减重手术对肥胖症大脑中枢调节的影响

Effects of bariatric surgery on central nervous system regulation of obesity

  • 摘要: 随着肥胖症在全世界范围内发病率的不断提高,治疗肥胖症的方法不断出现。然而,各种治疗方法的效果却因人而异,针对上述差异目前尚无明确的机制予以解释。近年来,多项研究揭示大脑中枢系统调控进食的作用机制,并提出肥胖症的发生、发展可能与大脑中枢系统的功能异常密切相关,包括食物摄入的稳态调节、中枢奖励、中枢认知控制、情绪、记忆及注意力系统等。因此,多数学者呼吁:肥胖症的治疗不能“无视大脑”。目前对肥胖症最有效的治疗方法是减重手术,其能够减轻患者42%~67%的多余体质量,并伴有大脑中枢系统反应活性的改变。功能性磁共振成像研究结果显示:减重手术患者术后中枢奖励系统反应活性降低,而中枢认知控制系统的抑制性控制功能增强。因此,笔者阐述大脑中枢系统对进食的调节作用,探讨减重手术对大脑中枢系统的影响。

     

    Abstract: As the incidence of obesity increases globally,treatment strategies of obesity emerge continuously. However, the weight loss effect varies between individuals without explicit explanations. In the recent years, many researchers have revealed regulation mechanisms of central nervous system on eating behavior, proposing that obese individuals exhibit brain functional abnormalities implicated in homeostatic regulation of food intake, central reward and motivation, emotion, memory, and attention system. Therefore, these scholars appeal that treating obesity cannot remain “brainless”. The most effective treatment currently available for obesity is bariatric surgery which lead to excess weight loss of 42%-67% in accompany with changes in brain activity. Functional magnetic resonance imaging showed a decreased activation in the central reward network and increased inhibitory control in the cognitive control system after bariatric surgeries. In this article, the authors introduce the central nervous system regulation of eating and investigate the effects of bariatric surgery on central nervous system.

     

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