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Steward T, Menchón JM, Jiménez-Murcia S, Soriano-Mas C, Fernández-Aranda F. Neural Network Alterations Across Eating Disorders: A Narrative Review of fMRI Studies. Curr Neuropharmacol 2018; 16:1150-1163. [PMID: 29046154 PMCID: PMC6187750 DOI: 10.2174/1570159x15666171017111532] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 08/18/2017] [Accepted: 10/10/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Functional magnetic resonance imaging (fMRI) has provided insight on how neural abnormalities are related to the symptomatology of the eating disorders (EDs): anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). More specifically, an increasingly growing number of brain imaging studies has shed light on how functionally connected brain networks contribute not only to disturbed eating behavior, but also to transdiagnostic alterations in body/interoceptive perception, reward processing and executive functioning. METHODS This narrative review aims to summarize recent advances in fMRI studies of patients with EDs by highlighting studies investigating network alterations that are shared across EDs. RESULTS AND CONCLUSION Findings on reward processing in both AN and BN patients point to the presence of altered sensitivity to salient food stimuli in striatal regions and to the possibility of hypothalamic inputs being overridden by top-down emotional-cognitive control regions. Additionally, innovative new lines of research suggest that increased activations in fronto-striatal circuits are strongly associated with the maintenance of restrictive eating habits in AN patients. Although significantly fewer studies have been carried out in patients with BN and BED, aberrant neural responses to both food cues and anticipated food receipt appear to occur in these populations. These altered responses, coupled with diminished recruitment of prefrontal cognitive control circuitry, are believed to contribute to the binge eating of palatable foods. Results from functional network connectivity studies are diverse, but findings tend to converge on indicating disrupted resting-state connectivity in executive networks, the default-mode network and the salience network across EDs.
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Affiliation(s)
| | | | | | - Carles Soriano-Mas
- Address correspondence to these authors at the Department of Psychiatry, Bellvitge University Hospital-IDIBELL, CIBEROBN and CIBERSAM, c/ Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat Barcelona, Spain; Tel: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mails: &
| | - Fernando Fernández-Aranda
- Address correspondence to these authors at the Department of Psychiatry, Bellvitge University Hospital-IDIBELL, CIBEROBN and CIBERSAM, c/ Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat Barcelona, Spain; Tel: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mails: &
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Large-Scale Network Coupling with the Fusiform Cortex Facilitates Future Social Motivation. eNeuro 2017; 4:eN-NWR-0084-17. [PMID: 29034316 PMCID: PMC5635486 DOI: 10.1523/eneuro.0084-17.2017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 09/20/2017] [Accepted: 09/26/2017] [Indexed: 11/21/2022] Open
Abstract
Large-scale functional networks, as identified through the coordinated activity of spatially distributed brain regions, have become central objects of study in neuroscience because of their contributions to many processing domains. Yet, it remains unclear how these domain-general networks interact with focal brain regions to coordinate thought and action. Here, we investigated how the default-mode network (DMN) and executive control network (ECN), two networks associated with goal-directed behavior, shape task performance through their coupling with other cortical regions several seconds in advance of behavior. We measured these networks' connectivity during an adaptation of the monetary incentive delay (MID) response-time task in which human participants viewed social and nonsocial images (i.e., pictures of faces and landscapes, respectively) while brain activity was measured using fMRI. We found that participants displayed slower reaction times (RTs) subsequent to social trials relative to nonsocial trials. To examine the neural mechanisms driving this subsequent-RT effect, we integrated independent components analysis (ICA) and a network-based psychophysiological interaction (nPPI) analysis; this allowed us to investigate task-related changes in network coupling that preceded the observed trial-to-trial variation in RT. Strikingly, when subjects viewed social rewards, an area of the fusiform gyrus (FG) consistent with the functionally-defined fusiform face area (FFA) exhibited increased coupling with the ECN (relative to the DMN), and the relative magnitude of coupling tracked the slowing of RT on the following trial. These results demonstrate how large-scale, domain-general networks can interact with focal, domain-specific cortical regions to orchestrate subsequent behavior.
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Neural correlates of altered feedback learning in women recovered from anorexia nervosa. Sci Rep 2017; 7:5421. [PMID: 28710363 PMCID: PMC5511172 DOI: 10.1038/s41598-017-04761-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 05/19/2017] [Indexed: 12/19/2022] Open
Abstract
Anorexia nervosa (AN) is associated with exaggerated self-control and altered reward-based decision making, but the underlying neural mechanisms are poorly understood. Consistent with the notion of excessive cognitive control, we recently found increased dorsal anterior cingulate cortex (dACC) activation in acutely ill patients (acAN) on lose-shift trials in a probabilistic reversal learning (PRL) task. However, undernutrition may modulate brain function. In attempt to disentangle trait from state factors, the current fMRI study investigated cognitive control in recovered patients (recAN). Thirty-one recAN and 31 healthy controls (HC) completed a PRL task during fMRI. Based on previous findings, we focused on hemodynamic responses during lose-shift behaviour and conducted supplementary functional connectivity analysis. RecAN showed elevated lose-shift behaviour relative to HC. On the neural level, recAN showed normal dACC responses, but increased activation in fronto-parietal control regions. A trend for increased coupling between frontal and parietal regions of interest was also evident in recAN. The current findings in recAN differ from those in our previous study in acAN. While aberrant dACC response to negative feedback may be a correlate of the underweight state in acAN, impaired behavioural adaptation and elevated activation of cognitive control regions in recAN is suggestive of altered neural efficiency.
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54
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Rzepa E, Dean Z, McCabe C. Bupropion Administration Increases Resting-State Functional Connectivity in Dorso-Medial Prefrontal Cortex. Int J Neuropsychopharmacol 2017; 20:455-462. [PMID: 28340244 PMCID: PMC5458340 DOI: 10.1093/ijnp/pyx016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/19/2017] [Accepted: 03/10/2017] [Indexed: 12/16/2022] Open
Abstract
Background Patients on the selective serotonergic reuptake inhibitors like citalopram report emotional blunting. We showed previously that citalopram reduces resting-state functional connectivity in healthy volunteers in a number of brain regions, including the dorso-medial prefrontal cortex, which may be related to its clinical effects. Bupropion is a dopaminergic and noradrenergic reuptake inhibitor and is not reported to cause emotional blunting. However, how bupropion affects resting-state functional connectivity in healthy controls remains unknown. Methods Using a within-subjects, repeated-measures, double-blind, crossover design, we examined 17 healthy volunteers (9 female, 8 male). Volunteers received 7 days of bupropion (150 mg/d) and 7 days of placebo treatment and underwent resting-state functional Magnetic Resonance Imaging. We selected seed regions in the salience network (amygdala and pregenual anterior cingulate cortex) and the central executive network (dorsal medial prefrontal cortex). Mood and anhedonia measures were also recorded and examined in relation to resting-state functional connectivity. Results Relative to placebo, bupropion increased resting-state functional connectivity in healthy volunteers between the dorsal medial prefrontal cortex seed region and the posterior cingulate cortex and the precuneus cortex, key parts of the default mode network. Conclusions These results are opposite to that which we found with 7 days treatment of citalopram in healthy volunteers. These results reflect a different mechanism of action of bupropion compared with selective serotonergic reuptake inhibitors. These results help explain the apparent lack of emotional blunting caused by bupropion in depressed patients.
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Affiliation(s)
- Ewelina Rzepa
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Zola Dean
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Ciara McCabe
- School of Psychology and Clinical Language Sciences, University of Reading, UK
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55
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Schultz CC, Wagner G, de la Cruz F, Berger S, Reichenbach JR, Sauer H, Bär KJ. Evidence for alterations of cortical folding in anorexia nervosa. Eur Arch Psychiatry Clin Neurosci 2017; 267:41-49. [PMID: 26678081 DOI: 10.1007/s00406-015-0666-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 12/06/2015] [Indexed: 12/13/2022]
Abstract
Anorexia nervosa (AN) is highly heritable, and the perspective on the etiology of AN has changed from a behavioral to a neurobiological and neurodevelopmental view. However, cortical folding as an important marker for deviations in brain development has yet rarely been explored in AN. Hence, in order to determine potential cortical folding alterations, we investigated fine-grained cortical folding in a cohort of 26 patients with AN, of whom 6 patients were recovered regarding their weight at the time point of MRI measurement. MRI-derived cortical folding was computed and compared between patients and healthy controls at about 150,000 points per hemisphere using a surface-based technique (FreeSurfer). Patients with AN exhibited highly significant increased cortical folding in a right dorsolateral prefrontal cortex region (DLPFC). Furthermore, a statistical trend in the same direction was found in the right visual cortex. We did not find a correlation of local cortical folding and current symptoms of the disease. In conclusion, our analyses provide first evidence that altered DLPFC cortical folding plays a role in the etiology of AN. The absence of correlations with clinical parameters implicates a relatively independence of cortical folding alterations from the current symptomatology and might thus be regarded as a trait characteristic of the disease potentially related to other neurobiological features of AN.
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Affiliation(s)
- C Christoph Schultz
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07740, Jena, Germany.
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07740, Jena, Germany.,Psychiatric Brain & Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Feliberto de la Cruz
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07740, Jena, Germany.,Psychiatric Brain & Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Sandy Berger
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07740, Jena, Germany.,Psychiatric Brain & Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute for Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Heinrich Sauer
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07740, Jena, Germany
| | - Karl J Bär
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07740, Jena, Germany.,Psychiatric Brain & Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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Canna A, Prinster A, Monteleone AM, Cantone E, Monteleone P, Volpe U, Maj M, Di Salle F, Esposito F. Interhemispheric functional connectivity in anorexia and bulimia nervosa. Eur J Neurosci 2017; 45:1129-1140. [PMID: 27992088 DOI: 10.1111/ejn.13507] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 11/15/2016] [Accepted: 12/14/2016] [Indexed: 01/18/2023]
Abstract
The functional interplay between hemispheres is fundamental for behavioral, cognitive, and emotional control. Anorexia nervosa (AN) and bulimia nervosa (BN) have been largely studied with brain magnetic resonance imaging (MRI) in relation to the functional mechanisms of high-level processing, but not in terms of possible inter-hemispheric functional connectivity anomalies. Using resting-state functional MRI (fMRI), voxel-mirrored homotopic connectivity (VMHC) and regional inter-hemispheric spectral coherence (IHSC) were studied in 15 AN and 13 BN patients and 16 healthy controls (HC). Using T1-weighted and diffusion tensor imaging MRI scans, regional VMHC values were correlated with the left-right asymmetry of corresponding homotopic gray matter volumes and with the white matter callosal fractional anisotropy (FA). Compared to HC, AN patients exhibited reduced VMHC in cerebellum, insula, and precuneus, while BN patients showed reduced VMHC in dorso-lateral prefrontal and orbito-frontal cortices. The regional IHSC analysis highlighted that the inter-hemispheric functional connectivity was higher in the 'Slow-5' band in all regions except the insula. No group differences in left-right structural asymmetries and in VMHC vs. callosal FA correlations were significant in the comparisons between cohorts. These anomalies, not explained by structural changes, indicate that AN and BN, at least in their acute phase, are associated with a loss of inter-hemispheric connectivity in regions implicated in self-referential, cognitive control and reward processing. These findings may thus gather novel functional markers to explore aberrant features of these eating disorders.
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Affiliation(s)
- Antonietta Canna
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via S. Allende, 84081, Baronissi (Salerno), Italy
| | - Anna Prinster
- Biostructure and Bioimaging Institute, National Research Council, Naples, Italy.,IRCCS SDN, Istituto di Ricerca Diagnostica e Nucleare, Naples, Italy
| | | | - Elena Cantone
- Section of ENT, Department of Neurosciences, Reproductive Sciences and Odontostomatology, "Federico II" University, Naples, Italy
| | - Palmiero Monteleone
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via S. Allende, 84081, Baronissi (Salerno), Italy.,Department of Psychiatry, Second University of Naples, Naples, Italy
| | - Umberto Volpe
- Department of Psychiatry, Second University of Naples, Naples, Italy
| | - Mario Maj
- Department of Psychiatry, Second University of Naples, Naples, Italy
| | - Francesco Di Salle
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via S. Allende, 84081, Baronissi (Salerno), Italy
| | - Fabrizio Esposito
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via S. Allende, 84081, Baronissi (Salerno), Italy
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Scaife JC, Godier LR, Filippini N, Harmer CJ, Park RJ. Reduced Resting-State Functional Connectivity in Current and Recovered Restrictive Anorexia Nervosa. Front Psychiatry 2017; 8:30. [PMID: 28400737 PMCID: PMC5368282 DOI: 10.3389/fpsyt.2017.00030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/08/2017] [Indexed: 12/18/2022] Open
Abstract
Functional connectivity studies based on resting-state functional magnetic resonance imaging (rs-fMRI) have shown alterations in brain networks associated with self-referential processing, cognitive control, and somatosensory processing in anorexia nervosa (AN). This study aimed to further investigate the functional connectivity of resting-state networks (RSNs) in homogenous subsamples of individuals with restrictive AN (current and recovered) and the relationship this has with core eating disorder psychopathology. rs-fMRI scans were obtained from 12 female individuals with restrictive AN, 14 females recovered from restrictive AN, and 16 female healthy controls. Independent components analysis revealed a set of functionally relevant RSNs, previously reported in the literature. Dual regression analysis showed decreased temporal coherence within the lateral visual and auditory RSNs in individuals with current AN and those recovered from AN compared to healthy individuals. This decreased connectivity was also found in regions associated with somatosensory processing, and is consistent with reduced interoceptive awareness and body image perception, characteristic of AN. Widespread gray matter (GM) reductions were also found in both the AN groups, and differences in functional connectivity were no longer significant when GM maps were added as a covariate in the dual regression analysis. This raises the possibility that deficits in somatosensory and interoceptive processing observed in AN may be in part underpinned or exacerbated by GM reductions.
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Affiliation(s)
- Jessica Clare Scaife
- Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital , Oxford , UK
| | - Lauren Rose Godier
- Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital , Oxford , UK
| | - Nicola Filippini
- Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK; FMRIB Centre, University of Oxford, Oxford, UK
| | - Catherine J Harmer
- Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital , Oxford , UK
| | - Rebecca J Park
- Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital , Oxford , UK
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Gaudio S, Wiemerslage L, Brooks SJ, Schiöth HB. A systematic review of resting-state functional-MRI studies in anorexia nervosa: Evidence for functional connectivity impairment in cognitive control and visuospatial and body-signal integration. Neurosci Biobehav Rev 2016; 71:578-589. [DOI: 10.1016/j.neubiorev.2016.09.032] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 08/11/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022]
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Boehm I, Geisler D, Tam F, King JA, Ritschel F, Seidel M, Bernardoni F, Murr J, Goschke T, Calhoun VD, Roessner V, Ehrlich S. Partially restored resting-state functional connectivity in women recovered from anorexia nervosa. J Psychiatry Neurosci 2016; 41:377-385. [PMID: 27045551 PMCID: PMC5082508 DOI: 10.1503/jpn.150259] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND We have previously shown increased resting-state functional connectivity (rsFC) in the frontoparietal network (FPN) and the default mode network (DMN) in patients with acute anorexia nervosa. Based on these findings we investigated within-network rsFC in patients recovered from anorexia nervosa to examine whether these abnormalities are a state or trait marker of the disease. To extend the understanding of functional connectivity in patients with anorexia nervosa, we also estimated rsFC between large-scale networks. METHODS Girls and women recovered from anorexia nervosa and pair-wise, age- and sex-matched healthy controls underwent a resting-state fMRI scan. Using independent component analyses (ICA), we isolated the FPN, DMN and salience network. We used standard comparisons as well as a hypothesis-based approach to test the findings of our previous rsFC study in this recovered cohort. Temporal correlations between network time-course pairs were computed to investigate functional network connectivity (FNC). RESULTS Thirty-one patients recovered from anorexia nervosa and 31 controls participated in our study. Standard group comparisons revealed reduced rsFC between the dorsolateral prefrontal cortex (dlPFC) and the FPN in the recovered group. Using a hypothesis-based approach we extended the previous finding of increased rsFC between the angular gyrus and the FPN in patients recovered from anorexia nervosa. No group differences in FNC were revealed. LIMITATIONS The study design did not allow us to conclude that the difference found in rsFC constitutes a scar effect of the disease. CONCLUSION This study suggests that some abnormal rsFC patterns found in patients recovered from anorexia nervosa normalize after long-term weight restoration, while distorted rsFC in the FPN, a network that has been associated with cognitive control, may constitute a trait marker of the disorder.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Stefan Ehrlich
- Correspondence to: S. Ehrlich, Technische Universität Dresden, Faculty of Medicine, University Hospital CG Carus, Dresden, Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Fetscherstraße 74, 01307 Dresden;
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60
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Rzepa E, McCabe C. Decreased anticipated pleasure correlates with increased salience network resting state functional connectivity in adolescents with depressive symptomatology. J Psychiatr Res 2016; 82:40-7. [PMID: 27459031 PMCID: PMC5036507 DOI: 10.1016/j.jpsychires.2016.07.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/13/2016] [Accepted: 07/15/2016] [Indexed: 12/01/2022]
Abstract
Previous studies have found dysfunctional resting state functional connectivity (RSFC) in depressed patients. Examining RSFC might aid biomarker discovery for depression. However RSFC in young people at risk of depression has yet to be examined. 35 healthy adolescents (13-18 yrs old.) were recruited. 17 scoring high on the Mood and Feelings Questionnaire (MFQ > 27 (High Risk: HR), and 18 scoring low on the MFQ < 15 (Low Risk: LR) matched on age and gender. We selected seed regions in the salience network (SN: amygdala and pregenual anterior cingulate cortex (pgACC)) and the central executive network (CEN: dorsal medial prefrontal cortex (dmPFC)). Mood and anhedonia measures were correlated with brain connectivity. We found decreased RSFC in the HR group between the amygdala and the pgACC and hippocampus and precuneus. We also found decreased RSFC in the HR group between the pgACC and the putamen and between the dmPFC and the precuneus. The pgACC RSFC with the insula/orbitofrontal cortex correlated inversely with the anticipation of pleasure in all subjects. Increased RSFC was observed between the pgACC and the prefrontal cortex and the amygdala and the temporal pole in the HR group compared to the LR group. Our findings are the first to show that adolescents with depression symptoms have dysfunctional RSFC between seeds in the SN and CEN with nodes in the Default Mode Network. As increased connectivity between the pgACC and the insula correlated with decreased ability to anticipate pleasure, we suggest this might be mechanism underlying the risk of experiencing anhedonia, a suggested biomarker for depression.
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Affiliation(s)
- Ewelina Rzepa
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Ciara McCabe
- School of Psychology and Clinical Language Sciences, University of Reading, UK.
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Donofry SD, Roecklein KA, Wildes JE, Miller MA, Erickson KI. Alterations in emotion generation and regulation neurocircuitry in depression and eating disorders: A comparative review of structural and functional neuroimaging studies. Neurosci Biobehav Rev 2016; 68:911-927. [PMID: 27422451 DOI: 10.1016/j.neubiorev.2016.07.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 06/13/2016] [Accepted: 07/11/2016] [Indexed: 12/18/2022]
Abstract
Major depression and eating disorders (EDs) are highly co-morbid and may share liability. Impaired emotion regulation may represent a common etiological or maintaining mechanism. Research has demonstrated that depressed individuals and individuals with EDs exhibit impaired emotion regulation, with these impairments being associated with changes in brain structure and function. The goal of this review was to evaluate findings from neuroimaging studies of depression and EDs to determine whether there are overlapping alterations in the brain regions known to be involved in emotion regulation, evidence of which would aid in the diagnosis and treatment of these conditions. Our review of the literature suggests that depression and EDs exhibit common structural and functional alterations in brain regions involved in emotion regulation, including the amygdala, ventral striatum and nucleus accumbens, anterior cingulate cortex, insula, and dorsolateral prefrontal cortex. We present preliminary support for a shared etiological mechanism. Future studies should consider manipulating emotion regulation in a sample of individuals with depression and EDs to better characterize abnormalities in these brain circuits.
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Affiliation(s)
- Shannon D Donofry
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States.
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States; The Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
| | - Jennifer E Wildes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Megan A Miller
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States; The Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
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Amianto F, Northoff G, Abbate Daga G, Fassino S, Tasca GA. Is Anorexia Nervosa a Disorder of the Self? A Psychological Approach. Front Psychol 2016; 7:849. [PMID: 27378967 PMCID: PMC4906654 DOI: 10.3389/fpsyg.2016.00849] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/20/2016] [Indexed: 01/26/2023] Open
Abstract
The debate concerning the pathogenesis and the maintaining factors of eating disorders, anorexia nervosa in particular, is ongoing especially since therapeutic interventions do not result in satisfactory and enduring rates of remission. This paper presents a model for the pathogenesis of eating disorders, based on the hypothesis of a deficiency in the development of the self. We present the theory in light of new evidence concerning the role of attachment insecurity in the development and maintenance of eating disorders. In particular, we define the self in eating disorders in a comprehensive way by taking into account recent evidence from experimental psychology and neurobiology. The paper considers the development of the self in terms of its synchronic (i.e., experienced in the moment) and diachronic (i.e., experienced as continuous over time) aspects. Both synchronic and diachronic aspects of the self are relevant to the expression of eating disorder symptoms. Further, the maturation of the self is interwoven with the development of attachment functioning from infancy to adolescence. This interplay between these developmental processes of the self and of attachment could be crucial in understanding the pathogenesis of eating disorders. The final part of the paper suggests a neurobiological link between the theory of the self in the eating disorders and the spatiotemporal functioning of the brain. Disturbances in spatiotemporal functioning may represent the neurobiological pathway by which deficiencies in the self is related to attachment functions in individuals with eating disorders.
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Affiliation(s)
- Federico Amianto
- Regional Expert Centre for Eating Disorders, Neurosciences Department, Psychiatry Section, University of Turin Turin, Italy
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa ON, Canada
| | - Giovanni Abbate Daga
- Regional Expert Centre for Eating Disorders, Neurosciences Department, Psychiatry Section, University of Turin Turin, Italy
| | - Secondo Fassino
- Regional Expert Centre for Eating Disorders, Neurosciences Department, Psychiatry Section, University of Turin Turin, Italy
| | - Giorgio A Tasca
- Psychology, The Ottawa Hospital, University of Ottawa, Ottawa ON, Canada
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63
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Phillipou A, Abel LA, Castle DJ, Hughes ME, Nibbs RG, Gurvich C, Rossell SL. Resting state functional connectivity in anorexia nervosa. Psychiatry Res Neuroimaging 2016; 251:45-52. [PMID: 27111812 DOI: 10.1016/j.pscychresns.2016.04.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 03/22/2016] [Accepted: 04/13/2016] [Indexed: 01/21/2023]
Abstract
Anorexia Nervosa (AN) is a serious psychiatric illness characterised by a disturbance in body image, a fear of weight gain and significantly low body weight. The factors involved in the genesis and maintenance of AN are unclear, though the potential neurobiological underpinnings of the condition are of increasing interest. Through the investigation of functional connectivity of the brain at rest, information relating to neuronal communication and integration of information that may relate to behaviours and cognitive symptoms can be explored. The aim of this study was to investigate functional connectivity of the default mode network, and sensorimotor and visual networks in AN. 26 females with AN and 27 healthy control participants matched for age, gender and premorbid intelligence underwent a resting state functional magnetic resonance imaging scan. Default mode network functional connectivity did not differ between groups. AN participants displayed reduced functional connectivity between the sensorimotor and visual networks, in comparison to healthy controls. This finding is discussed in terms of differences in visuospatial processing in AN and the distortion of body image experienced by these individuals. Overall, the findings suggest that sensorimotor and visual network connectivity may be related to visuospatial processing in AN, though, further research is required.
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Affiliation(s)
- Andrea Phillipou
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; Department of Mental Health, The Austin Hospital, Melbourne, VIC, Australia.
| | - Larry Allen Abel
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - David Jonathan Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia; Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Matthew Edward Hughes
- Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Richard Grant Nibbs
- Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University and The Alfred Hospital, Melbourne, VIC, Australia
| | - Susan Lee Rossell
- Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia; Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre, Monash University and The Alfred Hospital, Melbourne, VIC, Australia
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64
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Esposito R, Cieri F, di Giannantonio M, Tartaro A. The role of body image and self-perception in anorexia nervosa: the neuroimaging perspective. J Neuropsychol 2016; 12:41-52. [PMID: 27220759 DOI: 10.1111/jnp.12106] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/19/2016] [Indexed: 11/30/2022]
Abstract
Anorexia nervosa is a severe psychiatric illness characterized by intense fear of gaining weight, relentless pursuit of thinness, deep concerns about food and a pervasive disturbance of body image. Functional magnetic resonance imaging tries to shed light on the neurobiological underpinnings of anorexia nervosa. This review aims to evaluate the empirical neuroimaging literature about self-perception in anorexia nervosa. This narrative review summarizes a number of task-based and resting-state functional magnetic resonance imaging studies in anorexia nervosa about body image and self-perception. The articles listed in references were searched using electronic databases (PubMed and Google Scholar) from 1990 to February 2016 using specific key words. All studies were reviewed with regard to their quality and eligibility for the review. Differences in brain activity were observed using body image perception and body size estimation tasks showing significant modifications in activity of specific brain areas (extrastriate body area, fusiform body area, inferior parietal lobule). Recent studies highlighted the role of emotions and self-perception in anorexia nervosa and their neural substrate involving resting-state networks and particularly frontal and posterior midline cortical structures within default mode network and insula. These findings open new horizons to understand the neural substrate of anorexia nervosa.
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Affiliation(s)
- Roberto Esposito
- Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Filippo Cieri
- Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Armando Tartaro
- Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
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65
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Evidence for Thalamocortical Circuit Abnormalities and Associated Cognitive Dysfunctions in Underweight Individuals with Anorexia Nervosa. Neuropsychopharmacology 2016; 41:1560-8. [PMID: 26462619 PMCID: PMC4832017 DOI: 10.1038/npp.2015.314] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/29/2015] [Accepted: 09/29/2015] [Indexed: 11/09/2022]
Abstract
Anorexia nervosa (AN) is characterized by extremely low body weight resulting from pathological food restriction, and carries a mortality rate among the highest of any psychiatric illness. AN, particularly during the acute, underweight state of the illness, has been associated with abnormalities across a range of brain regions, including the frontal cortex and basal ganglia. Few studies of AN have investigated the thalamus, a key mediator of information flow through frontal-basal ganglia circuit loops. We examined both thalamic surface morphology using anatomical MRI and thalamo-frontal functional connectivity using resting-state functional MRI. Individuals with AN (n=28) showed localized inward deformations of the thalamus relative to healthy controls (HC, n=22), and abnormal functional connectivity between the thalamus and the dorsolateral and anterior prefrontal cortices. Alterations in thalamo-frontal connectivity were associated with deficits in performance on tasks probing cognitive control (Stroop task) and working memory (Letter-Number Sequencing (LNS) task). Our findings suggest that abnormalities in thalamo-frontal circuits may have a role in mediating aspects of cognitive dysfunction in underweight individuals with AN.
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66
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Chen H, Wang L, King TZ, Mao H. Increased frontal functional networks in adult survivors of childhood brain tumors. NEUROIMAGE-CLINICAL 2016; 11:339-346. [PMID: 27298763 PMCID: PMC4893013 DOI: 10.1016/j.nicl.2016.02.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/13/2016] [Accepted: 02/18/2016] [Indexed: 12/20/2022]
Abstract
Childhood brain tumors and associated treatment have been shown to affect brain development and cognitive outcomes. Understanding the functional connectivity of brain many years after diagnosis and treatment may inform the development of interventions to improve the long-term outcomes of adult survivors of childhood brain tumors. This work investigated the frontal region functional connectivity of 16 adult survivors of childhood cerebellar tumors after an average of 14.9 years from diagnosis and 16 demographically-matched controls using resting state functional MRI (rs-fMRI). Independent component analysis (ICA) was applied to identify the resting state activity from rs-fMRI data and to select the specific regions associated with executive functions, followed by the secondary analysis of the functional networks connecting these regions. It was found that survivors exhibited differences in the functional connectivity in executive control network (ECN), default mode network (DMN) and salience network (SN) compared to demographically-matched controls. More specifically, the number of functional connectivity observed in the survivors is higher than that in the controls, and with increased strength, or stronger correlation coefficient between paired seeds, in survivors compared to the controls. Observed hyperconnectivity in the selected frontal functional network thus is consistent with findings in patients with other neurological injuries and diseases. rs-fMRI and ICA analysis were used to investigate functional connectivity of adult survivors of childhood brain tumors. Survivors exhibited changes in connectivity in executive function, default mode and salience networks compared to controls. Observed increased number and strength of functional connectivity suggest adaption of hyperconnectivity by survivors.
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Affiliation(s)
- Hongbo Chen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA; School of Life and Environmental Sciences, Guilin University of Electronic Technology, Guilin, Guangxi, China
| | - Liya Wang
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology, The Cancer Hospital of Chinese Academy of Medical Sciences, Shenzhen, Guangdong, China
| | - Tricia Z King
- Department of Psychology and Neuroscience Institute, Georgia State University, Atlanta, GA, USA.
| | - Hui Mao
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
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67
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Van Autreve S, De. Baene W, Baeken C, van Heeringen K, Vancayseele N, Vervaet M. Differential Neural Correlates of Set-Shifting in the Bingeing-Purging and Restrictive Subtypes of Anorexia Nervosa: An fMRI Study. EUROPEAN EATING DISORDERS REVIEW 2016; 24:277-85. [PMID: 26856396 DOI: 10.1002/erv.2437] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/05/2015] [Accepted: 01/09/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Sara Van Autreve
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
| | - Wouter De. Baene
- Department of Experimental Psychology, Faculty of Psychology and Educational Sciences; Ghent University; Belgium
- Department of Cognitive Neuropsychology; Tilburg University; The Netherlands
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
| | - Kees van Heeringen
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
| | - Nikita Vancayseele
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
| | - Myriam Vervaet
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
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68
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Abstract
Studies published between the beginning of 2013 and May 2015 on the neuropsychological functioning of patients with anorexia nervosa compared with healthy participants framed in the context of the Research Domain Criteria matrix identifies evidence for functional differences in three domains: Negative Valance Systems-negative attentional biases and lack of neural responsivity to hunger; Cognitive Systems-limited congruence between clinical and cognitive performance, poorer non-verbal than verbal performance, altered attentional styles to disorder related stimuli, perceptual processing impairment in discriminating body images, weaknesses in central coherence, set shifting weaknesses at low weight status, decision-making weaknesses, and greater neural resources required for working memory; Systems for Social Processes-patients appear to have a different attentional response to faces, and perception and understanding of self and others. Hence, there is evidence to suggest that patients with anorexia nervosa have a specific neuropsychological performance style across tasks in three domains of functioning. Some current controversies and areas for future development are identified.
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Affiliation(s)
- Marie-Claire Reville
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
| | - Lorna O'Connor
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Ian Frampton
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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69
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Nagamitsu S, Sakurai R, Matsuoka M, Chiba H, Ozono S, Tanigawa H, Yamashita Y, Kaida H, Ishibashi M, Kakuma T, Croarkin PE, Matsuishi T. Altered SPECT (123)I-iomazenil Binding in the Cingulate Cortex of Children with Anorexia Nervosa. Front Psychiatry 2016; 7:16. [PMID: 26909048 PMCID: PMC4754452 DOI: 10.3389/fpsyt.2016.00016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 02/01/2016] [Indexed: 11/13/2022] Open
Abstract
Several lines of evidence suggest that anxiety plays a key role in the development and maintenance of anorexia nervosa (AN) in children. The purpose of this study was to examine cortical GABA(A)-benzodiazepine receptor binding before and after treatment in children beginning intensive AN treatment. Brain single-photon emission computed tomography (SPECT) measurements using (123)I-iomazenil, which binds to GABA(A)-benzodiazepine receptors, was performed in 26 participants with AN who were enrolled in a multimodal treatment program. Sixteen of the 26 participants underwent a repeat SPECT scan immediately before discharge at conclusion of the intensive treatment program. Eating behavior and mood disturbances were assessed using Eating Attitudes Test with 26 items (EAT-26) and the short form of the Profile of Mood States (POMS). Clinical outcome scores were evaluated after a 1-year period. We examined association between relative iomazenil-binding activity in cortical regions of interest and psychometric profiles and determined which psychometric profiles show interaction effects with brain regions. Further, we determined if binding activity could predict clinical outcome and treatment changes. Higher EAT-26 scores were significantly associated with lower iomazenil-binding activity in the anterior and posterior cingulate cortex. Higher POMS subscale scores were significantly associated with lower iomazenil-binding activity in the left frontal, parietal cortex, and posterior cingulate cortex (PCC). "Depression-Dejection" and "Confusion" POMS subscale scores, and total POMS score showed interaction effects with brain regions in iomazenil-binding activity. Decreased binding in the anterior cingulate cortex and left parietal cortex was associated with poor clinical outcomes. Relative binding increases throughout the PCC and occipital gyrus were observed after weight gain in children with AN. These findings suggest that cortical GABAergic receptor binding is altered in children with AN. This may be a state-related change, which could be used to monitor and guide the treatment of eating disorders.
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Affiliation(s)
- Shinichiro Nagamitsu
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
| | - Rieko Sakurai
- Graduate School of Medicine, Kurume University , Fukuoka , Japan
| | - Michiko Matsuoka
- Department of Psychiatry, Kurume University School of Medicine , Fukuoka , Japan
| | - Hiromi Chiba
- Department of Psychiatry, Kurume University School of Medicine , Fukuoka , Japan
| | - Shuichi Ozono
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
| | - Hitoshi Tanigawa
- Center of Diaginostic Imaging, Kurume University Hospital , Fukuoka , Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
| | - Hayato Kaida
- Department of Radiology, Kinki University Faculty of Medicine , Osakasayama , Japan
| | - Masatoshi Ishibashi
- Department of Radiology, Kurume University School of Medicine , Fukuoka , Japan
| | - Tatsuki Kakuma
- Biostatistics Center, Kurume University School of Medicine , Fukuoka , Japan
| | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA
| | - Toyojiro Matsuishi
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
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70
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Geisler D, Borchardt V, Lord AR, Boehm I, Ritschel F, Zwipp J, Clas S, King JA, Wolff-Stephan S, Roessner V, Walter M, Ehrlich S. Abnormal functional global and local brain connectivity in female patients with anorexia nervosa. J Psychiatry Neurosci 2016; 41:6-15. [PMID: 26252451 PMCID: PMC4688030 DOI: 10.1503/jpn.140310] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Previous resting-state functional connectivity studies in patients with anorexia nervosa used independent component analysis or seed-based connectivity analysis to probe specific brain networks. Instead, modelling the entire brain as a complex network allows determination of graph-theoretical metrics, which describe global and local properties of how brain networks are organized and how they interact. METHODS To determine differences in network properties between female patients with acute anorexia nervosa and pairwise matched healthy controls, we used resting-state fMRI and computed well-established global and local graph metrics across a range of network densities. RESULTS Our analyses included 35 patients and 35 controls. We found that the global functional network structure in patients with anorexia nervosa is characterized by increases in both characteristic path length (longer average routes between nodes) and assortativity (more nodes with a similar connectedness link together). Accordingly, we found locally decreased connectivity strength and increased path length in the posterior insula and thalamus. LIMITATIONS The present results may be limited to the methods applied during preprocessing and network construction. CONCLUSION We demonstrated anorexia nervosa-related changes in the network configuration for, to our knowledge, the first time using resting-state fMRI and graph-theoretical measures. Our findings revealed an altered global brain network architecture accompanied by local degradations indicating wide-scale disturbance in information flow across brain networks in patients with acute anorexia nervosa. Reduced local network efficiency in the thalamus and posterior insula may reflect a mechanism that helps explain the impaired integration of visuospatial and homeostatic signals in patients with this disorder, which is thought to be linked to abnormal representations of body size and hunger.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Stefan Ehrlich
- Correspondence to: S. Ehrlich, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden, Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Fetscherstraße 74, 01307 Dresden, Germany;
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71
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Moody TD, Sasaki MA, Bohon C, Strober MA, Bookheimer SY, Sheen CL, Feusner JD. Functional connectivity for face processing in individuals with body dysmorphic disorder and anorexia nervosa. Psychol Med 2015; 45:3491-3503. [PMID: 26219399 PMCID: PMC4879882 DOI: 10.1017/s0033291715001397] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) and anorexia nervosa (AN) are both characterized by distorted perception of appearance. Previous studies in BDD suggest abnormalities in visual processing of own and others' faces, but no study has examined visual processing of faces in AN, nor directly compared the two disorders in this respect. METHOD We collected functional magnetic resonance imaging data on 60 individuals of equivalent age and gender in each of three groups--20 BDD, 20 weight-restored AN, and 20 healthy controls (HC)--while they viewed images of others' faces that contained only high or low spatial frequency information (HSF or LSF). We tested hypotheses about functional connectivity within specialized sub-networks for HSF and LSF visual processing, using psychophysiological interaction analyses. RESULTS The BDD group demonstrated increased functional connectivity compared to HC between left anterior occipital face area and right fusiform face area (FFA) for LSF faces, which was associated with symptom severity. Both BDD and AN groups had increased connectivity compared to HC between FFA and precuneous/posterior cingulate gyrus for LSF faces, and decreased connectivity between FFA and insula. In addition, we found that LSF connectivity between FFA and posterior cingulate gyrus was significantly associated with thoughts about own appearance in AN. CONCLUSIONS Results suggest similar abnormal functional connectivity within higher-order systems for face processing in BDD and AN, but distinct abnormal connectivity patterns within occipito-temporal visual networks. Findings may have implications for understanding relationships between these disorders, and the pathophysiology underlying perceptual distortions.
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Affiliation(s)
- T. D. Moody
- Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | - M. A. Sasaki
- Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | - C. Bohon
- Psychiatry and Biobehavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - M. A. Strober
- Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | - S. Y. Bookheimer
- Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | - C. L. Sheen
- Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | - J. D. Feusner
- Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
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72
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Luo Y, Kong F, Qi S, You X, Huang X. Resting-state functional connectivity of the default mode network associated with happiness. Soc Cogn Affect Neurosci 2015; 11:516-24. [PMID: 26500289 DOI: 10.1093/scan/nsv132] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 10/20/2015] [Indexed: 01/05/2023] Open
Abstract
Happiness refers to people's cognitive and affective evaluation of their life. Why are some people happier than others? One reason might be that unhappy people are prone to ruminate more than happy people. The default mode network (DMN) is normally active during rest and is implicated in rumination. We hypothesized that unhappiness may be associated with increased default-mode functional connectivity during rest, including the medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC) and inferior parietal lobule (IPL). The hyperconnectivity of these areas may be associated with higher levels of rumination. One hundred forty-eight healthy participants underwent a resting-state fMRI scan. A group-independent component analysis identified the DMNs. Results indicated increased functional connectivity in the DMN was associated with lower levels of happiness. Specifically, relative to happy people, unhappy people exhibited greater functional connectivity in the anterior medial cortex (bilateral MPFC), posterior medial cortex regions (bilateral PCC) and posterior parietal cortex (left IPL). Moreover, the increased functional connectivity of the MPFC, PCC and IPL, correlated positively with the inclination to ruminate. These results highlight the important role of the DMN in the neural correlates of happiness, and suggest that rumination may play an important role in people's perceived happiness.
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Affiliation(s)
- Yangmei Luo
- Key Laboratory of Behavior and Cognitive Psychology in Shaanxi Province, School of Psychology, Shaanxi Normal University, Xi'an 710062, China Key Laboratory of Cognition and Personality of Ministry of Education, School of Psychology, Southwest University, Chongqing 400715, China
| | - Feng Kong
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Senqing Qi
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an 710062, China
| | - Xuqun You
- Key Laboratory of Behavior and Cognitive Psychology in Shaanxi Province, School of Psychology, Shaanxi Normal University, Xi'an 710062, China
| | - Xiting Huang
- Key Laboratory of Cognition and Personality of Ministry of Education, School of Psychology, Southwest University, Chongqing 400715, China
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73
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Alterations of EEG functional connectivity in resting state obese and overweight patients with binge eating disorder: A preliminary report. Neurosci Lett 2015; 607:120-124. [DOI: 10.1016/j.neulet.2015.09.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/10/2015] [Accepted: 09/22/2015] [Indexed: 02/01/2023]
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74
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García-García I, Jurado MÁ, Garolera M, Marqués-Iturria I, Horstmann A, Segura B, Pueyo R, Sender-Palacios MJ, Vernet-Vernet M, Villringer A, Junqué C, Margulies DS, Neumann J. Functional network centrality in obesity: A resting-state and task fMRI study. Psychiatry Res 2015; 233:331-8. [PMID: 26145769 DOI: 10.1016/j.pscychresns.2015.05.017] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 02/03/2015] [Accepted: 05/28/2015] [Indexed: 01/04/2023]
Abstract
Obesity is associated with structural and functional alterations in brain areas that are often functionally distinct and anatomically distant. This suggests that obesity is associated with differences in functional connectivity of regions distributed across the brain. However, studies addressing whole brain functional connectivity in obesity remain scarce. Here, we compared voxel-wise degree centrality and eigenvector centrality between participants with obesity (n=20) and normal-weight controls (n=21). We analyzed resting state and task-related fMRI data acquired from the same individuals. Relative to normal-weight controls, participants with obesity exhibited reduced degree centrality in the right middle frontal gyrus in the resting-state condition. During the task fMRI condition, obese participants exhibited less degree centrality in the left middle frontal gyrus and the lateral occipital cortex along with reduced eigenvector centrality in the lateral occipital cortex and occipital pole. Our results highlight the central role of the middle frontal gyrus in the pathophysiology of obesity, a structure involved in several brain circuits signaling attention, executive functions and motor functions. Additionally, our analysis suggests the existence of task-dependent reduced centrality in occipital areas; regions with a role in perceptual processes and that are profoundly modulated by attention.
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Affiliation(s)
- Isabel García-García
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - María Ángeles Jurado
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute for Brain, Cognition and Behaviour (IR3C), University of Barcelona, Barcelona, Spain; Grup de Recerca Consolidat en Neuropsicologia (2014 SGR 98), Barcelona, Spain.
| | - Maite Garolera
- Grup de Recerca Consolidat en Neuropsicologia (2014 SGR 98), Barcelona, Spain; Neuropsychology Unit, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Idoia Marqués-Iturria
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute for Brain, Cognition and Behaviour (IR3C), University of Barcelona, Barcelona, Spain
| | - Annette Horstmann
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; IFB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Bàrbara Segura
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Grup de Recerca Consolidat en Neuropsicologia (2014 SGR 98), Barcelona, Spain
| | - Roser Pueyo
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute for Brain, Cognition and Behaviour (IR3C), University of Barcelona, Barcelona, Spain; Grup de Recerca Consolidat en Neuropsicologia (2014 SGR 98), Barcelona, Spain
| | | | | | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carme Junqué
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Grup de Recerca Consolidat en Neuropsicologia (2014 SGR 98), Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Daniel S Margulies
- Max Planck Research Group for Neuroanatomy and Connectivity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jane Neumann
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; IFB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
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75
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McAdams CJ, Lohrenz T, Montague PR. Neural responses to kindness and malevolence differ in illness and recovery in women with anorexia nervosa. Hum Brain Mapp 2015; 36:5207-19. [PMID: 26416161 DOI: 10.1002/hbm.23005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/26/2015] [Accepted: 09/16/2015] [Indexed: 11/12/2022] Open
Abstract
In anorexia nervosa, problems with social relationships contribute to illness, and improvements in social support are associated with recovery. Using the multiround trust game and 3T MRI, we compare neural responses in a social relationship in three groups of women: women with anorexia nervosa, women in long-term weight recovery from anorexia nervosa, and healthy comparison women. Surrogate markers related to social signals in the game were computed each round to assess whether the relationship was improving (benevolence) or deteriorating (malevolence) for each subject. Compared with healthy women, neural responses to benevolence were diminished in the precuneus and right angular gyrus in both currently-ill and weight-recovered subjects with anorexia, but neural responses to malevolence differed in the left fusiform only in currently-ill subjects. Next, using a whole-brain regression, we identified an office assessment, the positive personalizing bias, that was inversely correlated with neural activity in the occipital lobe, the precuneus and posterior cingulate, the bilateral temporoparietal junctions, and dorsal anterior cingulate, during benevolence for all groups of subjects. The positive personalizing bias is a self-report measure that assesses the degree with which a person attributes positive experiences to other people. These data suggest that problems in perceiving kindness may be a consistent trait related to the development of anorexia nervosa, whereas recognizing malevolence may be related to recovery. Future work on social brain function, in both healthy and psychiatric populations, should consider positive personalizing biases as a possible marker of neural differences related to kindness perception.
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Affiliation(s)
- Carrie J McAdams
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, Texas.,Psychiatry, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas
| | - Terry Lohrenz
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, Virginia
| | - P Read Montague
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, Virginia.,Computational Psychiatry Unit, Virginia Tech, Roanoke, Virginia.,Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom.,Department of Physics, Virginia Tech, Blacksburg, Virginia
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76
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Abstract
Over the past decade, brain imaging has helped to better define eating disorder-related brain circuitry. Brain research on gray matter (GM) and white matter (WM) volumes had been inconsistent, possibly due to the effects of acute starvation, exercise, medication, and comorbidity, but newer studies have controlled for such effects. Those studies suggest larger left medial orbitofrontal gyrus rectus volume in ill adult and adolescent anorexia nervosa after recovery from anorexia nervosa, and in adult bulimia nervosa. The orbitofrontal cortex is important in terminating food intake, and altered function could contribute to self-starvation. The right insula, which processes taste but also interoception, was enlarged in ill adult and adolescent anorexia nervosa, as well as adults recovered from the illness. The fixed perception of being fat in anorexia nervosa could be related to altered insula function. A few studies investigated WM integrity, with the most consistent finding of reduced fornix integrity in anorexia and bulimia nervosa-a limbic pathway that is important in emotion but also food intake regulation. Functional brain imaging using basic sweet taste stimuli in eating disorders during the ill state or after recovery implicated repeatedly reward pathways, including insula and striatum. Brain imaging that targeted dopamine-related brain activity using taste-reward conditioning tasks suggested that this circuitry is hypersensitive in anorexia nervosa, but hyporesponsive in bulimia nervosa and obesity. Those results are in line with basic research and suggest adaptive reward system changes in the human brain in response to extremes of food intake-changes that could interfere with normalization of eating behavior.
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Affiliation(s)
- Guido K W Frank
- Departments of Psychiatry and Neuroscience,University of Colorado Anschutz Medical Campus,Children's Hospital Colorado,Aurora,Colorado,USA
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Dunlop K, Woodside B, Lam E, Olmsted M, Colton P, Giacobbe P, Downar J. Increases in frontostriatal connectivity are associated with response to dorsomedial repetitive transcranial magnetic stimulation in refractory binge/purge behaviors. NEUROIMAGE-CLINICAL 2015. [PMID: 26199873 PMCID: PMC4506986 DOI: 10.1016/j.nicl.2015.06.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background Conventional treatments for eating disorders are associated with poor response rates and frequent relapse. Novel treatments are needed, in combination with markers to characterize and predict treatment response. Here, resting-state functional magnetic resonance imaging (rs-fMRI) was used to identify predictors and correlates of response to repetitive transcranial magnetic stimulation (rTMS) of the dorsomedial prefrontal cortex (dmPFC) at 10 Hz for eating disorders with refractory binge/purge symptomatology. Methods 28 subjects with anorexia nervosa, binge−purge subtype or bulimia nervosa underwent 20–30 sessions of 10 Hz dmPFC rTMS. rs-fMRI data were collected before and after rTMS. Subjects were stratified into responder and nonresponder groups using a criterion of ≥50% reduction in weekly binge/purge frequency. Neural predictors and correlates of response were identified using seed-based functional connectivity (FC), using the dmPFC and adjacent dorsal anterior cingulate cortex (dACC) as regions of interest. Results 16 of 28 subjects met response criteria. Treatment responders had lower baseline FC from dmPFC to lateral orbitofrontal cortex and right posterior insula, and from dACC to right posterior insula and hippocampus. Responders had low baseline FC from the dACC to the ventral striatum and anterior insula; this connectivity increased over treatment. However, in nonresponders, frontostriatal FC was high at baseline, and dmPFC-rTMS suppressed FC in association with symptomatic worsening. Conclusions Enhanced frontostriatal connectivity was associated with responders to dmPFC-rTMS for binge/purge behavior. rTMS caused paradoxical suppression of frontostriatal connectivity in nonresponders. rs-fMRI could prove critical for optimizing stimulation parameters in a future sham-controlled trial of rTMS in disordered eating. dmPFC-rTMS was performed on patients with treatment-refractory AN and BN. Resting-state fMRI was collected to identify predictors and correlates of response. dmPFC-rTMS achieves robust improvement on bingeing and purging in AN and BN. Responders have lower baseline corticostriatal connectivity compared to nonresponders. Increased corticostriatal connectivity is associated with treatment response.
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Affiliation(s)
- Katharine Dunlop
- Institute of Medical Sciences, University of Toronto, Toronto, Canada ; MRI-Guided rTMS Clinic, University Health Network, Toronto, Canada
| | - Blake Woodside
- Institute of Medical Sciences, University of Toronto, Toronto, Canada ; Department of Psychiatry, University Health Network, Toronto, Canada ; Department of Psychiatry, University of Toronto, Toronto, Canada ; Eating Disorders Program, University Health Network, Toronto, Canada
| | - Eileen Lam
- Eating Disorders Program, University Health Network, Toronto, Canada
| | - Marion Olmsted
- Department of Psychiatry, University Health Network, Toronto, Canada ; Department of Psychiatry, University of Toronto, Toronto, Canada ; Eating Disorders Program, University Health Network, Toronto, Canada
| | - Patricia Colton
- Department of Psychiatry, University Health Network, Toronto, Canada ; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Peter Giacobbe
- MRI-Guided rTMS Clinic, University Health Network, Toronto, Canada ; Department of Psychiatry, University Health Network, Toronto, Canada ; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jonathan Downar
- Institute of Medical Sciences, University of Toronto, Toronto, Canada ; MRI-Guided rTMS Clinic, University Health Network, Toronto, Canada ; Department of Psychiatry, University Health Network, Toronto, Canada ; Toronto Western Research Institute, University Health Network, Toronto, Canada ; Department of Psychiatry, University of Toronto, Toronto, Canada
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78
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Bär KJ, de la Cruz F, Berger S, Schultz CC, Wagner G. Structural and functional differences in the cingulate cortex relate to disease severity in anorexia nervosa. J Psychiatry Neurosci 2015; 40:269-79. [PMID: 25825813 PMCID: PMC4478060 DOI: 10.1503/jpn.140193] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The dysfunction of specific brain areas might account for the distortion of body image in patients with anorexia nervosa. The present study was designed to reveal brain regions that are abnormal in structure and function in patients with this disorder. We hypothesized, based on brain areas of altered activity in patients with anorexia nervosa and regions involved in pain processing, an interrelation of structural aberrations in the frontoparietal-cingulate network and aberrant functional activation during thermal pain processing in patients with the disorder. METHODS We determined pain thresholds outside the MRI scanner in patients with anorexia nervosa and matched healthy controls. Thereafter, thermal pain stimuli were applied during fMRI imaging. Structural analyses with high-resolution structural T1-weighted volumes were performed using voxel-based morphometry and a surface-based approach. RESULTS Twenty-six patients and 26 controls participated in our study, and owing to technical difficulties, 15 participants in each group were included in our fMRI analysis. Structural analyses revealed significantly decreased grey matter volume and cortical thickness in the frontoparietal-cingulate network in patients with anorexia nervosa. We detected an increased blood oxygen level-dependent signal in patients during the painful 45 °C condition in the midcingulate and posterior cingulate cortex, which positively correlated with increased pain thresholds. Decreased grey matter and cortical thickness correlated negatively with pain thresholds, symptom severity and illness duration, but not with body mass index. LIMITATIONS The lack of a specific quantification of body image distortion is a limitation of our study. CONCLUSION This study provides further evidence for confined structural and functional brain abnormalities in patients with anorexia nervosa in brain regions that are involved in perception and integration of bodily stimuli. The association of structural and functional deviations with thermal thresholds as well as with clinical characteristics might indicate a common neuronal origin.
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Affiliation(s)
- Karl-Jürgen Bär
- Correspondence to: K.-J. Bär, Department of Psychiatry and Psychotherapy, University Hospital, Philosophenweg 3, 07743 Jena, Germany;
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Simon R, Engström M. The default mode network as a biomarker for monitoring the therapeutic effects of meditation. Front Psychol 2015; 6:776. [PMID: 26106351 PMCID: PMC4460295 DOI: 10.3389/fpsyg.2015.00776] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 05/25/2015] [Indexed: 12/13/2022] Open
Abstract
The default mode network (DMN) is a group of anatomically separate regions in the brain found to have synchronized patterns of activation in functional magnetic resonance imaging (fMRI). Mentation associated with the DMN includes processes such as mind wandering, autobiographical memory, self-reflective thought, envisioning the future, and considering the perspective of others. Abnormalities in the DMN have been linked to symptom severity in a variety of mental disorders indicating that the DMN could be used as a biomarker for diagnosis. These correlations have also led to the use of DMN modulation as a biomarker for assessing pharmacological treatments. Concurrent research investigating the neural correlates of meditation, have associated DMN modulation with practice. Furthermore, meditative practice is increasingly understood to have a beneficial role in the treatment of mental disorders. Therefore we propose the use of DMN measures as a biomarker for monitoring the therapeutic effects of meditation practices in mental disorders. Recent findings support this perspective, and indicate the utility of DMN monitoring in understanding and developing meditative treatments for these debilitating conditions.
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Affiliation(s)
- Rozalyn Simon
- Center for Medical Image Science and Visualization, Department of Medical and Health Sciences, Linköping University Linköping, Sweden
| | - Maria Engström
- Center for Medical Image Science and Visualization, Department of Medical and Health Sciences, Linköping University Linköping, Sweden
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80
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Gaudio S, Piervincenzi C, Beomonte Zobel B, Romana Montecchi F, Riva G, Carducci F, Quattrocchi CC. Altered resting state functional connectivity of anterior cingulate cortex in drug naïve adolescents at the earliest stages of anorexia nervosa. Sci Rep 2015; 5:10818. [PMID: 26043139 PMCID: PMC4455287 DOI: 10.1038/srep10818] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 04/29/2015] [Indexed: 02/02/2023] Open
Abstract
Previous Resting-State Functional Connectivity (RSFC) studies have shown several functional alterations in adults with or recovered from long Anorexia Nervosa (AN). The aim of this paper was to investigate whole brain RSFC in adolescents with AN in the earliest stages, less than 6 months, of the disorder. Sixteen drug-naïve outpatient female adolescents with AN-restrictive type (AN-r) (mean age: 15,8; SD 1,7) were compared to 16 age-matched healthy female (mean age: 16,3; SD 1,4). Relevant resting state networks (RSNs) were identified using independent component analysis (ICA) from functional magnetic resonance imaging data; a dual regression technique was used to detect between-group differences in the RSNs. Between-group differences of the functional connectivity maps were found in the executive control network (ECN). Particularly, decreased temporal correlation was observed in AN-r patients relative to healthy controls between the ECN functional connectivity maps and the anterior cingulate cortex (p < 0.05 corrected). Our results in AN adolescents may represent an early trait-related biomarker of the disease. Considering that the above mentioned network and its area are mainly involved in cognitive control and emotional processing, our findings could explain the impaired cognitive flexibility in relation to body image and appetite in AN patients.
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Affiliation(s)
- Santino Gaudio
- 1] Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma", Rome, Italy [2] Eating Disorders Centre "La Cura del Girasole" ONLUS, Rome, Italy
| | - Claudia Piervincenzi
- 1] Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy [2] Institute for Advanced Biomedical Technologies, University of G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Bruno Beomonte Zobel
- Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma", Rome, Italy
| | | | - Giuseppe Riva
- 1] Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy [2] Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Filippo Carducci
- Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy
| | - Carlo Cosimo Quattrocchi
- Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma", Rome, Italy
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81
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Wierenga CE, Bischoff-Grethe A, Melrose AJ, Irvine Z, Torres L, Bailer UF, Simmons A, Fudge JL, McClure SM, Ely A, Kaye WH. Hunger does not motivate reward in women remitted from anorexia nervosa. Biol Psychiatry 2015; 77:642-52. [PMID: 25481622 PMCID: PMC4359668 DOI: 10.1016/j.biopsych.2014.09.024] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 09/05/2014] [Accepted: 09/23/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Hunger enhances sensitivity to reward, yet individuals with anorexia nervosa (AN) are not motivated to eat when starved. This study investigated brain response to rewards during hunger and satiated states to examine whether diminished response to reward could underlie food restriction in AN. METHODS Using a delay discounting monetary decision task known to discriminate brain regions contributing to processing of immediate rewards and cognitive control important for decision making regarding future rewards, we compared 23 women remitted from AN (RAN group; to reduce the confounding effects of starvation) with 17 healthy comparison women (CW group). Monetary rewards were used because the rewarding value of food may be confounded by anxiety in AN. RESULTS Interactions of Group (RAN, CW) × Visit (hunger, satiety) revealed that, for the CW group, hunger significantly increased activation in reward salience circuitry (ventral striatum, dorsal caudate, anterior cingulate cortex) during processing of immediate reward, whereas satiety increased activation in cognitive control circuitry (ventrolateral prefrontal cortex, insula) during decision making. In contrast, brain response in reward and cognitive neurocircuitry did not differ during hunger and satiety in the RAN group. A main effect of group revealed elevated response in the middle frontal gyrus for the RAN group compared with the CW group. CONCLUSIONS Women remitted from AN failed to increase activation of reward valuation circuitry when hungry and showed elevated response in cognitive control circuitry independent of metabolic state. Decreased sensitivity to the motivational drive of hunger may explain the ability of individuals with AN to restrict food when emaciated. Difficulties in valuating emotional salience may contribute to inabilities to appreciate the risks inherent in this disorder.
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Affiliation(s)
| | | | - A. James Melrose
- University of California San Diego, Department of Psychiatry, San Diego CA USA
| | - Zoe Irvine
- University of California San Diego, Department of Psychiatry, San Diego CA USA
| | - Laura Torres
- University of California San Diego, Department of Psychiatry, San Diego CA USA
| | - Ursula F. Bailer
- University of California San Diego, Department of Psychiatry, San Diego CA USA
| | - Alan Simmons
- University of California San Diego, Department of Psychiatry, San Diego CA USA
| | - Julie L. Fudge
- University of Rochester Medical Center, Department of Psychiatry and Neurobiology and Anatomy, Rochester NY USA
| | | | - Alice Ely
- University of California San Diego, Department of Psychiatry, San Diego CA USA
| | - Walter H. Kaye
- University of California San Diego, Department of Psychiatry, San Diego CA USA
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Sanders N, Smeets PAM, van Elburg AA, Danner UN, van Meer F, Hoek HW, Adan RAH. Altered food-cue processing in chronically ill and recovered women with anorexia nervosa. Front Behav Neurosci 2015; 9:46. [PMID: 25774128 PMCID: PMC4342866 DOI: 10.3389/fnbeh.2015.00046] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 02/09/2015] [Indexed: 01/16/2023] Open
Abstract
Anorexia nervosa (AN) is a severe mental disorder characterized by food restriction and weight loss. This study aimed to test the model posed by Brooks et al. (2012a,b) that women suffering from chronic AN show decreased food-cue processing activity in brain regions associated with energy balance and food reward (bottom-up; BU) and increased activity in brain regions associated with cognitive control (top-down; TD) when compared with long-term recovered AN (REC) and healthy controls (HC). Three groups of women, 15 AN (mean illness duration 7.8 ± 4.1 years), 14 REC (mean duration of recovery 4.7 ± 2.7 years) and 15 HC viewed alternating blocks of food and non-food images preceded by a short instruction during functional magnetic resonance imaging (fMRI), after fasting overnight. Functional region of interests (fROIs) were defined in BU (e.g., striatum, hippocampus, amygdala, hypothalamus, and cerebellum), TD (e.g., medial and lateral prefrontal cortex, and anterior cingulate), the insula, and visual processing areas (VPA). Food-cue processing activation was extracted from all fROIs and compared between the groups. In addition, functional connectivity between the fROIs was examined by modular partitioning of the correlation matrix of all fROIs. We could not confirm the hypothesis that BU areas are activated to a lesser extent in AN upon visual processing of food images. Among the BU areas the caudate showed higher activation in both patient groups compared to HC. In accordance with Brooks et al.'s model, we did find evidence for increased TD control in AN and REC. The functional connectivity analysis yielded two clusters in HC and REC, but three clusters in AN. In HC, fROIs across BU, TD, and VPA areas clustered; in AN, one cluster span across BU, TD, and insula; one across BU, TD, and VPA areas; and one was confined to the VPA network. In REC, BU, TD, and VPA or VPA and insula clustered. In conclusion, despite weight recovery, neural processing of food cues is also altered in recovered AN patients.
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Affiliation(s)
- Nicole Sanders
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Utrecht, Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Paul A. M. Smeets
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
- Division of Human Nutrition, Wageningen University and Research Center, Wageningen, Netherlands
| | - Annemarie A. van Elburg
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Utrecht, Netherlands
- Faculty of Social Sciences, University of Utrecht, Utrecht, Netherlands
| | - Unna N. Danner
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Utrecht, Netherlands
| | - Floor van Meer
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Utrecht, Netherlands
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
| | - Hans W. Hoek
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Utrecht, Netherlands
- Parnassia Psychiatric Institute, The Hague, Netherlands
- Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Roger A. H. Adan
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Utrecht, Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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Ehrlich S, Lord AR, Geisler D, Borchardt V, Boehm I, Seidel M, Ritschel F, Schulze A, King JA, Weidner K, Roessner V, Walter M. Reduced functional connectivity in the thalamo-insular subnetwork in patients with acute anorexia nervosa. Hum Brain Mapp 2015; 36:1772-81. [PMID: 25611053 DOI: 10.1002/hbm.22736] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/05/2015] [Indexed: 12/17/2022] Open
Abstract
The neural underpinnings of anorexia nervosa (AN) are poorly understood. Results from existing functional brain imaging studies using disorder-relevant food- or body-stimuli have been heterogeneous and may be biased due to varying compliance or strategies of the participants. In this study, resting state functional connectivity imaging was used. To explore the distributed nature and complexity of brain function we characterized network patterns in patients with acute AN. Thirty-five unmedicated female acute AN patients and 35 closely matched healthy female participants underwent resting state functional magnetic resonance imaging. We used a network-based statistic (NBS) approach [Zalesky et al., 2010a] to identify differences between groups by isolating a network of interconnected nodes with a deviant connectivity pattern. Group comparison revealed a subnetwork of connections with decreased connectivity including the amygdala, thalamus, fusiform gyrus, putamen and the posterior insula as the central hub in the patient group. Results were not driven by changes in intranodal or global connectivity. No network could be identified where AN patients had increased coupling. Given the known involvement of the identified thalamo-insular subnetwork in interoception, decreased connectivity in AN patients in these nodes might reflect changes in the propagation of sensations that alert the organism to urgent homeostatic imbalances and pain-processes that are known to be severely disturbed in AN and might explain the striking discrepancy between patient's actual and perceived internal body state.
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Affiliation(s)
- Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden, Germany; MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
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84
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Abstract
According to the objectification theory ( Fredrickson & Roberts, 1997 ) girls and women are thought to adopt a self-objectified view of themselves as objects to be evaluated on the basis of their appearance. More, this experience is proposed to have a direct link with the health and well being of female subjects. The paper analyzes and discusses the objectification theory within the context of recent research on memory and spatial cognition. On one side, it describes self-objectification as a specific cognitive process: a woman internalizes an objectified self image, when she uses an allocentric frame of reference (observer mode) to remember events in which she evaluates herself based upon bodily appearance. On the other side it directly connects the objectification theory with the Allocentric Lock Hypothesis ( Riva, 2012 ), suggesting that eating disorders have as antecedent an allocentric (objective, from outside) negative image schema of the body that is no more updated by egocentric sensory inputs from perception. Both the similarities between the allocentric lock and the out-of-body experience and a review of the recent studies supporting this claim are also presented and discussed.
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Affiliation(s)
- Giuseppe Riva
- Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of Milan, Italy
| | - Santino Gaudio
- Diagnostic Imaging, Center for Integrated Research (CIR), Università Campus Bio-Medico, Rome, Italy
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Boehm I, Geisler D, King JA, Ritschel F, Seidel M, Deza Araujo Y, Petermann J, Lohmeier H, Weiss J, Walter M, Roessner V, Ehrlich S. Increased resting state functional connectivity in the fronto-parietal and default mode network in anorexia nervosa. Front Behav Neurosci 2014; 8:346. [PMID: 25324749 PMCID: PMC4183185 DOI: 10.3389/fnbeh.2014.00346] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 09/13/2014] [Indexed: 11/13/2022] Open
Abstract
The etiology of anorexia nervosa (AN) is poorly understood. Results from functional brain imaging studies investigating the neural profile of AN using cognitive and emotional task paradigms are difficult to reconcile. Task-related imaging studies often require a high level of compliance and can only partially explore the distributed nature and complexity of brain function. In this study, resting state functional connectivity imaging was used to investigate well-characterized brain networks potentially relevant to understand the neural mechanisms underlying the symptomatology and etiology of AN. Resting state functional magnetic resonance imaging data was obtained from 35 unmedicated female acute AN patients and 35 closely matched healthy controls female participants (HC) and decomposed using spatial group independent component analyses (ICA). Using validated templates, we identified components covering the fronto-parietal “control” network, the default mode network (DMN), the salience network, the visual and the sensory-motor network. Group comparison revealed an increased functional connectivity between the angular gyrus and the other parts of the fronto-parietal network in patients with AN in comparison to HC. Connectivity of the angular gyrus was positively associated with self-reported persistence in HC. In the DMN, AN patients also showed an increased functional connectivity strength in the anterior insula in comparison to HC. Anterior insula connectivity was associated with self-reported problems with interoceptive awareness. This study, with one of the largest sample to date, shows that acute AN is associated with abnormal brain connectivity in two major resting state networks (RSN). The finding of an increased functional connectivity in the fronto-parietal network adds novel support for the notion of AN as a disorder of excessive cognitive control, whereas the elevated functional connectivity of the anterior insula with the DMN may reflect the high levels of self- and body-focused ruminations when AN patients are at rest.
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Affiliation(s)
- Ilka Boehm
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Daniel Geisler
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Joseph A King
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Franziska Ritschel
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Maria Seidel
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Yacila Deza Araujo
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Juliane Petermann
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Heidi Lohmeier
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Jessika Weiss
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Martin Walter
- Department of Psychiatry, Otto-von-Guericke University Magdeburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany ; MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital Charlestown, MA, USA ; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital Boston, MA, USA
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Lavagnino L, Amianto F, D'Agata F, Huang Z, Mortara P, Abbate-Daga G, Marzola E, Spalatro A, Fassino S, Northoff G. Reduced resting-state functional connectivity of the somatosensory cortex predicts psychopathological symptoms in women with bulimia nervosa. Front Behav Neurosci 2014; 8:270. [PMID: 25136302 PMCID: PMC4120855 DOI: 10.3389/fnbeh.2014.00270] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 07/21/2014] [Indexed: 12/03/2022] Open
Abstract
Background: Alterations in the resting-state functional connectivity (rs-FC) of several brain networks have been demonstrated in eating disorders. However, very few studies are currently available on brain network dysfunctions in bulimia nervosa (BN). The somatosensory network is central in processing body-related stimuli and it may be altered in BN. The present study therefore aimed to investigate rs-FC in the somatosensory network in bulimic women. Methods: Sixteen medication-free women with BN (age = 23 ± 5 years) and 18 matched controls (age = 23 ± 3 years) underwent a functional magnetic resonance resting-state scan and assessment of eating disorder symptoms. Within-network and seed-based functional connectivity analyses were conducted to assess rs-FC within the somatosensory network and to other areas of the brain. Results: Bulimia nervosa patients showed a decreased rs-FC both within the somatosensory network (t = 9.0, df = 1, P = 0.005) and with posterior cingulate cortex and two visual areas (the right middle occipital gyrus and the right cuneus) (P = 0.05 corrected for multiple comparison). The rs-FC of the left paracentral lobule with the right middle occipital gyrus correlated with psychopathology measures like bulimia (r = −0.4; P = 0.02) and interoceptive awareness (r = −0.4; P = 0.01). Analyses were conducted using age, BMI (body mass index), and depressive symptoms as covariates. Conclusion: Our findings show a specific alteration of the rs-FC of the somatosensory cortex in BN patients, which correlates with eating disorder symptoms. The region in the right middle occipital gyrus is implicated in body processing and is known as extrastriate body area (EBA). The connectivity between the somatosensory cortex and the EBA might be related to dysfunctions in body image processing. The results should be considered preliminary due to the small sample size.
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Affiliation(s)
- Luca Lavagnino
- Department of Neuroscience, AOU San Giovanni Battista , Turin , Italy ; Institute of Mental Health Research, University of Ottawa, Royal Ottawa Healthcare Group , Ottawa, ON , Canada
| | - Federico Amianto
- Department of Neuroscience, AOU San Giovanni Battista , Turin , Italy
| | - Federico D'Agata
- Department of Neuroscience, AOU San Giovanni Battista , Turin , Italy
| | - Zirui Huang
- Institute of Mental Health Research, University of Ottawa, Royal Ottawa Healthcare Group , Ottawa, ON , Canada
| | - Paolo Mortara
- Department of Neuroscience, AOU San Giovanni Battista , Turin , Italy
| | | | - Enrica Marzola
- Department of Neuroscience, AOU San Giovanni Battista , Turin , Italy
| | - Angela Spalatro
- Department of Neuroscience, AOU San Giovanni Battista , Turin , Italy
| | - Secondo Fassino
- Department of Neuroscience, AOU San Giovanni Battista , Turin , Italy
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Royal Ottawa Healthcare Group , Ottawa, ON , Canada ; Graduate Institute of Humanities in Medicine, Taipei Medical University , Taipei , Taiwan ; Brain and Consciousness Research Center, Taipei Medical University-Shuang Ho Hospital , New Taipei City , Taiwan ; Research Center for Mind, Brain and Learning, National Chengchi University , Taipei , Taiwan ; Department of Psychology, National Chengchi University , Taipei , Taiwan ; Centre for Cognition and Brain Disorders (CCBD), Normal University Hangzhou , Hangzhou , China
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87
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McFadden KL, Tregellas JR, Shott ME, Frank GK. Reduced salience and default mode network activity in women with anorexia nervosa. J Psychiatry Neurosci 2014; 39:178-88. [PMID: 24280181 PMCID: PMC3997603 DOI: 10.1503/jpn.130046] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The neurobiology of anorexia nervosa is poorly understood. Neuronal networks contributing to action selection, self-regulation and interoception could contribute to pathologic eating and body perception in people with anorexia nervosa. We tested the hypothesis that the salience network (SN) and default mode network (DMN) would show decreased intrinsic activity in women with anorexia nervosa and those who had recovered from the disease compared to controls. The basal ganglia (BGN) and sensorimotor networks (SMN) were also investigated. METHODS Between January 2008 and January 2012, women with restricting-type anorexia nervosa, women who recovered from the disease and healthy control women completed functional magnetic resonance imaging during a conditioned stimulus task. Network activity was studied using independent component analysis. RESULTS We studied 20 women with anorexia nervosa, 24 recovered women and 24 controls. Salience network activity in the anterior cingulate cortex was reduced in women with anorexia nervosa (p = 0.030; all results false-discovery rate- corrected) and recovered women (p = 0.039) compared to controls. Default mode network activity in the precuneus was reduced in women with anorexia compared to controls (p = 0.023). Sensorimotor network activity in the supplementary motor area (SMA; p = 0.008), and the left (p = 0.028) and right (p = 0.002) postcentral gyrus was reduced in women with anorexia compared to controls; SMN activity in the SMA (p = 0.019) and the right postcentral gyrus (p = 0.008) was reduced in women with anorexia compared to recovered women. There were no group differences in the BGN. LIMITATIONS Differences between patient and control populations (e.g., depression, anxiety, medication) are potential confounds, but were included as covariates. CONCLUSION Reduced SN activity in women with anorexia nervosa and recovered women could be a trait-related biomarker or illness remnant, altering the drive to approach food. The alterations in the DMN and SMN observed only in women with anorexia nervosa suggest state-dependent abnormalities that could be related to altered interoception and body image in these women when they are underweight but that remit following recovery.
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Affiliation(s)
| | | | | | - Guido K.W. Frank
- Correspondence to: G.K.W. Frank, Departments of Psychiatry and Neuroscience, The Children’s Hospital, Gary Pavilion A036/B-130, 13123 East 16th Ave., Aurora CO 80045;
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Kullmann S, Giel KE, Teufel M, Thiel A, Zipfel S, Preissl H. Aberrant network integrity of the inferior frontal cortex in women with anorexia nervosa. NEUROIMAGE-CLINICAL 2014; 4:615-22. [PMID: 24936412 PMCID: PMC4053633 DOI: 10.1016/j.nicl.2014.04.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/02/2014] [Accepted: 04/05/2014] [Indexed: 12/30/2022]
Abstract
Neuroimaging studies investigating the neural profile of anorexia nervosa (AN) have revealed a predominant imbalance between the reward and inhibition systems of the brain, which are also hallmark characteristics of the disorder. However, little is known whether these changes can also be determined independent of task condition, using resting-state functional magnetic resonance imaging, in currently ill AN patients. Therefore the aim of our study was to investigate resting-state connectivity in AN patients (n = 12) compared to healthy athlete (n = 12) and non-athlete (n = 14) controls. For this purpose, we used degree centrality to investigate functional connectivity of the whole-brain network and then Granger causality to analyze effective connectivity (EC), to understand directional aspects of potential alterations. We were able to show that the bilateral inferior frontal gyrus (IFG) is a region of special functional importance within the whole-brain network, in AN patients, revealing reduced functional connectivity compared to both healthy control groups. Furthermore, we found decreased EC from the right IFG to the midcingulum and increased EC from the bilateral orbitofrontal gyrus to the right IFG. For the left IFG, we only observed increased EC from the bilateral insula to the left IFG. These results suggest that AN patients have reduced connectivity within the cognitive control system of the brain and increased connectivity within regions important for salience processing. Due to its fundamental role in inhibitory behavior, including motor response, altered integrity of the inferior frontal cortex could contribute to hyperactivity in AN. We evaluate resting-state functional (FC) and effective (EC) connectivity. We compare anorexia nervosa (AN) patients with healthy controls. AN patients show reduced FC in the inferior frontal gyrus (IFG). AN patients show reduced EC from the IFG and increased EC to the IFG. Altered FC patterns correlate with physical activity.
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Affiliation(s)
- Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany ; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany ; Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University, Tübingen, Germany ; fMEG Center, University of Tübingen, Tübingen, Germany
| | - Katrin E Giel
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University, Tübingen, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Tübingen, Germany
| | - Ansgar Thiel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Tübingen, Germany
| | - Stephan Zipfel
- Institute of Sport Science, University Tübingen, Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany ; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany ; Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University, Tübingen, Germany ; fMEG Center, University of Tübingen, Tübingen, Germany
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Abstract
OBJECTIVE Recent advances in neuroimaging techniques have enabled a better understanding of the neurobiological underpinnings of anorexia nervosa (AN). The aim of this paper was to summarise our current understanding of the neurobiology of AN. METHODS The literature was searched using the electronic databases PubMed and Google Scholar, and by additional hand searches through reference lists and specialist eating disorders journals. Relevant studies were included if they were written in English, only used human participants, had a specific AN group, used clinical populations of AN, group comparisons were reported for AN compared to healthy controls and not merely AN compared to other eating disorders or other psychiatric groups, and were not case studies. RESULTS The systematic review summarises a number of structural and functional brain differences which are reported in individuals with AN, including differences in neurotransmitter function, regional cerebral blood flow, glucose metabolism, volumetrics and the blood oxygen level dependent response. CONCLUSION Several structural and functional differences have been reported in AN, some of which reverse and others which persist following weight restoration. These findings have important implications for our understanding of the neurobiological underpinnings of AN, and further research in this field may provide new direction for the development of more effective treatments.
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Affiliation(s)
- Andrea Phillipou
- 1Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
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Mateos Rodríguez I, Cowdrey FA, Park RJ. Is there a place for mindfulness in the treatment of anorexia nervosa? ACTA ACUST UNITED AC 2013. [DOI: 10.1080/21662630.2013.795755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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