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Institute of Metabolic Science

Metabolic Research Laboratories
 

Research Interests 

I am interested in higher level perceptual and learning processes, and how these shape decision-making and behaviour. In particular, I try to understand how individual variability in such processes may contribute to seemingly irrational choices that may have health-harming consequences. This is relevant not just to an array of mental disorders but also to over-consumption and obesity. I think that it is very important that we do not consider the brain in isolation from either the body or from its external environment and that the study of high level cognitive processes must be shaped by close consideration of underlying metabolic and endocrine signals. This work benefits from collaboration with Professors Steve O’Rahilly, Sadaf Farooqi, Fiona Gribble and Frank Reimann. 

In addition, the study of fundamental reward-related processes in the human brain benefits from close links with basic neuroscientists in the departments of psychiatry, psychology and clinical neuroscience.  

My work has focused on how combined functional neuroimaging, behavioural and pharmacological studies can elucidate brain processes involved in responding to environmental stimuli and determining food choice. Pharmacological perturbations , for example with dopamine agonists and antagonists, can be used to explore the neurotransmitter basis for these processes and ensuing measures of food-related behaviours are set up to determine the relevance of these lab and imaging-based measures to real-world choice and consumption. These studies have formed the basis for targeted assessment of brain structural changes associated with obesity. 

The overall aim, through systematic exploration of these processes, is to understand choice and behaviour in detail and to determine the basis for marked variability in susceptibility to internally- and environmentally-driven consumption. Through this understanding, a fuller comprehension of the multiple factors contributing to obesity will be possible.


Research Funding 

The Bernard Wolfe Health Neuroscience Fund 

Wellcome 

Publications

Key publications: 

1: Harding JN, Wolpe N, Brugger SP, Navarro V, Teufel C, Fletcher PC. A new predictive coding model for a more comprehensive account of delusions. Lancet Psychiatry. 2024 Apr;11(4):295-302. doi: 10.1016/S2215-0366(23)00411-X. Epub 2024 Jan 16. PMID: 38242143. 

2: Brown SSG, Westwater ML, Seidlitz J, Ziauddeen H, Fletcher PC. Hypothalamic volume is associated with body mass index. Neuroimage Clin. 2023;39:103478. doi: 10.1016/j.nicl.2023.103478. Epub 2023 Jul 24. PMID: 37558541; PMCID: PMC10509524. 

3: Daniel-Watanabe L, Fletcher PC. Are Fear and Anxiety Truly Distinct? Biol Psychiatry Glob Open Sci. 2021 Oct 6;2(4):341-349. doi: 10.1016/j.bpsgos.2021.09.006. PMID: 36324663; PMCID: PMC9616241. 

4: Ventsel M, Pechey E, De-Loyde K, Pilling MA, Morris RW, Maistrello G, Ziauddeen H, Marteau TM, Hollands GJ, Fletcher PC. Effect of health warning labels on motivation towards energy-dense snack foods: Two experimental studies. Appetite. 2022 Aug 1;175:106084. doi: 10.1016/j.appet.2022.106084. Epub 2022 May 14. PMID: 35580820; PMCID: PMC9194909. 

5: Westwater ML, Murley AG, Diederen KMJ, Carpenter TA, Ziauddeen H, Fletcher PC. Characterizing cerebral metabolite profiles in anorexia and bulimia nervosa and their associations with habitual behavior. Transl Psychiatry. 2022 Mar 15;12(1):103. doi: 10.1038/s41398-022-01872-7. PMID: 35292626; PMCID: PMC8924163. 

6: Westwater ML, Mancini F, Shapleske J, Serfontein J, Ernst M, Ziauddeen H, Fletcher PC. Dissociable hormonal profiles for psychopathology and stress in anorexia and bulimia nervosa. Psychol Med. 2021 Dec;51(16):2814-2824. doi: 10.1017/S0033291720001440. Epub 2020 May 28. PMID: 32460904; PMCID: PMC8640366. 

7: Westwater ML, Mancini F, Gorka AX, Shapleske J, Serfontein J, Grillon C, Ernst M, Ziauddeen H, Fletcher PC. Prefrontal Responses during Proactive and Reactive Inhibition Are Differentially Impacted by Stress in Anorexia and Bulimia Nervosa. J Neurosci. 2021 May 19;41(20):4487-4499. doi: 10.1523/JNEUROSCI.2853-20.2021. Epub 2021 Apr 12. PMID: 33846229; PMCID: PMC8152613. 

8: Diederen KMJ, Fletcher PC. Dopamine, Prediction Error and Beyond. Neuroscientist. 2021 Feb;27(1):30-46. doi: 10.1177/1073858420907591. Epub 2020 Apr 26. PMID: 32338128; PMCID: PMC7804370. 

9: Ronan L, Alexander-Bloch A, Fletcher PC. Childhood Obesity, Cortical Structure, and Executive Function in Healthy Children. Cereb Cortex. 2020 Apr 14;30(4):2519-2528. doi: 10.1093/cercor/bhz257. PMID: 31646343; PMCID: PMC7175011. 

10: Teufel C, Fletcher PC. Forms of prediction in the nervous system. Nat Rev Neurosci. 2020 Apr;21(4):231-242. doi: 10.1038/s41583-020-0275-5. Epub 2020 Mar 10. Erratum in: Nat Rev Neurosci. 2020 May;21(5):297. doi: 10.1038/s41583-020-0296-0. PMID: 32157237. 

Bernard Wolfe Professor of Health Neuroscience
Wellcome Trust Senior Clinical Fellow
Department of Psychiatry
photo of paul fletcher

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