Leptin Therapy in a Congenital Leptin-Deficient Patient Leads to Acute and Long-Term Changes in Homeostatic, Reward, and Food-Related Brain Areas

Context: Mutations that lead to congenital leptin deficiency cause severe obesity, hyperphagia, and impaired satiety due to malfunctions of peripheral and brain-related mechanisms. Design and Patient: In a leptin-deficient adolescent girl, we investigated brain-related changes before and at two time points after leptin therapy (3 d and 6 months). Functional magnetic resonance imaging was performed during visual stimulation with food (high and low caloric) and nonfood pictures. Results: Results show acute and long-term effects in the amygdala, the orbitofrontal cortex, and the substantia nigra/ventral tegmental area for the comparison of food and nonfood pictures. For the comparison of high and low caloric pictures, pure acute effects in the ventral striatum and the orbitofrontal cortex could be observed as well as acute and long-term effects in the hypothalamus. Conclusion: This study gives additional insight in the influence of leptin therapy on brain functions in leptin deficiency. (J Clin Endocrinol Metab 96: E1283-E1287, 2011)