Cited by 166Regulation of Appetite and ObesityPharmacology and Obesity TreatmentDiabetes Treatment and Management

Dissociable hindbrain GLP1R circuits for satiety and aversion

Open access
Huang, Kuei-Pin, Acosta, Alisha A., Ghidewon, Misgana Y., McKnight, Aaron D., Almeida, Milena S., Nyema, Nathaniel T., Hanchak, Nicholas D., Patel, Nisha +4 more·2024·Nature

Abstract

The most successful obesity therapeutics, glucagon-like peptide-1 receptor (GLP1R) agonists, cause aversive responses such as nausea and vomiting1,2, effects that may contribute to their efficacy. Here, we investigated the brain circuits that link satiety to aversion, and unexpectedly discovered that the neural circuits mediating these effects are functionally separable. Systematic investigation across drug-accessible GLP1R populations revealed that only hindbrain neurons are required for the efficacy of GLP1-based obesity drugs. In vivo two-photon imaging of hindbrain GLP1R neurons demonstrated that most neurons are tuned to either nutritive or aversive stimuli, but not both. Furthermore, simultaneous imaging of hindbrain subregions indicated that area postrema (AP) GLP1R neurons are broadly responsive, whereas nucleus of the solitary tract (NTS) GLP1R neurons are biased towards nutritive stimuli. Strikingly, separate manipulation of these populations demonstrated that activation of NTSGLP1R neurons triggers satiety in the absence of aversion, whereas activation of APGLP1R neurons triggers strong aversion with food intake reduction. Anatomical and behavioural analyses revealed that NTSGLP1R and APGLP1R neurons send projections to different downstream brain regions to drive satiety and aversion, respectively. Importantly, GLP1R agonists reduce food intake even when the aversion pathway is inhibited. Overall, these findings highlight NTSGLP1R neurons as a population that could be selectively targeted to promote weight loss while avoiding the adverse side effects that limit treatment adherence. The neural circuits in the hindbrain that link satiety and aversion are shown to be separate, raising the possibility of developing obesity drugs without the common side effects of nausea and vomiting.

Integrity signals

Registry

Crossref · 10.1038/s41586-024-07685-6

Cites

79 of 79 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 33 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    DVC GLP1R deletion attenuated both the anorexic and aversive effects of semaglutide.

    “DVCGLP1R deletion attenuated both the anorexic and aversive effects of semaglutide”
    Quote in the paperSubstantial claim
  • Findingown data

    Acute or chronic activation of DVC GLP1R neurons decreased total energy expenditure.

    “as acute or chronic activation of DVCGLP1R neurons decreased total energy expenditure”
    Quote in the paperNot a substantial claim
  • Findingown data

    Activation of DVC GLP1R neurons conditioned flavor avoidance in the CFA assay.

    “activation of DVCGLP1R neurons conditioned a flavour avoidance”
    Quote in the paperSubstantial claim
  • Findingown data

    Chemogenetic inhibition of AP GLP1R neurons, but not NTS GLP1R neurons, blunted conditioned flavor avoidance to a semaglutide-paired flavor.

    “Chemogenetic inhibition (hM4Di) of APGLP1R neurons, but not NTSGLP1R neurons, blunted the CFA to a semaglutide-paired flavour”
    Quote in the paperSubstantial claim
  • Findingown data

    Inhibiting AP or NTS GLP1R neurons did not block food intake suppression by GLP1-based obesity drugs.

    “inhibiting neural activity in either population did not block the food intake suppression by GLP1-based obesity drugs”
    Quote in the paperSubstantial claim
  • May combine two claims. 46
  • The quote only partly states this claim. 3
  • Classified as probably not a substantial claim. 23
  • May combine two claims.

    Findingown data

    AP and NTS GLP1R neuron tuning to nutritive and aversive stimuli was not absolute; their physiological responses were mixed.

    “while APGLP1R neurons generally had greater responses to aversive stimuli and NTSGLP1R neurons had greater responses to nutritive stimuli, this neural tuning was not absolute”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Ensure administered intraduodenally is a nutritive stimulus.
    • Rests on an assumption: Lithium chloride administered intravenously is an aversive or nauseogenic stimulus.
  • May combine two claims.

    Findingown data

    Optogenetic activation of AP GLP1R→lPBN neurons, but not NTS GLP1R→PVH neurons, reduced time spent in the stimulated environment in a real-time place avoidance assay.

    “Optogenetic activation of APGLP1R→lPBN neurons, but not NTSGLP1R→PVH neurons, significantly reduced time spent in the environment where mice received stimulation”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim.

    Findingown data

    Among drug-accessible GLP1R populations, only hindbrain DVC GLP1R neurons are necessary for the efficacy of GLP1-based obesity drugs.

    “Systematic investigation across drug-accessible GLP1R populations revealed that only hindbrain neurons are required for the efficacy of GLP1-based obesity drugs.”
    • Also stated in: § Obesity drugs act on hindbrain GLP1R neurons · boosted
      “demonstrating the necessity of DVCGLP1R neurons for the efficacy of this obesity drug”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The necessity of each drug-accessible GLP1R neural population for the anorexic and weight-loss effects of obesity therapeutics had not been systematically tested.
  • May combine two claims.

    Findingown data

    Reanalysis of three single-cell/nucleus RNA sequencing datasets showed that AP and NTS GLP1R neurons are mixed excitatory and inhibitory populations, with a greater proportion of NTS GLP1R neurons being excitatory.

    “we combined and re-analyzed three existing single cell/nucleus RNA sequencing datasets13,16,17 to determine that APGLP1R and NTSGLP1R neurons are mixed excitatory and inhibitory populations, with a greater proportion of NTSGLP1R neurons being excitatory”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [13] Zhang, C. et al. Area postrema cell types that mediate nausea-associated behaviors. Neuron 109, 461–472 (2021). source

      Not checked in the free run.

    • cites [16] Ludwig, M. Q. et al. A genetic map of the mouse dorsal vagal complex and its role in obesity. Nat. Metab. 3, 530–545 (2021). source

      Not checked in the free run.

    • cites [17] Adriaenssens, A. et al. Hypothalamic and brainstem glucose-dependent insulinotropic polypeptide receptor neurons employ distinct mechanisms to affect feeding. 8, https://doi.org/10.1172/jci.insight.164921 (2023). source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Optogenetic activation of AP GLP1R→lPBN, but not NTS GLP1R→PVH, projections reduced hedonic and increased aversive real-time taste reactivity.

    “optogenetic activation of APGLP1R→lPBN, but not NTSGLP1R→PVH, projections reduced hedonic and increased aversive real-time taste reactivity”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    More AP GLP1R neurons were activated by aversive cinacalcet, whereas more NTS GLP1R neurons were activated by nutritive Ensure.

    “Further, more APGLP1R neurons were activated by the aversive stimulus (cinacalcet), whereas more NTSGLP1R neurons were activated by nutrients (Ensure)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Ensure administered intraduodenally is a nutritive stimulus.
    • Rests on an assumption: Lithium chloride administered intravenously is an aversive or nauseogenic stimulus.
  • May combine two claims.

    Findingown data

    Ablation of ARC or NG GLP1R neurons did not block food intake suppression by exendin-4 or semaglutide.

    “but not the populations in the ARC or NG, completely blocked food intake suppression by both exendin-4”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Semaglutide significantly activated both AP and NTS GLP1R neurons compared with vehicle.

    “Both APGLP1R and NTSGLP1R neurons were significantly activated by semaglutide in comparison to vehicle administration”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Neither AP nor NTS GLP1R deletion affected exendin-4- or semaglutide-induced anorexia.

    “Neither APGLP1R nor NTSGLP1R deletion affected exendin-4 or semaglutide-induced anorexia”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    AP GLP1R neuron activation, but not NTS GLP1R neuron activation, was sufficient to condition a CFA.

    “Similarly, APGLP1R neuron13, but not NTSGLP1R neuron, activation was sufficient to condition a CFA”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    AAV2.2 EYFP tracing showed axon terminals in the lPBN of AP GLP1R-injected mice and in the PVH of NTS GLP1R-injected mice, with virtually no collateralization.

    “This analysis revealed axon terminals in the lPBN of APGLP1R-injected mice, and axon terminals in the PVH of NTSGLP1R-injected mice, with virtually no collateralization”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Chemogenetic activation of DVC GLP1R neurons paired with a novel flavor reduced conditioned hedonic responses and increased conditioned aversive taste reactivity.

    “After pairing, mice displayed fewer conditioned hedonic responses and increased conditioned aversive responses compared to control mice”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Only activation of AP GLP1R neurons, not NTS GLP1R neurons, reduced hedonic and increased aversive taste reactivity.

    “Strikingly, only activation of APGLP1R neurons, and not NTSGLP1R neurons, reduced hedonic and increased aversive taste reactivity responses”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Activation of NTS GLP1R neurons increased inter-meal interval but did not change meal size, indicating increased satiety.

    “Activation of NTSGLP1R neurons increased inter-meal interval (Fig. 3i) but had no effect on meal size (Extended Data Fig. 8g), indicating that NTSGLP1R neurons increase satiety.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Alternative motion correction methods did not change the calcium imaging results or conclusions.

    “While these corrections did not influence our results or conclusions, they may be necessary for those analyzing frames with substantial uniform or non-uniform distortions, especially for preparations with ROIs along image edges.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    DVC GLP1R neurons form at least two subpopulations that are activated by either nutritive or aversive stimuli and are much less likely to be activated by both.

    “we also demonstrate that DVCGLP1R neurons form at least two subpopulations that are activated by either nutritive or aversive stimuli (and are much less likely to be activated by both).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Ensure administered intraduodenally is a nutritive stimulus.
    • Rests on an assumption: Lithium chloride administered intravenously is an aversive or nauseogenic stimulus.
  • May combine two claims. The quote only partly states this claim.

    Findingown data

    Exendin-4 reduced food intake in fasted control, ARC-ablated, and NG-ablated mice, but not in DVC-ablated mice.

    “(d) Food intake following IP injection of saline or exendin-4 in fasted control or GLP1R-ablated mice (n=8–14 mice/group, two-way repeated measures ANOVAs, all ps<0.01 except DVC where p=ns).”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Dark period energy expenditure normalized to lean mass did not significantly differ between high-fat diet-fed control mice and mice with chronic NaChBac-mediated DVCGLP1R neuron activation (p=0.06).

    “(f) Dark period energy expenditure normalized to lean mass by ANCOVA in high-fat diet-fed control mice or mice with chronic NaChBac-mediated DVCGLP1R neuron activation (n=7–8 mice/group, ANCOVA, p=0.06).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    GLP1R neurons in the dorsal vagal complex project densely to the NTS but not to the AP.

    “Images depict the dense GLP1R projection into the NTS but not into the AP.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Ensure administration increased average z-scored activity in both AP and NTS GLP1R neurons relative to saline.

    “Average z-scored activity responses in APGLP1R neurons (blue) and NTSGLP1R neurons (green) to saline or Ensure administration (n=6 mice, two-way ANOVA, AP: saline vs Ensure: p<0.01, NTS: saline vs. Ensure p<0.001).”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Quinine concentration significantly affected composite aversive taste reactivity scores and individual aversive behaviours.

    “Composite score (e, n=5–10 mice/group, one-way ANOVA, all ps<0.01) and individual behaviours (f, 5–10 mice/group, two-way ANOVA, all ps<0.05) for aversive taste reactivity responses to quinine concentrations (0, 2.4, 4 mM).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Chemogenetic activation of AP GLP1R neurons changed hedonic taste reactivity behaviours after conditioning, while activation of NTS GLP1R neurons did not.

    “Individual hedonic taste reactivity behaviours at baseline and after conditioning with chemogenetic APGLP1R (l, n=8 mice, two-way ANOVA, RMM baseline vs. conditioned p<0.001) or NTSGLP1R (m, n=5 mice, two-way ANOVA, all ps=ns) neuron activation.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Chemogenetic activation of AP GLP1R neurons reduced meal size in fasted mice, whereas activation of NTS GLP1R neurons did not.

    “Meal size in fasted mice following chemogenetic activation of APGLP1R or NTSGLP1R neurons (n=10–11 mice/group, two-way ANOVA, APGLP1R-hM3Dq vehicle vs. CNO: p<0.001, NTSGLP1R-hM3Dq vehicle vs. CNO: p=ns).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Semaglutide induced conditioned flavour avoidance in WT mice but not in DVC GLP1R-deleted mice.

    “Intake of flavour paired with semaglutide (CS+) in control (WT) or DVC GLP1R-deleted (Glp1rfl/fl) mice before (baseline) and after conditioning (n=6–8 mice/group, two-way ANOVA, WT baseline vs. conditioned: p<0.001, Glp1rfl/fl baseline vs. conditioned: p=ns).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Chemogenetic activation of AP GLP1R neurons changed aversive taste reactivity behaviours after conditioning, while activation of NTS GLP1R neurons did not.

    “Individual aversive taste reactivity behaviours at baseline and after conditioning with chemogenetic APGLP1R (n, n=8 mice, two-way ANOVA, CR baseline vs. conditioned: p<0.001) or NTSGLP1R (o, n=5 mice, two-way ANOVA, all ps=ns) neuron activation.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Optogenetic stimulation of APGLP1R→lPBN, but not NTSGLP1R→PVH, altered aversive taste reactivity behaviours.

    “Individual aversive taste reactivity behaviours at baseline (pre-stimulation) and during optogenetic stimulation of APGLP1R→lPBN (m, n=6 mice, two-way ANOVA, CR no stim vs. stim: p<0.001) or NTSGLP1R→PVH (n, n=6 mice, two-way ANOVA, all ps=ns) neurons.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Quinine concentration significantly affected composite hedonic taste reactivity scores and individual hedonic behaviours.

    “Composite score (c, n=5–10 mice/group, one-way ANOVA, all ps<0.05) and individual behaviours (d, n=5–10 mice/group, two-way ANOVA, all ps<0.001) for hedonic taste reactivity responses to quinine concentrations (0, 2.4, 4 mM).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Optogenetic activation of APGLP1R→lPBN or NTSGLP1R→PVH neurons did not affect 1-h food intake in control mice expressing EYFP.

    “Food intake (1 h) in control mice expressing EYFP in APGLP1R→lPBN (a, n=6 mice, paired t-test, p=ns) and NTSGLP1R→PVH (b, n=5 mice, two-sided paired t-test, p=ns) neurons.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Optogenetic activation of APGLP1R→lPBN or NTSGLP1R→PVH did not induce real-time place avoidance in fasted mice expressing ChR2.

    “Time spent in stimulation zone during real-time place avoidance assay in fasted mice expressing ChR2 in APGLP1R→lPBN (i, n=11 mice, two-way ANOVA, all ps=ns) or NTSGLP1R→PVH (j, n=7 mice, two-way ANOVA, all ps=ns) neurons.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The mean time to semaglutide-induced activation did not differ between AP and NTS GLP1R neurons.

    “Mean time to semaglutide-induced activation in APGLP1R and NTSGLP1R neurons depicted in h (n=5 mice, two-sided unpaired t-test, p=ns).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Optogenetic activation of APGLP1R→lPBN, but not NTSGLP1R→PVH, induced real-time place avoidance in ad libitum-fed mice expressing ChR2.

    “Time spent in stimulation zone during real-time place avoidance assay in ad libitum-fed mice expressing ChR2 in APGLP1R→lPBN (g, n=10–11 mice/group, two-way ANOVA, Trials 2&3 no stim vs. stim: ps<0.05) or NTSGLP1R→PVH (h, n=7 mice, two-way ANOVA, all ps=ns).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    The number of AP GLP1R neurons expressing hM3Dq correlates with avoidance behaviour, while the number of NTS GLP1R neurons expressing hM3Dq does not.

    “Number of APGLP1R, but not NTSGLP1R, neurons expressing chemogenetic receptors correlates with avoidance behaviour.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    In ad libitum-fed control mice expressing EYFP, optogenetic stimulation of APGLP1R→lPBN or NTSGLP1R→PVH did not affect time spent in the stimulation zone during a real-time place avoidance assay.

    “Time spent in stimulation zone during real-time place avoidance assay in ad libitum-fed control mice expressing EYFP in APGLP1R→lPBN (c, n=5–6 mice/group, two-way ANOVA, all ps=ns) or NTSGLP1R→PVH (d, n=5 mice, two-way ANOVA, all ps=ns) neurons.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    AP and NTS GLP1R neurons are generally distinct from other hindbrain cell types and mediate aversion and satiety, respectively.

    “Together with physiological and behavioural results, these data indicate that APGLP1R and NTSGLP1R neurons are generally distinct from other hindbrain cell types and mediate aversion and satiety responses, respectively.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    The NTS GLP1R→PVH circuit suppresses feeding without inducing aversion.

    “highlighting a NTSGLP1R→PVH circuit that suppresses feeding without inducing aversion.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    DVC GLP1R neuron activation suppresses food intake through increased satiety, indicated by longer inter-meal intervals and unchanged meal size, rather than through changes in energy expenditure.

    “These effects were mediated by suppression of food intake due to increased satiety – indicated by increased inter-meal interval and no change in meal size”
    • Also stated in: § Obesity drugs act on hindbrain GLP1R neurons · plain
      “and not by changes in energy expenditure”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    Two anatomically and functionally distinct GLP1R projections arising from the AP and NTS drive aversion and satiety, respectively.

    “reveal two anatomically and functionally distinct GLP1R projections – arising from the AP and the NTS – that drive aversion and satiety, respectively.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    GLP1R agonist obesity drugs produce aversive effects such as nausea and vomiting, and these effects may contribute to their therapeutic efficacy.

    “The most successful obesity therapeutics – glucagon-like peptide-1 receptor (GLP1R) agonists – cause aversive responses such as nausea and vomiting1,2, effects which may contribute to their efficacy.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [1] Wadden, T. A. et al. Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: The STEP 3 Randomized Clinical Trial. JAMA 325, 1403–1413 (2021). source

      Not checked in the free run.

    • cites [2] Wilding, J. P. H. et al. Once-weekly semaglutide in adults with overweight or obesity. N. Engl. J. Med. 384, 989–1002 (2021). source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    AP GLP1R and NTS GLP1R neurons send projections to largely different downstream brain regions and cell types, potentially mediating distinct anorexic behaviors.

    “Therefore, APGLP1R and NTSGLP1R neurons send projections to largely different downstream brain regions and cell types to potentially mediate distinct anorexic behaviours.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    lPBN CGRP neurons suppress food intake and drive aversion.

    “lPBNCGRP neurons suppress food intake and drive aversion28–30”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [28] Carter, M. E., Han, S. & Palmiter, R. D. Parabrachial calcitonin gene-related peptide neurons mediate conditioned taste aversion. J. Neurosci. 35, 4582–4586 (2015). source

      Not checked in the free run.

    • cites [29] Campos, C. A., Bowen, A. J., Schwartz, M. W. & Palmiter, R. D. Parabrachial CGRP neurons control meal termination. Cell Metab 23, 811–820 (2016). source

      Not checked in the free run.

    • cites [30] Carter, M. E., Soden, M. E., Zweifel, L. S. & Palmiter, R. D. Genetic identification of a neural circuit that suppresses appetite. Nature 503, 111–114 (2013). source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    NTS GLP1R neurons inhibit food intake and body weight without inducing aversion.

    “These data highlight NTSGLP1R neurons as a population that inhibits food intake and body weight without inducing aversion.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Investigators collecting or analyzing data were blinded to experimental conditions.

    “Investigators collecting (e.g, performing behavioural measurements) or analyzing (e.g., counting neurons) data were blinded to experimental conditions.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Mice showing excessive food grinding were excluded from all analyses.

    “Mice with excessive food grinding behaviours (<5% of all mice tested) were excluded from all analyses.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The adverse gastrointestinal side effects of GLP1-based obesity drugs are more severe at the start of treatment and tend to decrease over time.

    “Clinically, the adverse gastrointestinal side effects of GLP1-based obesity drugs are more severe at the start of treatment and tend to decrease over time54.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] Shu, Y. et al. Gastrointestinal adverse events associated with semaglutide: a pharmacovigilance study based on FDA adverse event reporting system. Front. Public Health 10, 996179 (2022). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Study design and conductown data

    Before calcium activity analysis, AP and NTS boundaries were drawn using anatomical landmarks to prevent bias.

    “Prior to analysis of calcium activity (to prevent any bias), boundaries between the AP and NTS were drawn for each z plane using (1) the differential density of GLP1R neurons in AP vs. NTS which creates a natural boundary”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationcitation

    Because nausea and vomiting are side effects of many treatments, the concept of dissociable circuits could be applied to investigate other therapeutics.

    “Because nausea and vomiting are side effects of thousands of treatments for human disease60, this concept could be applied to investigate other therapeutics”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60] Wickham, R. J. Nausea and vomiting: a palliative care imperative. Curr. Oncol. Rep. 22, 1 (2020). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Mice that did not eat during the 4-6 h post-CNO period were excluded from inter-meal interval analyses.

    “Mice that did not eat in this time period (n=2 across all experiments) were excluded from inter-meal-interval analyses.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    NTS serotonin 2C receptors are both necessary and sufficient for the anorexic effects of lorcaserin.

    “NTS serotonin 2C receptors (5HT2CR) are both necessary and sufficient for the anorexic effects of a previously-used obesity drug, lorcaserin47.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] D’Agostino, G. et al. Nucleus of the solitary tract serotonin 5-HT2C receptors modulate food intake. Cell Metab. 28, 619–630 (2018). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Technical constraints, including imaging under anesthesia and applying only one trial each of nutritive and aversive stimuli within the same imaging session, limit interpretations of the results.

    “We also note that technical constraints, such as imaging under anesthesia and applying only one trial each of nutritive and aversive stimuli within the same imaging session, limit interpretations of results.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    DTA has previously been used to ablate nodose ganglion neurons.

    “because DTA has been previously used to ablate NG neurons67”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [67] Ghidewon, M. et al. Growth differentiation factor 15 (GDF15) and semaglutide inhibit food intake and body weight through largely distinct, additive mechanisms. Diabetes Obes. Metab. 24, 1010–1020 (2022). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    There were no significant body weight differences between groups at baseline.

    “Although there were no significant body weight differences between groups at baseline”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    NTS CCK neurons project to the lPBN and PVH; NTS CCK→lPBN projections cause negative valence, whereas NTS CCK→PVH projections do not.

    “NTSCCK neurons also project to the lPBN and PVH, and NTSCCK→lPBN projections cause negative valence but NTSCCK→PVH projections do not49–51.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [49] D’Agostino, G. et al. Appetite controlled by a cholecystokinin nucleus of the solitary tract to hypothalamus neurocircuit., eLife 5, e12225 (2016). source

      Not checked in the free run.

    • cites [50] Roman, C. W., Sloat, S. R. & Palmiter, R. D. A tale of two circuits: CCKNTS neuron stimulation controls appetite and induces opposing motivational states by projections to distinct brain regions. Neuroscience 358, 316–324 (2017). source

      Not checked in the free run.

    • cites [51] Cheng, W. et al. Calcitonin receptor neurons in the mouse nucleus tractus solitarius control energy balance via the non-aversive suppression of feeding. Cell Metab. 31, 301–312 (2020). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Fluorescently tagged semaglutide binds in both the AP and the NTS.

    “Although fluorescently-tagged semaglutide binds in both the AP and the NTS10”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Gabery, S. et al. Semaglutide lowers body weight in rodents via distributed neural pathways. JCI Insight 5, https://doi.org/10.1172/jci.insight.133429 (2020). source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Both Casp3 and DTA methods effectively ablated the targeted GLP1R neurons.

    “We verified that both techniques (Casp3 and DTA) effectively ablated our neurons of interest (Extended Data Fig. 1b, c).”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    All sample sizes reported in the manuscript refer to biological replicates.

    “All ns reported throughout the manuscript are biological replicates.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims. The quote only partly states this claim.

    Study design and conductown data

    Exclusions from data were limited to mice with significant spillage, unexpected illness or euthanasia, and no food intake for meal pattern analyses.

    “There were no exclusions from the data except for the following: For food intake measurements, mice with significant spillage were excluded from analysis”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Study design and conductown data

    No significant sex differences were observed across all studies except one experiment, so results for males and females were combined.

    “Except for one experiment (Extended Data Fig. 1f) which had a smaller but still significant effect in female compared to male mice, we did not observe any significant sex differences across all studies and therefore we combined results for males and females.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    GLP1R signaling reduces motivational aspects of feeding and other behaviors such as alcohol and drug intake.

    “given the role of GLP1R signaling in reducing motivational aspects of feeding and other behaviours such as alcohol and drug intake38,57–59”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [38] Alhadeff, A. L. & Grill, H. J. Hindbrain nucleus tractus solitarius glucagon-like peptide-1 receptor signaling reduces appetitive and motivational aspects of feeding. Am. J. Physiol. Regul. Integr. Comp. Physiol. 307, R465–R470 (2014). source

      Not checked in the free run.

    • cites [57] Egecioglu, E. et al. The glucagon-like peptide 1 analogue Exendin-4 attenuates alcohol mediated behaviors in rodents. Psychoneuroendocrinology 38, 1259–1270 (2013). source

      Not checked in the free run.

    • cites [58] Tuesta, L. M. et al. GLP-1 acts on habenular avoidance circuits to control nicotine intake. Nat. Neurosci. 20, 708–716 (2017). source

      Not checked in the free run.

    • cites [59] Schmidt, H. D. et al. Glucagon-like peptide-1 receptor activation in the ventral tegmental area decreases the reinforcing efficacy of cocaine. Neuropsychopharmacology 41, 1917–1928 (2016). source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Mice lacking viral expression or with expression outside the target region were excluded from analyses after post-mortem verification.

    “Where appropriate, viral expression was verified post-mortem; any mouse that did not express virus or expressed virus outside of the target region was excluded from analyses.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    For between-subject analyses, mice were randomly assigned to experimental condition.

    “For between-subject analyses, mice were randomly assigned to experimental condition.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Power analyses were run to ensure that sample sizes were sufficient to determine significant differences between groups.

    “Power analyses were run [beta = 0.2 (80% power), alpha =0.05] with effect sizes based on pilot studies (n=3–6) to ensure that sample sizes (number of mice for behavioural studies, number of neurons for physiological/anatomical studies) were sufficient to determine significant differences between groups.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Alternative motion correction strategies did not significantly change the proportions of activated neurons or individual calcium traces in this imaging setup.

    “Although these alternate motion correction strategies did not significantly change our data, we note for readers that some imaging preparations (especially those that have more ROIs around the edges of frames) may require such strategies.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    Individual AP and NTS GLP1R neurons are specialized, with most biased toward nutritive or aversive stimuli and less overlap than expected by chance.

    “That the probability of a cell being activated by both stimuli is generally lower than the product of individual probabilities suggests a level of specialization of individual cells where most are biased toward nutritive or aversive stimuli, with less overlap than would be expected by chance.”
    Quote in the paperSubstantial claim
63 of 63
  • The paper relies on this without support.

    The necessity of each drug-accessible GLP1R neural population for the anorexic and weight-loss effects of obesity therapeutics had not been systematically tested.

    “However, the necessity of each of these neural populations (Fig. 1a) in the anorexic and weight loss effects of obesity therapeutics has not been systematically tested.”
  • The paper relies on this without support.

    Whether nausea and satiety arise from similar or different neural circuits remains unclear.

    “whether nausea and satiety arise from similar or different neural circuits remains unclear.”
  • The paper relies on this without support.

    Dissociable GLP1R-mediated mechanisms for satiety and nausea or aversion remain unknown.

    “this depends on the existence of dissociable GLP1R-mediated mechanisms for satiety and nausea/aversion, which remain unknown.”
  • The paper relies on this without support.

    It is unknown whether GLP1 drug-induced nausea and anorexia are intrinsically linked as a mechanism for food intake suppression and weight loss.

    “it is unknown whether these features are intrinsically linked as a mechanism for food intake suppression and weight loss.”
  • The paper relies on this without support.

    Ensure administered intraduodenally is a nutritive stimulus.

    “responsivity to nutrients [Ensure, administered intraduodenally (ID)]”
  • The paper relies on this without support.

    Lithium chloride administered intravenously is an aversive or nauseogenic stimulus.

    “or nauseogenic/aversive stimuli [cinacalcet or lithium chloride (LiCl), both administered IV]”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Recent mechanistic studies, primarily in rodents, have identified sites of direct action putatively mediating the effects of GLP-1-based anti-obesity medications on eating and body weight, including the area postrema and nucleus tractus solitarius, locus coeruleus, hypothalamic arcuate and dorsomedial nuclei, and lateral septal nucleus.

    “Recent mechanistic studies, primarily conducted in rodents, have identified a number of sites of direct action putatively mediating the effects of GLP-1-based AOMs on eating and body weight, including the area postrema and nucleus tractus solitarius (47‐49), locus coeruleus (50), hypothalamic arcuate (51, 52) and dorsomedial nuclei (53), and the lateral septal nucleus (54).”
  • GLP-1R-expressing neuron populations in the area postrema, and at least some of the nucleus tractus solitarius, are clearly activated by GLP-1RAs and appear to mediate at least some of the effects of these drugs on satiation, satiety, and nausea/malaise, likely by recruiting circuits which are endogenous targets of supraphysiological gut-derived GLP-1.

    “GLP-1R-expressing neuron populations in the AP, and at least some of the NTS, are clearly activated by GLP-1RAs and appear to mediate at least some of the effects of these drugs on satiation, satiety, and nausea/malaise (47‐49), likely by recruiting circuits which are endogenous targets of (supraphysiological) gut-derived GLP-1.”
  • The individual necessity of distinct GLP-1R neuron populations for the anorectic and weight loss effects of GLP-1RAs has now been claimed by multiple studies using various loss-of-function approaches in rodents.

    “The individual necessity of distinct GLP-1R neuron populations for the anorectic and weight loss effects of GLP-1RAs has now been claimed by multiple studies using various loss-of-function approaches in rodents (47, 50‐54, 69).”
  • A recent rodent study posited the area postrema and nucleus tractus solitarius as indispensable targets for the anorectic and weight loss effects of semaglutide, and that GLP-1R neurons in the area postrema, but not nucleus tractus solitarius, drive GLP-1RA-mediated nausea responses.

    “Indeed, a recent rodent study has posited the AP and NTS as indispensable targets for the anorectic and weight loss effects of semaglutide, and that GLP-1R neurons in the AP, but not NTS, drive GLP-1RA-mediated nausea responses (47).”
  • There are populations of GLP-1R neurons within the area postrema and nucleus tractus solitarius that facilitate nausea and satiation/satiety, likely through functionally discrete neurocircuits.

    “Hence it appears that there are populations of GLP-1R neurons within the AP and NTS that facilitate nausea and satiation/satiety, likely through functionally discrete neurocircuits (47).”

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Authors
Huang, K.-P., Acosta, A. A., Ghidewon, M. Y., McKnight, A. D., Almeida, M. S., Nyema, N. T., Hanchak, N. D., Patel, N., Gbenou, Y. S. K., Adriaenssens, A. E., Bolding, K. A., & Alhadeff, A. L.
Affiliations
  • Monell Chemical Senses Center (US)
  • University College London (GB)
Corresponding author
Alhadeff, Amber L.
Venue
Nature
Published
2024-07-10
Volume
632
Issue
8025
Pages
585-593
ISSN
  • 0028-0836 (ISSN-L)
  • 1476-4687
OpenAlex
W4400491973
Cited by
166
References
79
Citations by year
2026: 62 · 2025: 82 · 2024: 22
FWCI
35.56
Type
journal article
Language
en
Open access
Locations
  • Nature (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
  • National Science Foundation (2236662)
  • American Heart Association (898990)
  • University of Pennsylvania
  • Novo Nordisk Fonden (NNF21SA0072744)
  • National Institutes of Health (1s10od030354-01)
  • National Institute on Deafness and Other Communication Disorders (R01DC020927)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R00DK119574, R01DK131558)
  • National Center for Complementary and Integrative Health (DP2AT011965)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
GLP-1 receptor, satiety, aversion, nausea and vomiting, obesity drugs, hindbrain, nucleus tractus solitarius, area postrema, two-photon calcium imaging, neural circuits, dietary intake, weight loss
MeSH terms
Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Animals, Avoidance Learning, Eating, Female, Food, Male, Mice, Inbred C57BL, Neural Pathways, Neurons, Obesity, Rhombencephalon, Satiety Response, Solitary Nucleus, Anti-Obesity Agents, Area Postrema, Mice, Glucagon-Like Peptide 1

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

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