Imperial College London
Alternate

Dr Tony Goldstone

Faculty of Medicine, Department of Brain Sciences

Reader in PsychoNeuroEndocrinology
 
 
 
//

Contact

 

+44 (0)20 7594 5989tony.goldstone Website

 
 
//

Location

 

S25Commonwealth BuildingHammersmith Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Murphy:2020:clinem/dgaa697,
author = {Murphy, CF and Stratford, N and Docherty, NG and Moran, B and Elliott, JA and Healy, M-L and McMorrow, JP and Ravi, N and Goldstone, AP and Reynolds, JV and le, Roux CW},
doi = {clinem/dgaa697},
journal = {J Clin Endocrinol Metab},
title = {A Pilot Study of Gut-Brain Signaling After Octreotide Therapy for Unintentional Weight Loss After Esophagectomy.},
url = {http://dx.doi.org/10.1210/clinem/dgaa697},
year = {2020}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Recurrence-free patients after esophageal cancer surgery face long-term nutritional consequences, occurring in the context of an exaggerated post-prandial gut hormone response. Acute gut hormone suppression influences brain reward signaling and eating behavior. This study aimed to suppress gut hormone secretion and characterize reward responses and eating behavior among post-esophagectomy patients with unintentional weight loss. METHODS: This pilot study prospectively studied post-operative patients with ≥10% body weight loss (BWL) beyond one year who were candidates for clinical treatment with long-acting Octreotide (LAR). Before and after four weeks of treatment, gut hormone secretion, food cue reactivity (functional MRI), eating motivation (progressive ratio task), ad libitum food intake, body composition, and symptom burden were assessed. RESULTS: 8 patients (7 male, age: mean±SD 62.8±9.4 years, post-operative BWL: 15.5±5.8%) participated. Octreotide LAR did not significantly suppress total post-prandial plasma GLP-1 response at four weeks (P=0.08). Post-prandial symptom burden improved after treatment (Sigstad score median(range): 12(2-28) vs. 8(3-18), P=0.04), but weight remained stable (Pre:68.6±12.8kg vs. Post:69.2±13.4kg, P=0.13). There was no significant change in brain reward system responses, during evaluation of high-energy or low-energy food pictures, nor their appeal rating. Moreover, treatment did not alter motivation to eat (P=0.41) nor ad libitum food intake(P=0.46). CONCLUSION: The protocol used made it feasible to characterize the gut-brain axis and eating behavior in this cohort. Inadequate suppression of gut hormone responses four weeks after Octreotide LAR administration may explain the lack of gut-brain pathway alterations. A higher dose or shorter inter-dose interval may be required to optimize the intervention.
AU  - Murphy,CF
AU  - Stratford,N
AU  - Docherty,NG
AU  - Moran,B
AU  - Elliott,JA
AU  - Healy,M-L
AU  - McMorrow,JP
AU  - Ravi,N
AU  - Goldstone,AP
AU  - Reynolds,JV
AU  - le,Roux CW
DO  - clinem/dgaa697
PY  - 2020///
TI  - A Pilot Study of Gut-Brain Signaling After Octreotide Therapy for Unintentional Weight Loss After Esophagectomy.
T2  - J Clin Endocrinol Metab
UR  - http://dx.doi.org/10.1210/clinem/dgaa697
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33000149
ER  -
Download