The role of LEAP2 on cognitive impulsivity after refeeding: evidence from a preclinical study in female mice and from patients with anorexia nervosa

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The paper tested whether the ghrelin/LEAP2 balance relates to cognitive impulsivity after chronic food restriction and subsequent refeeding, combining a longitudinal cohort of 30 female patients with anorexia nervosa (after weight restoration and 6 months post-discharge) with behavioral testing in female mice subjected to 15 days of 50% food restriction followed by 10 days of refeeding. It found that, in patients, a higher ghrelin/LEAP2 ratio was negatively correlated with impulse control after weight restoration, especially in those maintaining weight gain after discharge, whereas in mice food restriction increased cognitive impulsivity and refeeding only partially normalized it. In the refed mice state, plasma LEAP2 levels showed a positive correlation with cognitive impulsivity, alongside a negative correlation between cognitive impulsivity and DRD1 gene expression in the prefrontal cortex. The study is limited by its focus on female subjects and by being a preprint not yet peer reviewed. Relevance to endometriosis: the paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Abstract Recent findings suggest an impact of the ghrelin/LEAP2 balance on the dynamics of reward sensitivity and a potential role of LEAP2 as a biomarker of remission in patients with anorexia nervosa. We hypothesized that the ghrelin/LEAP2 balance was involved in impulsive food choices after chronic food restriction and a period of refeeding. Impulse control and plasma ghrelin and LEAP2 concentrations were evaluated in a longitudinal study of 30 female patients with AN after weight restoration and 6-months after discharge to evaluate their remission status. Cognitive impulsivity was also assessed in young C57Bl6/J female mice at baseline, after a 15-day 50% quantitative food restriction and following a 10-day refeeding. We collected blood for ghrelin and LEAP2 measurement and brain areas involved in metabolic response or reward and cognitive control. Ghrelin/LEAP2 ratio was negatively correlated with impulse control in patients after weight restoration, more specifically in patients maintaining weight gain after discharge. In mice, food restriction increased cognitive impulsivity and refeeding only partially restored this phenotype compared to control conditions. Cognitive impulsivity was also positively correlated with plasma LEAP2 levels and negatively correlated with DRD1 gene expression in the prefrontal cortex in the refed state only. Our results provide evidence that the interplay between LEAP2 and cognitive impulsivity is sensitive to changes in the nutritional status in both patients and female mice. Metabolic and cognitive consequences of food restriction could be implicated in how food choices are being modified in patients and might be associated with better chances of stable remission in AN.
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The role of LEAP2 on cognitive impulsivity after refeeding: evidence from a preclinical study in female mice and from patients with anorexia nervosa | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The role of LEAP2 on cognitive impulsivity after refeeding: evidence from a preclinical study in female mice and from patients with anorexia nervosa Virginie Tolle, Chloé Tezenas du Montcel, Héloise Hamelin, Nicolas Lebrun, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6854962/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 05 Mar, 2026 Read the published version in Translational Psychiatry → Version 1 posted 12 You are reading this latest preprint version Abstract Recent findings suggest an impact of the ghrelin/LEAP2 balance on the dynamics of reward sensitivity and a potential role of LEAP2 as a biomarker of remission in patients with anorexia nervosa. We hypothesized that the ghrelin/LEAP2 balance was involved in impulsive food choices after chronic food restriction and a period of refeeding. Impulse control and plasma ghrelin and LEAP2 concentrations were evaluated in a longitudinal study of 30 female patients with AN after weight restoration and 6-months after discharge to evaluate their remission status. Cognitive impulsivity was also assessed in young C57Bl6/J female mice at baseline, after a 15-day 50% quantitative food restriction and following a 10-day refeeding. We collected blood for ghrelin and LEAP2 measurement and brain areas involved in metabolic response or reward and cognitive control. Ghrelin/LEAP2 ratio was negatively correlated with impulse control in patients after weight restoration, more specifically in patients maintaining weight gain after discharge. In mice, food restriction increased cognitive impulsivity and refeeding only partially restored this phenotype compared to control conditions. Cognitive impulsivity was also positively correlated with plasma LEAP2 levels and negatively correlated with DRD1 gene expression in the prefrontal cortex in the refed state only. Our results provide evidence that the interplay between LEAP2 and cognitive impulsivity is sensitive to changes in the nutritional status in both patients and female mice. Metabolic and cognitive consequences of food restriction could be implicated in how food choices are being modified in patients and might be associated with better chances of stable remission in AN. Health sciences/Diseases/Psychiatric disorders Biological sciences/Neuroscience delay discounting anorexia nervosa animal models dopamine LEAP2 Full Text Additional Declarations Yes P. G. received during the last 5 years fees for presentations at congresses or participation in scientific boards from Angelini, Biogen, Janssen, Lundbeck, Merk, Newron, Otsuka, Richter and Viatris. All other authors declare that they have no conflicts of interest. Table 1 and 2 are available in the Supplementary Files section. Supplementary Files ManuscritDDTSupplementaryinformationFINAL.pdf Supplementary file FigureS3FINAL.pdf Figure S3 FigureS2FINAL.pdf Figure S2 TableS1FINAL.pdf Table S1 TableS4FINAL.pdf Table S4 FigureS5FINAL.pdf Figure S5 Table2FINAL.pdf Table 2 FigureS1FINAL.pdf Figure S1 TableS2FINAL.pdf Table S2 FigureS4FINAL.pdf Figure S4 Table1FINAL.pdf Table 1 TableS3FINAL.pdf Table S3 ManuscritDDTSupplementaryinformationFINAL.pdf Supplementary information Cite Share Download PDF Status: Published Journal Publication published 05 Mar, 2026 Read the published version in Translational Psychiatry → Version 1 posted Editorial decision: revise 15 Jul, 2025 Review # 3 received at journal 13 Jul, 2025 Review # 1 received at journal 02 Jul, 2025 Reviewer # 3 agreed at journal 18 Jun, 2025 Review # 2 received at journal 18 Jun, 2025 Reviewer # 2 agreed at journal 18 Jun, 2025 Reviewer # 1 agreed at journal 16 Jun, 2025 Reviewers invited by journal 16 Jun, 2025 Editor assigned by journal 12 Jun, 2025 Submission checks completed at journal 12 Jun, 2025 First submitted to journal 12 Jun, 2025 Unknown event 10 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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We hypothesized that the ghrelin/LEAP2 balance was involved in impulsive food choices after chronic food restriction and a period of refeeding.\r\nImpulse control and plasma ghrelin and LEAP2 concentrations were evaluated in a longitudinal study of 30 female patients with AN after weight restoration and 6-months after discharge to evaluate their remission status. Cognitive impulsivity was also assessed in young C57Bl6/J female mice at baseline, after a 15-day 50% quantitative food restriction and following a 10-day refeeding. We collected blood for ghrelin and LEAP2 measurement and brain areas involved in metabolic response or reward and cognitive control.\r\nGhrelin/LEAP2 ratio was negatively correlated with impulse control in patients after weight restoration, more specifically in patients maintaining weight gain after discharge. In mice, food restriction increased cognitive impulsivity and refeeding only partially restored this phenotype compared to control conditions. Cognitive impulsivity was also positively correlated with plasma LEAP2 levels and negatively correlated with DRD1 gene expression in the prefrontal cortex in the refed state only. \r\nOur results provide evidence that the interplay between LEAP2 and cognitive impulsivity is sensitive to changes in the nutritional status in both patients and female mice. 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