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Obesity: An Addiction? Imaging of Neurotransmitter Systems in Obesity

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PET and SPECT in Psychiatry

Abstract

The brain is important in the regulation of eating behavior and satiety signaling. There is also evidence that many neurotransmitters are involved in food intake regulation and eating behavior; consequently dysregulated neurotransmitter systems may be involved in the pathophysiology of obesity. This chapter presents an overview of results of neurotransmitter imaging studies in obese humans.

Presently, the dopaminergic, serotonergic, noradrenergic, opioid and cannabinoid systems have been studied with molecular imaging techniques in obese humans. The major findings are increased serotonin (5-hydroxytryptamine; 5-HT) 5-HT2A receptor availability in cortical regions, a complex relationship between dopamine D2/3 receptor (DRD2/3) availability and body mass index (BMI), probably an important role of the striatal and extra-striatal mu opioid receptor, and a possible role of the cannabinoid type 1 (CB1) receptor. There is no disturbance in serotonin transporter (SERT) availability in the thalamus and midbrain or in striatal dopamine transporter (DAT) availability. The effects of bariatric surgery on neurotransmission and findings in subgroups such as patients with binge eating disorder or insulin resistance are also discussed.

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van de Giessen, E., McIlwrick, S., Veltman, D., van den Brink, W., Booij, J. (2021). Obesity: An Addiction? Imaging of Neurotransmitter Systems in Obesity. In: Dierckx, R.A., Otte, A., de Vries, E.F.J., van Waarde, A., Sommer, I.E. (eds) PET and SPECT in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-57231-0_26

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