PMID- 27293200 OWN - NLM STAT- MEDLINE DCOM- 20171030 LR - 20221207 IS - 1935-5548 (Electronic) IS - 0149-5992 (Linking) VI - 39 IP - 8 DP - 2016 Aug TI - Neuronal Food Reward Activity in Patients With Type 2 Diabetes With Improved Glycemic Control After Bariatric Surgery. PG - 1311-7 LID - 10.2337/dc16-0094 [doi] AB - OBJECTIVE: Obesity and type 2 diabetes mellitus (T2DM) are associated with altered food-related neuronal functions. Besides weight loss, substantial improvement of glucose metabolism in patients with T2DM can be achieved by bariatric surgery. We aimed to target the neuronal and behavioral correlates of improved glycemic control after bariatric surgery. RESEARCH DESIGN AND METHODS: Two patient groups with T2DM were recruited. The treatment group (n = 12) consisted of patients who had undergone Roux-en-Y gastric bypass (RYGB) surgery, and a control group consisted of patients who did not undergo surgery (n = 12). The groups were matched for age and current BMI. HbA1c was matched by using the presurgical HbA1c of the RYGB group and the current HbA1c of the nonsurgical group. Neuronal activation during a food reward task was measured using functional MRI (fMRI). Behavioral data were assessed through questionnaires. RESULTS: RYGB improved HbA1c from 7.07 +/- 0.50 to 5.70 +/- 0.16% (P < 0.05) and BMI from 52.21 +/- 1.90 to 35.71 +/- 0.84 kg/m(2) (P < 0.001). Behavioral results showed lower wanting and liking scores as well as lower eating behavior-related pathologies for the patients after RYGB than for similar obese subjects without surgery but with impaired glycemic control. The fMRI analysis showed higher activation for the nonsurgical group in areas associated with inhibition and reward as well as in the precuneus, a major connectivity hub in the brain. By contrast, patients after RYGB showed higher activation in the visual, motor, cognitive control, memory, and gustatory regions. CONCLUSIONS: In obese patients with diabetes, RYGB normalizes glycemic control and leads to food reward-related brain activation patterns that are different from those of obese patients with less-well-controlled T2DM and without bariatric surgery. The differences in food reward processing might be one factor in determining the outcome of bariatric surgery in patients with T2DM. CI - (c) 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. FAU - Frank, Sabine AU - Frank S AD - Institute for Medical Psychology and Behavioural Neurobiology, University of Tubingen, Tubingen, Germany. FAU - Heinze, Jaana M AU - Heinze JM AD - Department of Internal Medicine IV, University Hospital, Tubingen, Germany German Center for Diabetes Research, Munchen-Neuherberg, Germany. FAU - Fritsche, Andreas AU - Fritsche A AD - Department of Internal Medicine IV, University Hospital, Tubingen, Germany German Center for Diabetes Research, Munchen-Neuherberg, Germany andreas.fritsche@med.uni-tuebingen.de. FAU - Linder, Katarzyna AU - Linder K AD - Department of Internal Medicine IV, University Hospital, Tubingen, Germany German Center for Diabetes Research, Munchen-Neuherberg, Germany. FAU - von Feilitzsch, Maximilian AU - von Feilitzsch M AD - Department of General, Visceral and Transplant Surgery, University Hospital, Tubingen, Germany. FAU - Konigsrainer, Alfred AU - Konigsrainer A AD - Department of General, Visceral and Transplant Surgery, University Hospital, Tubingen, Germany. FAU - Haring, Hans-Ulrich AU - Haring HU AD - Department of Internal Medicine IV, University Hospital, Tubingen, Germany German Center for Diabetes Research, Munchen-Neuherberg, Germany. FAU - Veit, Ralf AU - Veit R AD - Institute for Medical Psychology and Behavioural Neurobiology, University of Tubingen, Tubingen, Germany Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, University of Tubingen, Tubingen, Germany German Center for Diabetes Research, Munchen-Neuherberg, Germany. FAU - Preissl, Hubert AU - Preissl H AD - Department of Internal Medicine IV, University Hospital, Tubingen, Germany German Center for Diabetes Research, Munchen-Neuherberg, Germany Department of Pharmacy and Biochemistry, Faculty of Science, University of Tubingen, Tubingen, Germany. LA - eng SI - ClinicalTrials.gov/NCT01900483 PT - Journal Article DEP - 20160612 PL - United States TA - Diabetes Care JT - Diabetes care JID - 7805975 RN - 0 (Blood Glucose) RN - 0 (Glycated Hemoglobin A) SB - IM MH - Blood Glucose/*metabolism MH - Body Mass Index MH - Brain/diagnostic imaging/*physiology MH - Case-Control Studies MH - Cross-Sectional Studies MH - Diabetes Mellitus, Type 2/blood/*surgery MH - Eating MH - Female MH - *Gastric Bypass MH - Glycated Hemoglobin/metabolism MH - *Health Behavior MH - Humans MH - Image Processing, Computer-Assisted MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Obesity/blood/surgery MH - *Reward MH - Surveys and Questionnaires MH - Weight Loss EDAT- 2016/06/14 06:00 MHDA- 2017/10/31 06:00 CRDT- 2016/06/14 06:00 PHST- 2016/01/21 00:00 [received] PHST- 2016/04/26 00:00 [accepted] PHST- 2016/06/14 06:00 [entrez] PHST- 2016/06/14 06:00 [pubmed] PHST- 2017/10/31 06:00 [medline] AID - dc16-0094 [pii] AID - 10.2337/dc16-0094 [doi] PST - ppublish SO - Diabetes Care. 2016 Aug;39(8):1311-7. doi: 10.2337/dc16-0094. Epub 2016 Jun 12.