Functional magnetic resonance of brain response to cholecystokinin (CCK) in gastrectomy with vagotomy

• Grant number: 10/03520-7
• Support Opportunities: Regular Research Grants
• Start date: June 01, 2010
• End date: May 31, 2012
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Mayra Mayumi Kamiji
• Grantee: Mayra Mayumi Kamiji
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated researchers: Antonio Carlos dos Santos ; Draulio Barros de Araujo ; Lucila Leico Kagohara Elias

Abstract

The energy balance regulation seems to be altered following total gastrectomy (TG) and vagotomy. Information regarding brain areas involved in food intake regulation is still limited and to our knowledge, such investigation in TG has not been performed hitherto. In this study, the objective is to evaluate, using blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI), the brain activity response to CCK-8 endovenous infusion following TG with truncal vagotomy. The objective is to test the hypothesis that: (1) increased activation of NTS and inhibition of both appetite and subsequent food intake following CCK-8 endovenous administration would occur following TG and vagotomy; and (2) at six months after TG and vagotomy, activation of NTS, appetite and food intake subsequently to CCK-8 would differ from those before surgery. Subjects undergoing TG due to gastric cancer or other digestive tract disease and asymptomatic subjects will be studied. Gastrectomized subjects will be studied before, one month and six months after surgery. Habitual food intake will be assessed by food recall and dietary record; antropometry by body mass index and bioelectrical impedance, and resting energy expenditure by indirect calorimetry. Imaging study will be performed before and after endovenous administration (45 min) of CCK-8 (1ng kg-1min-1). During the exam, an appetite questionnaire as well as blood collection for CCK-8 measurement will be performed. CCK-8 will be determined by radioimmunoassay. Thirty minutes after the end of the study, the subjects will be offered a meal which will be analysed in relation to composition and energy value. The energy balance regulation seems to be altered following total gastrectomy (TG) and vagotomy. Information regarding brain areas involved in food intake regulation is still limited and to our knowledge, such investigation in TG has not been performed hitherto. In this study, the objective is to evaluate, using blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI), the brain activity response to CCK-8 endovenous infusion following TG with truncal vagotomy. The objective is to test the hypothesis that: (1) increased activation of NTS and inhibition of both appetite and subsequent food intake following CCK-8 endovenous administration would occur following TG and vagotomy; and (2) at six months after TG and vagotomy, activation of NTS, appetite and food intake subsequently to CCK-8 would differ from those before surgery. Subjects undergoing TG due to gastric cancer or other digestive tract disease and asymptomatic subjects will be studied. Gastrectomized subjects will be studied before, one month and six months after surgery. Habitual food intake will be assessed by food recall and dietary record; antropometry by body mass index and bioelectrical impedance, and resting energy expenditure by indirect calorimetry. Imaging study will be performed before and after endovenous administration (45 min) of CCK-8 (1ng kg-1min-1). During the exam, an appetite questionnaire as well as blood collection for CCK-8 measurement will be performed. CCK-8 will be determined by radioimmunoassay. Thirty minutes after the end of the study, the subjects will be offered a meal which will be analysed in relation to composition and energy value. (AU)