Obesity mechanism after hypothalamic damage: Cohort analysis of neuroimaging, psychological, cognitive, and clinical phenotyping data

Front Endocrinol (Lausanne). 2023 Mar 28:14:1114409. doi: 10.3389/fendo.2023.1114409. eCollection 2023.

Abstract

Objective: The hypothalamus regulates energy homeostasis, and its damage results in severe obesity. We aimed to investigate the multifaceted characteristics of hypothalamic obesity.

Methods: We performed multidimensional analyses of brain structure/function and psychological and behavioral phenotypes in 29 patients with hypothalamic damage (HD) (craniopharyngioma) and 31 controls (non-functional pituitary adenoma). Patients underwent structural and functional magnetic resonance imaging and completed self-reports and cognitive tasks.

Results: Patients with HD showed significantly higher postoperative weight gain than controls. The HD group also showed significant hypothalamic damage and lower neural activation in the left caudate nucleus in response to food images. The HD group had significantly higher food inattention, lower satiety, and higher restrained eating behavior. Within the HD group, higher restrained eating behavior was significantly associated with lower activation in the bilateral fusiform gyrus.

Conclusion: These results suggest that hypothalamic damage contributes to weight gain by altering the brain response, attention, satiety, and eating behaviors. The present study proposes novel neuro-psycho-behavioral mechanisms targeted for patients with hypothalamic obesity.

Keywords: attention; cognitive task; craniopharyngioma; fMRI; hypothalamic obesity; hypothalamus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cognition
  • Cohort Studies
  • Humans
  • Hypothalamic Diseases* / pathology
  • Hypothalamus* / pathology
  • Neuroimaging
  • Obesity / complications
  • Obesity / diagnostic imaging
  • Obesity / pathology
  • Weight Gain

Grants and funding

This work was supported by the National Research Foundation of Korea (NRF 2017R1A2B2008412). This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number :HI22C1060).