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Prolonged fasting impairs neural reactivity to visual stimulation

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Previous literature has shown that hypoglycemia influences the intensity of the BOLD signal. A similar but smaller effect may also be elicited by low normal blood glucose levels in healthy individuals. This may not only confound the BOLD signal measured in fMRI, but also more generally interact with cognitive processing, and thus indirectly influence fMRI results. Here we show in a placebo-controlled, crossover, double-blind study on 40 healthy subjects, that overnight fasting and low normal levels of glucose contrasted to an activated, elevated glucose condition have an impact on brain activation during basal visual stimulation. Additionally, functional connectivity of the visual cortex shows a strengthened association with higher-order attention-related brain areas in an elevated blood glucose condition compared to the fasting condition. In a fasting state visual brain areas show stronger coupling to the inferior temporal gyrus. Results demonstrate that prolonged overnight fasting leads to a diminished BOLD signal in higher-order occipital processing areas when compared to an elevated blood glucose condition. Additionally, functional connectivity patterns underscore the modulatory influence of fasting on visual brain networks. Patterns of brain activation and functional connectivity associated with a broad range of attentional processes are affected by maturation and aging and associated with psychiatric disease and intoxication. Thus, we conclude that prolonged fasting may decrease fMRI design sensitivity in any task involving attentional processes when fasting status or blood glucose is not controlled.

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This work was supported by the Faculty of Medicine, RWTH Aachen University (START program 138/09) and by the German Research Foundation (DFG, IRTG 1328, International Research Training Group). UH is supported by a grant from the IZKF Aachen (Interdisciplinary Center for Clinical Research within the faculty of Medicine at the RWTH Aachen University, N4-4). We thank the IZKF Aachen (David Weyer, Andre Schüppen) for technical support. This work is also subject to the medical doctoral thesis of AW.

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Kohn, N., Wassenberg, A., Toygar, T. et al. Prolonged fasting impairs neural reactivity to visual stimulation. Brain Struct Funct 221, 147–158 (2016).

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