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Clinical Studies and Practice

Deactivation of the left dorsolateral prefrontal cortex in Prader–Willi syndrome after meal consumption

International Journal of Obesity volume 40, pages 1360–1368 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

Prader–Willi syndrome (PWS) is a type of human genetic obesity that may give us information regarding the physiology of non-syndromic obesity. The objective of this study was to investigate the functional correlates of hunger and satiety in individuals with PWS in comparison with healthy controls with obesity, hypothesizing that we would see significant differences in activation in the left dorsolateral prefrontal cortex (DLPFC) based on prior findings.

Subjects/Methods:

This study compared the central effects of food consumption in nine individuals with PWS (7 men, 2 women; body fat 35.3±10.0%) and seven controls (7 men; body fat 28.8±7.6%), matched for percentage body fat. H215O-PET (positron emission tomography) scans were performed before and after consumption of a standardized liquid meal to obtain quantitative measures of regional cerebral blood flow (rCBF), a marker of neuronal activity.

Results:

Compared with obese controls, PWS showed altered (P<0.05 family-wise error cluster-level corrected; voxelwise P<0.001) rCBF before and after meal consumption in multiple brain regions. There was a significant differential rCBF response within the left DLPFC after meal ingestion with decreases in DLPFC rCBF in PWS; in controls, DLPFC rCBF tended to remain unchanged. In more liberal analyses (P<0.05 family-wise error cluster-level corrected; voxelwise P<0.005), rCBF of the right orbitofrontal cortex (OFC) increased in PWS and decreased in controls. In PWS, ΔrCBF of the right OFC was associated with changes in appetite ratings.

Conclusions:

The pathophysiology of eating behavior in PWS is characterized by a paradoxical meal-induced deactivation of the left DLPFC and activation in the right OFC, brain regions implicated in the central regulation of eating behavior.

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Acknowledgements

We thank the dietary, nursing and technical staff of the National Institutes of Health Clinical Unit in Phoenix, AZ, for their assistance. Most of all, the we thank the volunteers for their participation in the study. This research was supported by the Intramural Research Program of the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

Author contributions

MR and CMW wrote the manuscript and analyzed the data. KC and PT helped analyzing the data. MGH analyzed parts of the data. ADP was principally involved in designing the study and collected the data. MR, ADP, KC, EMR, PT, JK, MGH, DSNTL and CMW contributed to the interpretations of findings and commented on and edited the drafts. JK is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Department of Health and Human Services, Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA

    M Reinhardt, J Krakoff, M G Hohenadel, D S N T Le & C M Weise

  2. Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany

    M Reinhardt

  3. Department of Nutrition Sciences, Drexel University, Philadelphia, PA, USA

    A D Parigi

  4. Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, USA

    A D Parigi

  5. Banner Alzheimer’s Institute, Phoenix, AZ, USA

    K Chen, E M Reiman & P Thiyyagura

  6. Neurogenomics Division, Translational Genomics Research Institute, University of Arizona, and Arizona State University, Phoenix, AZ, USA

    E M Reiman

  7. Department of Neurology, University of Leipzig, Leipzig, Germany

    C M Weise

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  1. M Reinhardt
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Correspondence to M Reinhardt.

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Reinhardt, M., Parigi, A., Chen, K. et al. Deactivation of the left dorsolateral prefrontal cortex in Prader–Willi syndrome after meal consumption. Int J Obes 40, 1360–1368 (2016). https://doi.org/10.1038/ijo.2016.75

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