The Cerebellum Plays More Than One Role in the Dysregulation of Appetite: Review of Structural Evidence from Typical and Eating Disorder Populations

Abstract

BackgroundDysregulated appetite control is characteristic of anorexia nervosa (AN) and obesity (OB). Studies using a broad range of methods suggest the cerebellum plays an important role in appetite control, and it is implicated in both AN and OB with reports of aberrant grey matter volume (GMV) compared to non-clinical populations. As functions of the cerebellum are anatomically segregated, specific localization of aberrant anatomy may indicate how it affects appetite control in different states.ObjectiveTo determine if there were consistencies in regions of cerebellar GMV changes affected in AN and OB, and across normative variation.Methodsystematic review and meta-analysis using Ginger ALE.ResultsTwenty publications were identified as either case-control studies (with total n=619) or regressed weight from normative data against brain volume (with total n=3,518). AN and OB analyses both showed consistently decreased GMV within the left cerebellum, but volume reduction was anterior for AN and posterior for OB, with minimal overlap. Analysis of the normative dataset identified a cluster in right posterior lobe.DiscussionThese findings suggest that more than one area of the cerebellum is involved in control of eating behaviour and is differentially affected in normal variation and pathological conditions. Specifically, we hypothesise an association with sensorimotor and emotional learning in AN, but with executive function in OB.

Intermittent energy restriction changes the regional homogeneity of the obese human brain

“…Studies have shown that the cerebellum can interact through hormonal and neural networks; specific networks, such as the hypothalamus and insula, are associated with food intake ( Sader et al, 2022 ). In this study, we found significant decreases in leptin and adiponectin levels, consistent with previous IER weight loss results ( Friedman and Mantzoros, 2015 ; Forny-Germano et al, 2019 ).…”