Single-arm longitudinal study to assess changes in insula functional connectivity following a mobile-based lifestyle intervention in adults with metabolic abnormalities

Abstract

Backgrounds: Mobile-based lifestyle intervention has been widely used to improve behavior for obesity and overweight. This study targeting adults with metabolic abnormalities aims to identify neural correlates related to weight loss due to mobile-based lifestyle intervention. Methods: We conducted 8 weeks of mobile-based lifestyle intervention for 37 adults with metabolic abnormalities, including overweight. Participants underwent physical measurements, blood tests, psychometric questionnaires, and resting-state functional magnetic resonance imaging (fMRI) scans before and after the mobilebased intervention. For the resting-state fMRI, brain regions that showed changes in functional connectivity (FC) before and after mobile-based intervention were explored. Seed-based FC analysis was performed focusing on the subregions of the insular cortex. Results: Participants significantly reduced body mass index (BMI) after mobile-based intervention. The degree of BMI reduction was significantly correlated with compliance with the intervention. In resting fMRI, FC of the posterior insula with the bilateral inferior parietal lobule and the left ventrolateral prefrontal cortex were enhanced after mobile-based intervention. The increase in FC between the posterior insula and the inferior posterior lobule showed a significant correlation with the decrease in binge eating scale scores. Conclusion: The mobile-based lifestyle intervention significantly reduced weight and alleviated binge eating in adults with metabolic abnormalities. FC enhancement between the posterior insula and the frontoparietal regions was also observed after mobile-based lifestyle intervention. The relationship between these FC changes and strengthening weight control through mobile-based lifestyle intervention should be investigated through future research.