Opposing neural effects of naltrexone on food reward and aversion: implications for the treatment of obesity
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Opioid antagonism reduces the consumption of palatable foods in humans but the neural substrates implicated in these effects are less well understood.
The aim of the present study was to examine the effects of the opioid antagonist, naltrexone, on neural response to rewarding and aversive sight and taste stimuli.
We used functional magnetic resonance imaging (fMRI) to examine the neural responses to the sight and taste of pleasant (chocolate) and aversive (mouldy strawberry) stimuli in 20 healthy volunteers who received a single oral dose of naltrexone (50 mg) and placebo in a double-blind, repeated-measures cross-over, design.
Relative to placebo, naltrexone decreased reward activation to chocolate in the dorsal anterior cingulate cortex and caudate, and increased aversive-related activation to unpleasant strawberry in the amygdala and anterior insula.
These findings suggest that modulation of key brain areas involved in reward processing, cognitive control and habit formation such as the dorsal anterior cingulate cortex (dACC) and caudate might underlie reduction in food intake with opioid antagonism. Furthermore we show for the first time that naltrexone can increase activations related to aversive food stimuli. These results support further investigation of opioid treatments in obesity.
KeywordsReward Aversion fMRI Naltrexone Food Obesity Neuroimaging Opioid antagonism
Conflicts of interest
Dr. McCabe has acted as a consultant to P1Vital, Givaudan, GWpharma, the British Broadcasting Company (BBC) and Channel 4. Professor Harmer is a company director of Oxford Psychologists and has acted as a consultant to Servier, GlaxoSmithKline, Astra Zeneca, Johnson & Johnson, Roche, Lundbeck and P1Vital. Professor Cowen is a member of an advisory board for Lundbeck. Elizabeth Murray, Sietske Brouwer and Rob McCutcheon report no biomedical financial interests or potential conflicts of interest.
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