The Nervous Physiology Mechanism FMRI Study Of Bariatric Surgery Intervene In Obesity

With the continuous development of society and people’s living standards, the diet structure of people constantly changes. Because a lot of of high-calorie snack(eg: KFC, Mc Donald’s, Mads, etc.) are popular in recent years, so people live in a high-calorie social environment. Meanwhile, with the pressure of social life increasing, the regulation of emotion are abnormal, so people increase food ingestion to reduce social pressure along with reduced physical activity, resulting in threat to human health. Negative influences of obesity and overweight on social economics and health indicators are evident. Societal implications include direct health expenditures, healthcare insurance schemes and funds available for other services that are health and non-health-related. Obesity is associated with increased risks for atherosclerotic cerebrovascular disease, coronary heart disease, colorectal cancer, hyperlipidemia, hypertension, gallbladder disease and diabetes mellitus, and a higher mortality rate. A number of medical and surgical strategies are available to treat obesity. Among, bariatric surgery is the most effective method to treat obesity, but the pathophysiology mechanism of bariatric surgery remains unclear.Based on previous reports and the basis of our work, the article explained the nervous physiology mechanism of bariatric surgery intervene in obesity. This article found the central brain targets and pathophysiology mechanism of obesity in the resting and task state. The main work and innovation of this paper are as follows: firstly, subjects of selection, experimental design, data collection, data processing and analysis are described in detail. Among, we focused on the specific implementation of the principles and methods of Granger causality. We found ROI by two-sample T-test between obese and normal groups, then described the different causal relationships in the ROI of obese group( pre- and post surgery) and normal group. Secondly, the nervous physiology mechanism study that bariatric surgery intervene in obesity in the resting state. Obese patients compared with normal control group, the activity of brain regions increased, including the dorsal prefrontal cortex(DLPFC), orbitofrontal cortex(OFC), nucleus accumbens(NAc), amygdala(AMY), insula, hippocampus(HIPP), the ventral tegmental area(VTA), putamen(Putamen) etc; the activity of brain regions decreased, including ACC, VMPFC, Caudate, Thalamus. Granger causal relationship study found that driving action enhanced from OFC to Insula, HIPP, Putamen, DLPFC,ACC and VMPFC in obese group, all brain nuclei in the ROI Granger causal connection acted on the DLPFC. Compared pre-surgery with post-surgery after one month of obese group, the activity of brain regions increased, including Thalamus, Caudate, AMY, VMPFC and VTA; the activity of brain regions decreased, including ACC, HIPP, DLPFC, OFC and Putamen; in addition, Insula and NAc changed unobviously. Granger causal relationship study found that the energy reduced flowing into the DLPFC, including the OFC, VMPFC, Insula and HIPP, driving action decreased from OFC to Caudate, NAc, Insula, AMY, HIPP, Putamen and DLPFC. Finally, nervous physiology mechanism study that bariatric surgery intervene in obesity in the task state. This section mainly established the brain functional interactive model of bariatric surgery to the regulation of the brain circuit. Obese patients compared with normal control group under the high-calorie food images stimulation state, the activity of ACC, Putamen, Insula, HIPP and Thalamus activity levels increased, the activity level of DLPFC decreased; Obese patients compared with normal control group under the low-calorie food images stimulation state, the activity of HIPP increased, the ACC, VMPFC and DLPFC decreased. Compared pre-surgery with post-surgery after one month of obese group under the high-calorie food images stimulation state, the activity of brain regions increased, including Caudate, AMY, HIPP and Thalamus. the activity of brain regions decreased, including ACC、DLPFC and VMPFC; Compared pre-surgery with post-surgery after one month of obese group under the low-calorie food images stimulation state, the activity of HIPP increased, the activity of ACC, VMPFC and DLPFC decreased. In addition, based on comparative research of task state, we found a significant and meaningful brain nuclear HIPP.The article explained the nervous physiology mechanism that bariatric surgery intervene in obesity by f MRI and setting controlled experiments. This article found the central brain targets and pathophysiology mechanism of obesity in the resting and task state, providing radiographic evidence for clinical treatment. The current study will provide clinical and theoretical support to the improvement of appropriate treatment.