Partial Reversibility of Hypothalamic Dysfunction and Changes in Brain Activity After Body Mass Reduction in Obese Subjects

• Published in: Diabetes (New York, N.Y.) Vol. 60; no. 6; pp. 1699 - 1704
• Main Authors: van de Sande-Lee, Simone, Pereira, Fabrício R.S., Cintra, Dennys E., Fernandes, Paula T., Cardoso, Adilson R., Garlipp, Célia R., Chaim, Eliton A., Pareja, Jose C., Geloneze, Bruno, Li, Li Min, Cendes, Fernando, Velloso, Licio A.
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.06.2011
• Subjects: Activity patterns; Adolescent; Adult; Antiinflammatory agents; Bariatric Surgery; Biological and medical sciences; Body fluids; Body mass; Body mass index; Brain; Brain - metabolism; Brain - physiology; Brain mapping; Brain research; Cerebrospinal fluid; Complications and side effects; Cytokines; Diabetes; Diabetes mellitus; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Functional magnetic resonance imaging; Gastrointestinal surgery; Glucose; Health aspects; Humans; Hypothalamus; Hypothalamus - metabolism; Hypothalamus - physiology; Hypothalamus - physiopathology; Inflammation; Interleukin 6; Interleukin-10 - cerebrospinal fluid; Interleukin-6 - cerebrospinal fluid; Magnetic Resonance Imaging; Male; Medical sciences; Metabolic diseases; Metabolism; Middle Aged; Obesity; Obesity - metabolism; Obesity - surgery; Obesity Studies; Patient outcomes; Patients; Physiological aspects; Promotion; Research design; Scanning; Surgery; Tumor necrosis factor-TNF; Young Adult; Brazil; Endocrinopathy; Human; Obesity; Dysfunction; Diabetes mellitus; Central nervous system; Nutrition disorder; Reversibility; Hypothalamus; Nutritional status; Encephalon
• ISSN: 0012-1797; 1939-327X; 1939-327X
• DOI: 10.2337/db10-1614

Inflammation and dysfunction of the hypothalamus are common features of experimental obesity. However, it is unknown whether obesity and massive loss of body mass can modify the immunologic status or the functional activity of the human brain. Therefore, the aim of this study was to determine the effect of body mass reduction on brain functionality. In humans, changes in hypothalamic activity after a meal or glucose intake can be detected by functional magnetic resonance imaging (fMRI). Distinct fMRI analytic methods have been developed to explore changes in the brain's activity in several physiologic and pathologic conditions. We used two analytic methods of fMRI to explore the changes in the brain activity after body mass reduction. Obese patients present distinct functional activity patterns in selected brain regions compared with lean subjects. On massive loss of body mass, after bariatric surgery, increases in the cerebrospinal fluid (CSF) concentrations of interleukin (IL)-10 and IL-6 are accompanied by changes in fMRI patterns, particularly in the hypothalamus. Massive reduction of body mass promotes a partial reversal of hypothalamic dysfunction and increases anti-inflammatory activity in the CSF.