Food Reward in Cachexia Induced by Acute or Chronic Disease

Study Overview
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Brief Summary
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To study activity in the reward-circuitry of the brain in patients suffering from cachexia induced by cancer or chronic disease.

Detailed Description
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The activity in the food reward-circuitry of the brain in patients suffering from cachexia induced by cancer (lung cancer or pancreatic cancer) or chronic disease (chronic obstructive pulmonary disease) will be analysed by using functional magnetic resonance imaging. In addition, the role of the peripheral satiety hormones will be evaluated.

Official Title
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Analysis of Food Reward System in Cachexia Induced by Acute or Chronic Disease

Conditions
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Cachexia, Chronic Obstructive Pulmonary Disease, Non-small Cell Lung Cancer, Pancreatic Cancer

Intervention / Treatment
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* Other: Functional magnetic resonance imaging (fMRI)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: For cachectic patients: weight loss exceeds 5% of total body weight over the past 6 months, or >2% when body mass index is <20 kg/m2 For non-cachectic patients: no weight loss of ≥5% during the last 6 months Non-small cell lung cancer or gastro-intestinal cancer, pathology proven or diagnosis of COPD consistent with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria Exclusion Criteria: Contra-indications for fMRI examination (operation to your head or brain in the past; implanted electronic devices, for instance a pacemaker, neurostimulator, cochlear or hearing implant; insulin pump under your skin; Pregnant subjects, claustrophobia; pregnancy; metal parts in your body (except from teeth filling and connectors): implants; brain vessel clamps, prostheses, intra-uterine device, metal splinter in the eye, metal braces or other metal objects, permanent eye make-up) Psychiatric or other disorders likely to impact on informed consent Presence of brain metastasis (screening is not mandatory) Medical history of cerebrovascular accident, brain tumour, brain metastasis Previous radiotherapy to brain, both stereotactic and whole brain radiotherapy Memory problems Current use of tube feeding or parental nutrition Patients with an active second malignancy Patients unable to lie still for 2 hours Unable to complete the cognitive task Pre-existing swallowing difficulties Allergy to gluten-, milk- or wheat products Self-reported hyperthyroidism Self-reported diabetes mellitus Current use of appetite stimulant medications

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cachectic cancer patients<br>Cachectic cancer patients, including non-small cell lung cancer (NSCLC) and gastro-intestinal cancer. The study participants will undergo fMRI scanning. | Other: Functional magnetic resonance imaging (fMRI)<br>* The food-cue elicited response in the reward-circuitry of the brain will be assessed by using fMRI. This technique is based on different magnetic properties of oxygenated and deoxygenated blood. Increased neuronal activity causes an increase in blood flow. Thereby, neuronal activity is indirectly reflected by changes in blood oxygenation level-dependent (BOLD) contrast.<br>|
| Non-cachectic cancer patients<br>Non-cachectic cancer patients, including NSCLC and gastro-intestinal cancer. The study participants will undergo Functional magnetic resonance imaging (fMRI) scanning. | Other: Functional magnetic resonance imaging (fMRI)<br>* The food-cue elicited response in the reward-circuitry of the brain will be assessed by using fMRI. This technique is based on different magnetic properties of oxygenated and deoxygenated blood. Increased neuronal activity causes an increase in blood flow. Thereby, neuronal activity is indirectly reflected by changes in blood oxygenation level-dependent (BOLD) contrast.<br>|
| Cachectic COPD patients<br>Diagnosis of Chronic Obstructive Pulmonary Disease (COPD) consistent with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The study participants will undergo fMRI scanning. | Other: Functional magnetic resonance imaging (fMRI)<br>* The food-cue elicited response in the reward-circuitry of the brain will be assessed by using fMRI. This technique is based on different magnetic properties of oxygenated and deoxygenated blood. Increased neuronal activity causes an increase in blood flow. Thereby, neuronal activity is indirectly reflected by changes in blood oxygenation level-dependent (BOLD) contrast.<br>|
| Non-cachectic COPD patients<br>Diagnosis of COPD consistent with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The study participants will undergo fMRI scanning. | Other: Functional magnetic resonance imaging (fMRI)<br>* The food-cue elicited response in the reward-circuitry of the brain will be assessed by using fMRI. This technique is based on different magnetic properties of oxygenated and deoxygenated blood. Increased neuronal activity causes an increase in blood flow. Thereby, neuronal activity is indirectly reflected by changes in blood oxygenation level-dependent (BOLD) contrast.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reward-related activity in response to food cues, as indicated by Blood Oxygenation Level Dependent (BOLD) values in specified brain areas related to food reward. |  | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dietary intake assessed by a food diary |  | 2 years | 
| Blood parameters: glucose (mmol/L) |  | 2 years | 
| Blood parameters: insulin (pmol/L) |  | 2 years | 
| Blood parameters: leptin (ug/L) |  | 2 years | 
| Blood parameters: ghrelin (pg/mL) |  | 2 years | 
| Blood parameters: glucagon-like peptide-1 (pmol/L) |  | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cachexia, Food reward