et al, 2012) suggests various impaired brain structures and functions in patients with obesity in reward (e.g., striatum, orbitofrontal cortex, and insula) and cognitive control and attention (e.g., PFC and ACC)
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