Short-term plasticity of gray matter associated with leptin deficiency and replacement.

Context: Leptin affects neurogenesis, neuronal growth, and viability. We previously reported that leptin supplementation increased gray matter (GM) concentration in the anterior cingulate gyrus (ACG), cerebellum, and inferior parietal lobule, areas that are also involved in food intake. Objective: The aim of this study was to report the changes in brain structure at different states of leptin supplementation. Design: We conducted a nonrandomized trial. Setting and Patients: We studied three adults with congenital leptin deficiency due to a mutation in the leptin gene. Intervention: Patients received treatment with recombinant methionyl human leptin, with annual 11- to 36-d periods of treatment withholding followed by treatment restoration over 3 yr. Main Outcome Measures: GM concentration (by voxel-based morphometry analysis of magnetic resonance scans) was correlated with body mass index (BMI) and leptin supplementation. Results: Annually withholding leptin supplementation for several weeks increased BMI...