Neurobehavioral phenotypes of delay discounting and cognitive control in child attention‐deficit/hyperactivity disorder and obesity: Shared or distinct?
Abstract:Background: Attention-deficit/hyperactivity disorder (ADHD) and obesity have been independently associated with deficient cognitive control (CC) and heightened preference for immediate reward. Objectives: We aimed to identify specific shared and distinct neurobehavioral phenotypes of child obesity and ADHD by simultaneously measuring CC and preference for immediate reward in children with and without ADHD who varied in body weight. Methods: This case-control study included 323 8-12 year olds (ADHD n = 215, typ… Show more
“…The comorbidity of obesity and MetS 149,150 with psychiatric and neurodevelopmental disorders 151,152 (e.g., depression, attention deficit hyperactivity disorder ADHD) 153,154 also deserves further attention. For example, increasing evidence suggests that ADHD and obesity share neural and genetic underpinnings 155,156 and thus findings of studies that do not screen out individuals with ADHD symptoms may be driven in part by a subset of individuals with both obesity and ADHD symptomatology who may not be wholly representative of the larger population 157 . Measurement of eating‐related phenotypes may also be important as this could influence results 74 .…”
Section: Future Directionsmentioning
confidence: 99%
“…For example, increasing evidence suggests that ADHD and obesity share neural and genetic underpinnings 155 , 156 and thus findings of studies that do not screen out individuals with ADHD symptoms may be driven in part by a subset of individuals with both obesity and ADHD symptomatology who may not be wholly representative of the larger population. 157 Measurement of eating-related phenotypes may also be important as this could influence results. 74 Complementarily, adoption across the field of best methodological and analytical practices for food-related imaging including adjustment for appropriate covariates (e.g., hunger state) as well as appropriate statistical thresholding and adjustment for multiple comparisons would also help improve the quality of research and promote robust findings.…”
Summary
Obesity and components of the metabolic syndrome (MetS) are associated with differences in brain structure and function and in general and food‐related cognition in adults. Here, we review evidence for similar phenomena in children and adolescents, with a focus on the implications of extant research for possible underlying mechanisms and potential interventions for obesity and MetS in youth. Current evidence is limited by a relative reliance on small cross‐sectional studies. However, we find that youth with obesity and MetS or MetS components show differences in brain structure, including alterations in grey matter volume and cortical thickness across brain regions subserving reward, cognitive control and other functions, as well as in white matter integrity and volume. Children with obesity and MetS components also show some evidence for hyperresponsivity of food reward regions and hyporesponsivity of cognitive control circuits during food‐related tasks, altered brain responses to food tastes, and altered resting‐state connectivity including between cognitive control and reward processing networks. Potential mechanisms for these findings include neuroinflammation, impaired vascular reactivity, and effects of diet and obesity on myelination and dopamine function. Future observational research using longitudinal measures, improved sampling strategies and study designs, and rigorous statistical methods, promises to further illuminate dynamic relationships and causal mechanisms. Intervention studies targeted at modifiable biological and behavioural factors associated with paediatric obesity and MetS can further inform mechanisms, as well as test whether brain and behaviour can be altered for beneficial outcomes.
“…The comorbidity of obesity and MetS 149,150 with psychiatric and neurodevelopmental disorders 151,152 (e.g., depression, attention deficit hyperactivity disorder ADHD) 153,154 also deserves further attention. For example, increasing evidence suggests that ADHD and obesity share neural and genetic underpinnings 155,156 and thus findings of studies that do not screen out individuals with ADHD symptoms may be driven in part by a subset of individuals with both obesity and ADHD symptomatology who may not be wholly representative of the larger population 157 . Measurement of eating‐related phenotypes may also be important as this could influence results 74 .…”
Section: Future Directionsmentioning
confidence: 99%
“…For example, increasing evidence suggests that ADHD and obesity share neural and genetic underpinnings 155 , 156 and thus findings of studies that do not screen out individuals with ADHD symptoms may be driven in part by a subset of individuals with both obesity and ADHD symptomatology who may not be wholly representative of the larger population. 157 Measurement of eating-related phenotypes may also be important as this could influence results. 74 Complementarily, adoption across the field of best methodological and analytical practices for food-related imaging including adjustment for appropriate covariates (e.g., hunger state) as well as appropriate statistical thresholding and adjustment for multiple comparisons would also help improve the quality of research and promote robust findings.…”
Summary
Obesity and components of the metabolic syndrome (MetS) are associated with differences in brain structure and function and in general and food‐related cognition in adults. Here, we review evidence for similar phenomena in children and adolescents, with a focus on the implications of extant research for possible underlying mechanisms and potential interventions for obesity and MetS in youth. Current evidence is limited by a relative reliance on small cross‐sectional studies. However, we find that youth with obesity and MetS or MetS components show differences in brain structure, including alterations in grey matter volume and cortical thickness across brain regions subserving reward, cognitive control and other functions, as well as in white matter integrity and volume. Children with obesity and MetS components also show some evidence for hyperresponsivity of food reward regions and hyporesponsivity of cognitive control circuits during food‐related tasks, altered brain responses to food tastes, and altered resting‐state connectivity including between cognitive control and reward processing networks. Potential mechanisms for these findings include neuroinflammation, impaired vascular reactivity, and effects of diet and obesity on myelination and dopamine function. Future observational research using longitudinal measures, improved sampling strategies and study designs, and rigorous statistical methods, promises to further illuminate dynamic relationships and causal mechanisms. Intervention studies targeted at modifiable biological and behavioural factors associated with paediatric obesity and MetS can further inform mechanisms, as well as test whether brain and behaviour can be altered for beneficial outcomes.
“…Existing research has also incorporated the effectiveness of EFT interventions for such populations with high DD levels and the ability to delay gratification as a promising goal for cognitive-behavioral interventions. [46,47]…”
Section: People With Overweight or Obesity And Ddmentioning
A growing number of studies have applied Episodic Future Thinking (EFT) to cognitive interventions in specific population. However, The variability in study populations may lead to inconsistent results and present challenges in the optimal intervention approach and scope of adaptation. This scoping review aimed to identify and describe specific methods, considerations, and results collected and reported in randomized controlled trials of EFT applied to diet and weight management in people with overweight or obesity. A systematic scoping review was conducted by published guidelines for this review. We conducted a structured search of English-language articles in Web of Science, PubMed, Embase, CINAHL, ProQuest, and Cochrane, with the literature focusing on studies published up to December 28, 2022. After screening and full-text review, 16 studies were included. The studies included people of all ages with overweight or obesity, including women, children, and home-based EFT interventions. The vast majority of intervention studies screened participants for psychological characteristics, and the effects of EFT applied in people with overweight or obesity were somewhat significant, although there was some variation in the literature. Although the individual heterogeneity of studies makes the synthesis of results somewhat variable, it still demonstrates the breadth and accessibility of EFT interventions in people with overweight or obesity. The application of EFT to individualized interventions in people with overweight or obesity is a further complement and optimization of weight management through behavioral cognitive therapy.
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