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Investigating the Central and Peripheral Mechanisms by Which Glucocorticoids Affect Hunger

Phase 1
Completed
Conditions
Obesity
Interventions
Registration Number
NCT02722200
Lead Sponsor
Yale University
Brief Summary

The purpose of this study is to examine if glucocorticoids will change neural activation in regions of the corticolimbic-striatal system that regulate feeding.

Detailed Description

The primary hypothesis tested in this study will be to determine if that in response to food cues, glucocorticoids will change neural activation in regions of the corticolimbic-striatal system that regulate feeding. It is anticipate that these changes will correlate with hunger ratings and food intake. Further, this research will also examine if glucocorticoids will increase the basal metabolic rate and alter multiple systemic appetite-regulating hormones compared to saline. It is expected that these changes will correlate positively with hunger ratings and food intake as well.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
28
Inclusion Criteria
  • BMI < = 26 kg/m2
  • Ability to read and write English
Exclusion Criteria
  • Creatinine > 1.5
  • Hgb < 10 mg/dL
  • ALT > 2.5 x ULN
  • Untreated thyroid disease
  • Uncontrolled or severe hypertension
  • Known neurological disorders
  • Diabetes or impaired glucose tolerance
  • Untreated or severe psychiatric disorders
  • Malignancy
  • Endogenous hypercortisolism
  • Addison's disease
  • Bleeding disorders
  • Smoking
  • Current or recent steroid use in the last 3 months
  • Illicit drug use
  • Eating disorders
  • Drug or alcohol addiction
  • History of claustrophobia
  • Pregnancy
  • Breastfeeding
  • Contraindications to MRI
  • Use of any psychoactive medication within the past 3 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Intravenous salinesalineSubjects in the saline arm will receive an infusion of saline overnight in the research unit prior to fMRI testing on either the first or second visit.
Intravenous glucocorticoidshydrocortisoneSubjects in the glucocorticoids arm will receive an infusion of hydrocortisone overnight in the research unit prior to fMRI testing on either the first or second visit.
Primary Outcome Measures
NameTimeMethod
Change in Brain Response to Food Imagery90 minutes

Brain response to images of food either during hydrocortisone infusion or saline infusion will be measured through fMRI. Brain response is operationally defined as the change in functional MRI-measured blood oxygen levels in specific regions of the brain between the resting state and intervention state. The fMRI sequences last anywhere from 1-5 min. Total scan time will be approximately 90 minutes. The slices taken with each sequences equal 25-75.

The outcome is a comparison between the resting oxygen levels and oxygen levels during the interventions. BioImage Suite software is used to categorize if there is a significance between the two levels at a p \< 0.05.

Average Hunger Rating90 minutes

Average hunger rating will be captured using the Visual Food Cue Task. This standardized method presents a series of images consisting of high calorie food, low calorie food, and non-food pictures presented randomly across four runs during the fMRI session. Each picture will be presented only once in a randomized order for each participant.

Participants will be instructed to rate their "hunger", "liking" and "wanting" of the item on a 9-point Likert scale utilizing a 4-key button box. The hunger, wanting, and liking scales are all rated on a scale of 1-9, 1 being the least and 9 being the most. These scores are presented as an average across measurement points during the fMRI. Every time a food image is shown, the rater provides a rating of hunger, wanting and liking of it- people will be shown approximately 40-60 photos.

Secondary Outcome Measures
NameTimeMethod
Average Wanting Rating90 minutes

Average wanting rating will be captured using the Visual Food Cue Task. This standardized method presents a series of images consisting of high calorie food, low calorie food, and non-food pictures presented randomly across four runs during the fMRI session. Each picture will be presented only once in a randomized order for each participant. Participants will be instructed to rate their "hunger", "liking" and "wanting" of the item on a 9-point Likert scale utilizing a 4-key button box. The hunger, wanting, and liking scales are all rated on a scale of 1-9, 1 being the least and 9 being the most. These scores are presented as an average across measurement points during the fMRI.

Average Liking Rating90 minutes

Average wanting rating will be captured using the Visual Food Cue Task. This standardized method presents a series of images consisting of high calorie food, low calorie food, and non-food pictures presented randomly across four runs during the fMRI session. Each picture will be presented only once in a randomized order for each participant. Participants will be instructed to rate their "hunger", "liking" and "wanting" of the item on a 9-point Likert scale utilizing a 4-key button box. The hunger, wanting, and liking scales are all rated on a scale of 1-9, 1 being the least and 9 being the most. These scores are presented as an average across measurement points during the fMRI.

Adrenocorticotropic Hormone90 minutes

Adrenocorticotropic Hormone (ACTH) will be collected from serum at the beginning and end of the procedure.

Glucagon90 minutes

Glucagon will be collected from serum at the beginning and end of the procedure.

Leptin90 minutes

Leptin will be collected from serum at the beginning and end of the procedure.

Cortisone90 minutes

Cortisone will be collected from serum at the beginning and end of the procedure.

Glucose90 minutes

Glucose will be collected from serum at the beginning and end of the procedure.

Insulin90 minutes

Insulin will be collected from serum at the beginning and end of the procedure.

Neuropeptide Y90 minutes

Neuropeptide Y (NPY) will be collected from serum at the beginning and end of the procedure.

Total Cortisol90 minutes

Total cortisol will be collected from serum at the beginning and end of the procedure.

Free Cortisol90 minutes

Free cortisol will be collected from serum at the beginning and end of the procedure.

Ghrelin90 minutes

Ghrelin will be collected from serum at the beginning and end of the procedure.

Glucagon-like peptide-190 minutes

Glucagon-like peptide-1 (GLP-1) will be collected from serum at the beginning and end of the procedure.

Trial Locations

Locations (1)

Yale University

🇺🇸

New Haven, Connecticut, United States

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