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Neuronal correlates of appetite regulation in patients with schizophrenia: Is there a basis for future appetite dysfunction?

Published online by Cambridge University Press:  15 April 2020

O. Lungu
Affiliation:
Departement de psychiatrie, Université de Montréal, Montréal, Québec, Canada C.H.U.M and Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
K. Anselmo
Affiliation:
Departement de psychiatrie, Université de Montréal, Montréal, Québec, Canada Centre de recherche Fernand-Seguin, affilié à l'université de Montréal, 7401 Hochelaga, H1N 3V2, Montréal, Québec, Canada
G. Letourneau
Affiliation:
Departement de psychiatrie, Université de Montréal, Montréal, Québec, Canada Centre de recherche Fernand-Seguin, affilié à l'université de Montréal, 7401 Hochelaga, H1N 3V2, Montréal, Québec, Canada
A. Mendrek
Affiliation:
Departement de psychiatrie, Université de Montréal, Montréal, Québec, Canada Centre de recherche Fernand-Seguin, affilié à l'université de Montréal, 7401 Hochelaga, H1N 3V2, Montréal, Québec, Canada
B. Stip
Affiliation:
École polytechnique de Montréal, Montréal, Québec, Canada
O. Lipp
Affiliation:
Departement de psychiatrie, Université de Montréal, Montréal, Québec, Canada Centre de recherche Fernand-Seguin, affilié à l'université de Montréal, 7401 Hochelaga, H1N 3V2, Montréal, Québec, Canada
P. Lalonde
Affiliation:
Departement de psychiatrie, Université de Montréal, Montréal, Québec, Canada Centre de recherche Fernand-Seguin, affilié à l'université de Montréal, 7401 Hochelaga, H1N 3V2, Montréal, Québec, Canada
L. Ait Bentaleb
Affiliation:
Departement de psychiatrie, Université de Montréal, Montréal, Québec, Canada Centre de recherche Fernand-Seguin, affilié à l'université de Montréal, 7401 Hochelaga, H1N 3V2, Montréal, Québec, Canada
E. Stip*
Affiliation:
Departement de psychiatrie, Université de Montréal, Montréal, Québec, Canada Centre de recherche Fernand-Seguin, affilié à l'université de Montréal, 7401 Hochelaga, H1N 3V2, Montréal, Québec, Canada
*
Corresponding author. E-mail address:emmanuel.stip@umontreal.ca (E. Stip).
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Abstract:

Background

Given the undesired metabolic side effects of atypical antipsychotic medication it is important to understand the neuronal basis related to processing of appetite regulation in patients affected by schizophrenia.

Methods:

Here we used functional magnetic resonance imaging (fMRI) to assess brain activity in response to food cues and neutral stimuli in twenty patients with schizophrenia and eleven healthy individuals. In addition to clinical and dietary habits assessments, we collected, in patients, measurements of fasting glucose, ghrelin, leptin, insulin, prolactin and lipids blood concentration and we correlated the cerebral activity with clinical and metabolic measures.

Results:

Both groups engaged a common neuronal network while processing food cues, which included the left insula, primary sensorimotor areas, and inferior temporal and parietal cortices. Cerebral responses to appetitive stimuli in thalamus, parahippocampus and middle frontal gyri were specific only to schizophrenic patients, with parahippocampal activity related to hunger state and increasing linearly over time. Antipsychotic medication dosage correlated positively with a cognitive measure reflecting food cravings, whereas the severity of the disease correlated negatively with a cognitive measure indicating dietary restraint in eating habits. These cognitive variables correlated, in turn, with parahippocampal and thalamic neuronal activities, respectively.

Conclusions:

We identified a specific neural substrate underlying cognitive processing of appetitive stimuli in schizophrenia, which may contribute to appetite dysfunction via perturbations in processing of homeostatic signals in relation to external stimuli. Our results also suggest that both antipsychotic medication and the disease severity per se could amplify these effects, via different mechanisms and neuronal networks.

Type
Original article
Copyright
Copyright © European Psychiatric Association

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