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Haynos AF, Lavender JM, Nelson J, Crow SJ, Peterson CB. Moving towards specificity: A systematic review of cue features associated with reward and punishment in anorexia nervosa. Clin Psychol Rev 2020; 79:101872. [PMID: 32521390 DOI: 10.1016/j.cpr.2020.101872] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/16/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022]
Abstract
Models of anorexia nervosa (AN) posit that symptoms are maintained through deficient reward and enhanced punishment processing. However, theoretical and empirical inconsistencies highlight the need for a more nuanced conceptualization of this literature. Our goal was to comprehensively review the research on reward and punishment responding in AN from a cue-specific lens to determine which stimuli evoke or discourage reward and punishment responses in this population, and, ultimately, what properties these rewarding and punishing cues might share. A systematic review interrogating reward and punishment responses to specific cues yielded articles (n = 92) that examined responses to disorder relevant (e.g., food) and irrelevant (e.g., money) stimuli across self-report, behavioral, and biological indices. Overall, in most studies individuals with AN exhibited aversive responses to cues signaling higher body weights, social contexts, and monetary losses, and appetitive responses to cues for weight loss behaviors and thinness. Findings were more mixed on responses to palatable food and monetary gains. Results highlight that reward and punishment responding in AN are context specific and may be affected by varied stimulus qualities (e.g., predictability, controllability, delay, effort). Increasing specificity in future research on reward and punishment mechanisms in AN will better inform development of precisely-targeted interventions.
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Affiliation(s)
- Ann F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States of America.
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America; The Metis Foundation, San Antonio, TX, United States of America
| | - Jillian Nelson
- Department of Psychology, George Mason University, Fairfax, VA, United States of America
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States of America; The Emily Program, St. Paul, MN, United States of America
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States of America; The Emily Program, St. Paul, MN, United States of America
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Kaufmann LK, Hänggi J, Jäncke L, Baur V, Piccirelli M, Kollias S, Schnyder U, Martin-Soelch C, Milos G. Age influences structural brain restoration during weight gain therapy in anorexia nervosa. Transl Psychiatry 2020; 10:126. [PMID: 32366823 PMCID: PMC7198513 DOI: 10.1038/s41398-020-0809-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 01/22/2023] Open
Abstract
Neuroimaging studies on anorexia nervosa (AN) have consistently reported globally reduced gray matter in patients with acute AN. While first studies on adolescent AN patients provide evidence for the reversibility of these impairments after weight gain, longitudinal studies with detailed regional analysis for adult AN patients are lacking and factors associated with brain restitution are poorly understood. We investigated structural changes in anorexia nervosa using T1-weighted magnetic resonance images with surface-based morphometry. The sample consisted of 26 adult women with severe AN and 30 healthy controls. The longitudinal design comprised three time points, capturing the course of weight-restoration therapy in AN patients at distinct stages of weight gain (BMI ≤ 15.5 kg/m2; 15.5 < BMI < 17.5 kg/m2; BMI ≥ 17.5 kg/m2). Compared to controls, AN patients showed globally decreased cortical thickness and subcortical volumes at baseline. Linear mixed effect models revealed the reversibility of these alterations, with brain restoration being most pronounced during the first half of treatment. The restoration of cortical thickness of AN patients negatively correlated with age, but not duration of illness. After weight restoration, residual group differences of cortical thickness remained in the superior frontal cortex. These findings indicate that structural brain alterations of adult patients with severe AN recuperate independently of the duration of illness during weight-restoration therapy. The temporal pattern of brain restoration suggests a decrease in restoration rate over the course of treatment, with patients' age as a strong predictor of brain restitution, possibly reflecting decreases of brain plasticity as patients grow older.
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Affiliation(s)
- Lisa-Katrin Kaufmann
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland. .,Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland. .,Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland.
| | - Jürgen Hänggi
- grid.7400.30000 0004 1937 0650Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Lutz Jäncke
- grid.7400.30000 0004 1937 0650Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650International Normal Aging and Plasticity Imaging Center (INAPIC), University of Zurich, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University Research Priority Program (URPP) “Dynamic of Healthy Aging”, University of Zurich, Zurich, Switzerland
| | - Volker Baur
- grid.7400.30000 0004 1937 0650Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marco Piccirelli
- grid.412004.30000 0004 0478 9977Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Spyros Kollias
- grid.412004.30000 0004 0478 9977Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Ulrich Schnyder
- grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
| | - Chantal Martin-Soelch
- grid.8534.a0000 0004 0478 1713Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Gabriella Milos
- grid.7400.30000 0004 1937 0650Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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53
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Kinnaird E, Stewart C, Tchanturia K. The relationship of autistic traits to taste and olfactory processing in anorexia nervosa. Mol Autism 2020; 11:25. [PMID: 32276668 PMCID: PMC7146886 DOI: 10.1186/s13229-020-00331-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/27/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is a heightened prevalence of autism in anorexia nervosa (AN) compared to the general population. Autistic people with AN experience a longer illness duration and poorer treatment outcomes. Whether sensory differences in autism could contribute to altered taste and smell as a potential maintaining factor in AN is under-explored. The aim of this study was to explore whether autistic traits are associated with taste and olfaction differences in AN. METHODS The study recruited n = 40 people with AN, and n = 40 healthy controls (HC). Smell sensitivity was measured using the Sniffin' Sticks test. Taste sensitivity was measured using taste strips. Participants self-rated their autistic traits using the Autism Spectrum Quotient. RESULTS There were no significant differences on taste and olfactory outcomes between people with AN and HC. These findings did not change after controlling for the heightened levels of autistic traits in the AN group. No relationship between taste and smell outcomes and autistic traits were identified within the AN group. LIMITATIONS The current study is not able to draw conclusions about taste and smell processing in co-occurring autism and AN as it only measured levels of autistic traits, rather than comparing people with and without an autism diagnosis. CONCLUSIONS No significant associations between autistic traits and taste and smell processing in AN were identified. Future research should consider further exploring this area, including by comparing autistic women to women with AN.
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Affiliation(s)
- Emma Kinnaird
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Catherine Stewart
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.
- Eating Disorders Service, South London and Maudsley NHS Foundation Trust, London, UK.
- Department of Psychology, Illia State University, Tbilisi, Georgia.
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Wang L, Bi K, Song Z, Zhang Z, Li K, Kong QM, Li XN, Lu Q, Si TM. Disturbed Resting-State Whole-Brain Functional Connectivity of Striatal Subregions in Bulimia Nervosa. Int J Neuropsychopharmacol 2020; 23:356-365. [PMID: 32215560 PMCID: PMC7311647 DOI: 10.1093/ijnp/pyaa023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 03/19/2020] [Accepted: 03/25/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Disturbed self-regulation, taste reward, as well as somatosensory and visuospatial processes were thought to drive binge eating and purging behaviors that characterize bulimia nervosa. Although studies have implicated a central role of the striatum in these dysfunctions, there have been no direct investigations on striatal functional connectivity in bulimia nervosa from a network perspective. METHODS We calculated the functional connectivity of striatal subregions based on the resting-state functional Magnetic Resonance Imaging data of 51 bulimia nervosa patients and 53 healthy women. RESULTS Compared with the healthy women, bulimia nervosa patients showed increased positive functional connectivity in bilateral striatal nuclei and thalamus for nearly all of the striatal subregions, and increased negative functional connectivity in bilateral primary sensorimotor cortex and occipital areas for both ventral striatum and putamen subregions. Only for the putamen subregions, we observed reduced negative functional connectivity in the prefrontal (bilateral superior and middle frontal gyri) and parietal (right inferior parietal lobe and precuneus) areas. Several striatal connectivities with occipital and primary sensorimotor cortex significantly correlated with the severity of bulimia. CONCLUSIONS The findings indicate bulimia nervosa-related alterations in striatal functional connectivity with the dorsolateral prefrontal cortex supporting self-regulation, the subcortical striatum and thalamus involved in taste reward, as well as the visual occipital and sensorimotor regions mediating body image, which contribute to our understanding of neural circuitry of bulimia nervosa and encourage future therapeutic developments for bulimia nervosa by modulating striatal pathway.
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Affiliation(s)
- Li Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Peking University the Sixth Hospital (Institute of Mental Health); National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Kun Bi
- Key Laboratory of Child Development and Learning Science, School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China
| | - Zhou Song
- Taiyuan Psychiatric Hospital, Taiyuan, Shanxi, China
| | - Zhe Zhang
- Taiyuan Psychiatric Hospital, Taiyuan, Shanxi, China
| | - Ke Li
- Peking University the Sixth Hospital (Institute of Mental Health); National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Qing-Mei Kong
- Peking University the Sixth Hospital (Institute of Mental Health); National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Xue-Ni Li
- Department of Radiology, 306 Hospital of People’s Liberation Army, Beijing, China
| | - Qing Lu
- Key Laboratory of Child Development and Learning Science, School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China
| | - Tian-Mei Si
- Peking University the Sixth Hospital (Institute of Mental Health); National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
- Correspondence: Tian-Mei Si, PhD, Clinical Psychopharmacology Division, Institute of Mental Health, Peking University, No. 51 Hua Yuan Bei Road, Hai Dian District 100191, Beijing, China ()
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55
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Li X, Liu X, Wang Y, Li L, Zheng L, Liu Y, Ma J, Zhang L. Altered regional gray matter volume in Chinese female patients with bulimia nervosa. BMC Psychiatry 2020; 20:94. [PMID: 32122309 PMCID: PMC7053150 DOI: 10.1186/s12888-020-02493-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/11/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Bulimia nervosa (BN) is a psychiatric disorder with unclear pathophysiology. Several studies have associated BN with structural and functional changes in the brain, but findings have been inconsistent. Here we explored this potential association in a small group of Chinese women with BN. METHODS This retrospective study examined 34 women with BN and 34 age-matched healthy controls, all of whom underwent T1-weighted magnetic resonance imaging (MRI). Voxel-based morphometry was carried out to explore alterations in regional grey matter volume (GMV) that may be associated with BN. RESULTS The BN group showed smaller GMV in the left medial superior frontal gyrus (SFGmed.L), right superior temporal gyrus (STG.R), right median cingulate and paracingulate gyri (DCG.R), left median cingulate and paracingulate gyri (DCG.L) and left dorsolateral superior frontal gyrus (SFGdor.L). No regions showing GMV increases in BN were identified. The GMV reduction did not correlate with body mass index, duration of illness, or patients' self-esteem or overall self-evaluation. GMV reduction correlated negatively with age in the SFGmed. L (r = - 0.516, P < 0.005), DCG. R (r = - 0.556, P < 0.005), DCG. L (r = - 0.576, P < 0.05) and SFGdor. L (r = - 0.576, P < 0.005). CONCLUSIONS Women with BN show reduced GMV in several brain regions, but it is difficult to know whether these changes are the result of BN pathology or of binge-eating and compensatory behavior. These changes may be associated with impaired inhibitory control, body dissatisfaction and emotion dysregulation.
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Affiliation(s)
- Xiao Li
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu, 610041 Sichuan China
| | - Xiaowei Liu
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu, 610041 Sichuan China
| | - Yu Wang
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu, 610041 Sichuan China
| | - Lingfei Li
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu, 610041 Sichuan China
| | - Linli Zheng
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu, 610041 Sichuan China
| | - Yaya Liu
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu, 610041 Sichuan China ,Zun Yi Psychiatric Hospital, Zunyi, 563000 Guizhou China
| | - Jing Ma
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu, 610041 Sichuan China
| | - Lan Zhang
- Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu, 610041, Sichuan, China.
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Molina-Ruiz RM, García-Saiz T, Looi JCL, Via Virgili E, Rincón Zamorano M, de Anta Tejado L, López HT, Perera JLC, Díaz-Marsá M. Neural Mechanisms in Eating Behaviors: A Pilot fMRI Study of Emotional Processing. Psychiatry Investig 2020; 17:225-236. [PMID: 32160692 PMCID: PMC7113175 DOI: 10.30773/pi.2019.0038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/14/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Emotional processing dysfunction evident in eating disorders (ED) such as anorexia nervosa (AN) and bulimia nervosa (BN), is considered relevant to the development and maintenance of these disorders. The purpose of the current functional magnetic resonance imaging (fMRI) study was to pilot a comparison of the activity of the fronto-limbic and fronto-striatal brain areas during an emotion processing task in persons with ED. METHODS 24 women patients with ED were scanned, while showing emotionally stimulating (pleasant, unpleasant) and neutral images from the International Affective Picture System (IAPS). RESULTS During the pleasant condition, significant differences in Dorsolateral Prefrontal Cortex (DLPFC) activations were found with AN participants presenting greater activation compared to BN and ED comorbid groups (EDc) and healthy controls also showing greater activation of this brain area compared to BN and EDc. Left putamen was less activated in EDc compared to both controls (C) and AN. During the unpleasant condition, AN participants showed hyperactivation of the Orbito-frontal Cortex (OFC) when compared to EDc. CONCLUSION This study highlights the potential functional relevance of brain areas that have been associated with self-control. These findings should help advance understanding the neural substrate of ED, though they should be considered as preliminary and be cautiously interpreted.
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Affiliation(s)
- Rosa M Molina-Ruiz
- Psychiatry Department, Universitary Hospital Clinico San Carlos de Madrid, IddISC, Madrid, Spain
| | - T García-Saiz
- Artificial Intelligence Department, UNED. E.T.S.I. Informatics, Madrid, Spain
| | - Jeffrey C L Looi
- Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, Australia
| | - E Via Virgili
- Hospital Materno-Infantil Sant Joan de Déu, Barcelona, Spain
| | - M Rincón Zamorano
- Artificial Intelligence Department, UNED. E.T.S.I. Informatics, Madrid, Spain
| | - Laura de Anta Tejado
- Psychiatry Department, Universitary Hospital Clinico San Carlos de Madrid, IddISC, Madrid, Spain
| | - Helena Trebbau López
- Psychiatry Department, Universitary Hospital Clinico San Carlos de Madrid, IddISC, Madrid, Spain
| | | | - Marina Díaz-Marsá
- Psychiatry Department, Universitary Hospital Clinico San Carlos de Madrid, IddISC, Madrid, Spain
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Lai J, Xu T, Zhang H, Xi C, Zhou H, Du Y, Jiang J, Wu L, Zhang P, Xu Y, Hu S, Xu D. Fractional amplitude of low frequency fluctuation in drug-naïve first-episode patients with anorexia nervosa: A resting-state fMRI study. Medicine (Baltimore) 2020; 99:e19300. [PMID: 32118747 PMCID: PMC7478752 DOI: 10.1097/md.0000000000019300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To characterize the fractional amplitude of low-frequency fluctuation (fALFF) in drug-naïve first-episode female patients with anorexia nervosa (AN) using resting-state functional magnetic resonance imaging (rs-fMRI).Whole brain rs-fMRI data were collected from 7 drug-naïve first-episode female patients with DSM-5 AN and 14 age-matched healthy female controls. fALFF values were calculated and compared between the two groups using a two-sample t test. Correlation analysis between the fALFF values in the entire brain and body mass index (BMI) was performed.Compared with the healthy controls, increased fALFF values were observed in the AN patients in their right hippocampus and left superior frontal gyrus, while decreased fALFF values were observed in their left rectus and left middle occipital gyrus. Moreover, low BMI was significantly associated with decreased fALFF in the left inferior frontal gyrus but increased fALFF in the left calcarine. In particular, the z-standardized fALFF (zfALFF) value of the left rectus was positive associated with BMI.Our findings suggest that spontaneous brain activity in the frontal region, hippocampus and rectus, characterized by fALFF values, was altered in drug-naïve, first-episode female patients with AN.
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Affiliation(s)
- Jianbo Lai
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management in Zhejiang Province
- Brain Research Institute of Zhejiang University
| | - Tingting Xu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
- Mental Health Centre, Xiaoshan Hospital of Zhejiang Province, Hangzhou
| | - Haorong Zhang
- Shanghai Key Laboratory of Magnetic Resonance Imaging & Institute of Cognitive Neuroscience, East China Normal University, Shanghai, China
| | - Caixi Xi
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Hetong Zhou
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management in Zhejiang Province
- Brain Research Institute of Zhejiang University
| | - Yanli Du
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Jiajun Jiang
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Lingling Wu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Peifen Zhang
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Yi Xu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management in Zhejiang Province
- Brain Research Institute of Zhejiang University
| | - Shaohua Hu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management in Zhejiang Province
- Brain Research Institute of Zhejiang University
| | - Dongrong Xu
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University & New York State Psychiatric Institute, New York, NY 10032
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Abstract
BACKGROUND Eating disorders are a significant cause of morbidity and mortality. The etiology and maintenance of eating-disorder symptoms are not well understood. Evidence suggests that there may be gustatory alterations in patients with eating disorders. OBJECTIVE This article systematically reviews research assessing gustatory differences in patients with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). METHOD A systematic review was performed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, examining taste and eating disorders. We reviewed electronic databases and identified 1,490 peer-reviewed English-language studies. Of these, 49 met inclusion criteria. RESULTS Studies employed psychophysical measures (n = 27), self-reported questionnaires (n = 5), and neuroimaging techniques (i.e., electroencephalography, functional magnetic resonance imaging; n = 17). Psychophysical studies showed that individuals with BN, in general, had greater preference for sweetness than healthy controls, and those with AN had a greater aversion for fat than controls. In neuroimaging studies, findings suggested that predictable administration of sweet-taste stimuli was associated with reduced activation in taste-reward regions of the brain among individuals with AN (e.g., insula, ventral, and dorsal striatum) but increased activation in BN and BED. DISCUSSION To our knowledge, this systematic review is the first to synthesize literature on taste differences in AN, BN, and BED. The inconsistency and variability in methods used across studies increased difficulties in comparing studies and disease processes. Further studies with well-defined population parameters are warranted to better understand how taste varies in patients with eating disorders.
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Affiliation(s)
- Ariana M. Chao
- Department of Biobehavioral Health Sciences, The University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Abhrarup Roy
- Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, Department of Health and Human Services, National Institutes of Health, Bethesda, MD, USA
| | - Alexis T. Franks
- Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, Department of Health and Human Services, National Institutes of Health, Bethesda, MD, USA
| | - Paule V. Joseph
- Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, Department of Health and Human Services, National Institutes of Health, Bethesda, MD, USA
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Leppanen J, Cardi V, Sedgewick F, Treasure J, Tchanturia K. Basal ganglia volume and shape in anorexia nervosa. Appetite 2020; 144:104480. [PMID: 31586464 PMCID: PMC6891247 DOI: 10.1016/j.appet.2019.104480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 09/07/2019] [Accepted: 10/01/2019] [Indexed: 12/04/2022]
Abstract
Background Reward-centred models have proposed that anomalies in the basal ganglia circuitry that underlies reward learning and habit formation perpetuate anorexia nervosa (AN). The present study aimed to investigate the volume and shape of key basal ganglia regions, including the bilateral caudate, putamen, nucleus accumbens (NAcc), and globus pallidus in AN. Methods The present study combined data from two existing studies resulting in a sample size of 46 women with AN and 56 age-matched healthy comparison (HC) women. Group differences in volume and shape of the regions of interest were examined. Within the AN group, the impact of eating disorder characteristics on volume and shape of the basal ganglia regions were also explored. Results The shape analyses revealed inward deformations in the left caudate, right NAcc, and bilateral ventral and internus globus pallidus, and outward deformations in the right middle and posterior globus pallidus in the AN group. Conclusions The present findings appear to fit with the theoretical models suggesting that there are alterations in the basal ganglia regions associated with habit formation and reward processing in AN. Further investigation of structural and functional connectivity of these regions in AN as well as their role in recovery would be of interest.
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Affiliation(s)
- Jenni Leppanen
- Kings' College London, Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine, London, United Kingdom.
| | - Valentina Cardi
- Kings' College London, Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine, London, United Kingdom
| | - Felicity Sedgewick
- University of Bristol, 35 Berkeley Square, Clifton, Bristol, United Kingdom
| | - Janet Treasure
- Kings' College London, Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Kate Tchanturia
- Kings' College London, Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom; Illia State University, Department of Psychology, Tbilisi, Georgia
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60
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Kot E, Kucharska K, Monteleone AM, Monteleone P. Structural and functional brain correlates of altered taste processing in anorexia nervosa: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2019; 28:122-140. [DOI: 10.1002/erv.2713] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/30/2019] [Accepted: 11/05/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Emilia Kot
- Faculty of PsychologyUniversity of Warsaw Warsaw Poland
| | | | | | - Palmiero Monteleone
- Department of PsychiatryUniversity of Campania “Luigi Vanvitelli” Naples Italy
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Section of NeurosciencesUniversity of Salerno Salerno Italy
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Evidence for a sex-specific contribution of polygenic load for anorexia nervosa to body weight and prefrontal brain structure in nonclinical individuals. Neuropsychopharmacology 2019; 44:2212-2219. [PMID: 31284291 PMCID: PMC6898345 DOI: 10.1038/s41386-019-0461-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/27/2019] [Accepted: 07/01/2019] [Indexed: 12/14/2022]
Abstract
Genetic predisposition and brain structural abnormalities have been shown to be involved in the biological underpinnings of anorexia nervosa (AN). Prefrontal brain regions are suggested to contribute through behavioral inhibition mechanisms to body weight. However, it is unknown if and to which extent biological correlates for AN might be present in individuals without clinical AN symptomatology. We therefore investigated the contribution of polygenic load for AN on body weight and prefrontal brain structure in a sample of n = 380 nonclinical individuals. A polygenic score (PGS) reflecting the individual genetic load for the trait of anorexia nervosa was calculated. Structural MRI data were acquired and preprocessed using the cortical parcellation stream of FreeSurfer. We observed a significant PGS × sex interaction effect on body mass index (BMI), which was driven by a negative correlation between PGS and BMI in female participants. Imaging analyses revealed significant interaction effects of sex × PGS on surface area of the lateral orbitofrontal cortex (OFC), the pars orbitalis (PO), the rostral middle frontal gyrus (RMF) and the pars triangularis (PT) of the left frontal cortex. The interaction effects were driven by positive correlations between PGS and prefrontal surface areas in female participants and negative correlations in male participants. We furthermore found sex-specific associations between BMI and left RMF surface area as well as between BMI and left PO and left RMF thickness. Our findings demonstrate a sex-specific association between polygenic load for AN, BMI, and prefrontal brain structure in nonclinical individuals. Hence, this study identifies structural abnormalities associated with polygenic load for AN and BMI in brain regions deeply involved in behavioral inhibition and impulse regulation as candidate brain regions for future research.
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Abstract
Eating disorders are severe psychiatric illnesses with a typical age of onset in adolescence. Brain research in youth and young adults may help us identify specific neurobiology that contributes to onset and maintenance of those disorders. This article provides a state-of-the-art review of our current understanding of the neurobiology of anorexia nervosa and bulimia nervosa. This includes brain structure and function studies to understand food restriction, binge-eating or purging behaviors, cognitive and emotional factors, as well as interoception. Binge-eating disorder and avoidant restrictive food intake disorder are also discussed, but the literature is still very small.
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63
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Coniglio KA, Christensen KA, Haynos AF, Rienecke RD, Selby EA. The posited effect of positive affect in anorexia nervosa: Advocating for a forgotten piece of a puzzling disease. Int J Eat Disord 2019; 52:971-976. [PMID: 31361353 PMCID: PMC7176354 DOI: 10.1002/eat.23147] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/19/2019] [Accepted: 07/18/2019] [Indexed: 01/01/2023]
Abstract
Anorexia nervosa (AN) is a complex and life-threatening eating disorder. Current models of AN onset and maintenance have largely focused on the role of negative affect, while fewer models have described the role of positive affect (PA). Given that these theoretical models have informed current treatment approaches, and that treatment remains minimally effective for adults with AN, we advocate that targeting PA is one avenue for advancing maintenance models and by extension, treatment. We specifically propose that AN may arise and be chronically and pervasively maintained as a function of dysregulated PA in response to weight loss and weight loss behaviors (e.g., restriction, excessive exercise), to a degree that is not accounted for in existing models of AN. We present evidence from multiple domains, including biological, behavioral, and self-report, supporting the hypothesis that PA dysregulation in AN contributes to the maintenance of the disorder. We conclude with several specific avenues for treatment development research as well as a call for future work elucidating the biological correlates of PA.
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Affiliation(s)
- Kathryn A. Coniglio
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Kara A. Christensen
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
- Department of Psychology, The Ohio State University, Columbus, Ohio
| | - Ann F. Haynos
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Renee D. Rienecke
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Edward A. Selby
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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Abnormal structural brain network and hemisphere-specific changes in bulimia nervosa. Transl Psychiatry 2019; 9:206. [PMID: 31455767 PMCID: PMC6712015 DOI: 10.1038/s41398-019-0543-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/25/2019] [Accepted: 07/17/2019] [Indexed: 12/18/2022] Open
Abstract
Bulimia nervosa (BN) is characterized by episodic binge eating and purging behaviors. Disrupted neural processes of self-regulation, taste-rewarding, and body image has been associated with the pathogenesis of BN. However, the structural basis for these behavioral and functional deficits remains largely unknown. We employed diffusion tensor imaging and graph theory approaches (including the nodal properties and network-based statistics (NBS)) to characterize the whole-brain structural network of 48 BN and 44 healthy women. For nodal measures of strength, local efficiency, and betweenness centrality, BN patients displayed abnormal increases in multiple left-lateralized nodes within the mesocorticolimbic reward circuitry (including the orbitofrontal cortex, anterior cingulate, insular, medial temporal, and subcortical areas), lateral temporal-occipital cortex, and precuneus, while reduced global efficiency was observed in the right-lateralized nodes within the dorsolateral prefrontal cortex, mesocorticolimbic circuitry, somatosensory and visuospatial system. Several mesocorticolimbic nodes significantly correlated with BN symptoms. At a network level, we found increased left-lateralized connections primarily within the orbitofrontal cortex and its connections to mesocorticolimbic and lateral temporal-occipital areas, but reduced right-lateralized connections across the inferior frontal gyrus and insula, as well as their connections to the lateral temporal cortex. This study revealed BN-related changes in white-matter connections across the prefrontal control, mesocorticolimbic reward, somatosensory and visuospatial systems. The hemispheric-specific change could be an important aspect of the pathophysiology of BN. By characterizing whole-brain structural network changes of BN, our study provides novel evidence for understanding the behavioral and functional deficits of the disorder.
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Plasma neurofilament light chain concentration is increased in anorexia nervosa. Transl Psychiatry 2019; 9:180. [PMID: 31371701 PMCID: PMC6675786 DOI: 10.1038/s41398-019-0518-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/20/2019] [Indexed: 12/12/2022] Open
Abstract
Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality and, to a large extent, unknown pathophysiology. Structural brain differences, such as global or focal reductions in grey or white matter volumes, as well as enlargement of the sulci and the ventricles, have repeatedly been observed in individuals with AN. However, many of the documented aberrances normalize with weight recovery, even though some studies show enduring changes. To further explore whether AN is associated with neuronal damage, we analysed the levels of neurofilament light chain (NfL), a marker reflecting ongoing neuronal injury, in plasma samples from females with AN, females recovered from AN (AN-REC) and normal-weight age-matched female controls (CTRLS). We detected significantly increased plasma levels of NfL in AN vs CTRLS (medianAN = 15.6 pg/ml, IQRAN = 12.1-21.3, medianCTRL = 9.3 pg/ml, IQRCTRL = 6.4-12.9, and p < 0.0001), AN vs AN-REC (medianAN-REC = 11.1 pg/ml, IQRAN-REC = 8.6-15.5, and p < 0.0001), and AN-REC vs CTRLS (p = 0.004). The plasma levels of NfL are negatively associated with BMI overall samples (β (±se) = -0.62 ± 0.087 and p = 6.9‧10-12). This indicates that AN is associated with neuronal damage that partially normalizes with weight recovery. Further studies are needed to determine which brain areas are affected, and potential long-term sequelae.
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von Schwanenflug N, Müller DK, King JA, Ritschel F, Bernardoni F, Mohammadi S, Geisler D, Roessner V, Biemann R, Marxen M, Ehrlich S. Dynamic changes in white matter microstructure in anorexia nervosa: findings from a longitudinal study. Psychol Med 2019; 49:1555-1564. [PMID: 30149815 DOI: 10.1017/s003329171800212x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Gray matter (GM) 'pseudoatrophy' is well-documented in patients with anorexia nervosa (AN), but changes in white matter (WM) are less well understood. Here we investigated the dynamics of microstructural WM brain changes in AN patients during short-term weight restoration in a combined longitudinal and cross-sectional study design. METHODS Diffusion-weighted images were acquired in young AN patients before (acAN-Tp1, n = 56) and after (acAN-Tp2, n = 44) short-term weight restoration as well as in age-matched healthy controls (HC, n = 60). Images were processed using Tract-Based-Spatial-Statistics to compare fractional anisotropy (FA) across groups and timepoints. RESULTS In the cross-sectional comparison, FA was significantly reduced in the callosal body in acAN-Tp1 compared with HC, while no differences were found between acAN-Tp2 and HC. In the longitudinal arm, FA increased with weight gain in acAN-Tp2 relative to acAN-Tp1 in large parts of the callosal body and the fornix, while it decreased in the right corticospinal tract. CONCLUSIONS Our findings reveal that dynamic, bidirectional changes in WM microstructure in young underweight patients with AN can be reversed with brief weight restoration therapy. These results parallel those previously observed in GM and suggest that alterations in WM in non-chronic AN are also state-dependent and rapidly reversible with successful intervention.
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Affiliation(s)
- Nina von Schwanenflug
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Dirk K Müller
- Department of Psychiatry and Neuroimaging Center,Technische Universität Dresden,Dresden,Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Siawoosh Mohammadi
- Department of Systems Neuroscience,Medical Center Hamburg-Eppendorf,Hamburg,Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry,Faculty of Medicine,Eating Disorder Research and Treatment Center, Technische Universität Dresden,Dresden,Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University,Magdeburg,Germany
| | - Michael Marxen
- Department of Psychiatry and Neuroimaging Center,Technische Universität Dresden,Dresden,Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
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Tomba E, Tecuta L, Crocetti E, Squarcio F, Tomei G. Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta-analysis. Int J Eat Disord 2019; 52:759-776. [PMID: 31169332 DOI: 10.1002/eat.23095] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/29/2019] [Accepted: 05/03/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE In psychiatry, the presence of residual symptoms after treatment is linked to the definitions of remission and recovery. To identify the presence of residual eating disorder (ED) symptoms and associated non-ED clinical features in remitted and recovered EDs, the current systematic review with meta-analysis was performed. METHOD A systematic review was conducted on residual ED symptoms and non-ED clinical features including comorbid psychopathology, neurophysiological functioning, cognitive functioning, and quality of life in ED patients considered remitted or recovered. To examine residual ED symptoms, meta-analyses were performed while considering age, study quality, remission, and recovery criteria strictness as moderators. Sensitivity, publication bias, and heterogeneity analyses were also conducted. RESULTS The 64 studies selected for the systematic review underscored the presence of residual ED symptoms in anorexia nervosa (AN) and bulimia nervosa (BN), and impairments and deficits in the additional features examined. From the 64 studies, 31 were selected regarding residual ED symptoms in AN for meta-analysis. Large effect sizes indicated that remitted/recovered AN patients reported significantly lower body mass index (Hedges' g = -0.62[-0.77, -0.46]) and significantly greater symptomatology in terms of ED examination-questionnaire (Hedges'g = 0.86 [0.48,1.23]) and ED inventory (Hedges' g = 0.94[0.64,1.24]) than healthy controls, independently of remission and recovery criteria strictness, age, and study quality. DISCUSSION The presence of residual ED symptoms in AN is quantitatively supported, whereas the presence of residual ED symptoms in BN should be further investigated. Data on binge-eating disorder are missing. Future research should use consistent, multicomponent, and standardized comparable indicators of recovery.
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Affiliation(s)
- Elena Tomba
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Lucia Tecuta
- Department of Psychology, University of Bologna, Bologna, Italy
| | | | - Fabio Squarcio
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giuliano Tomei
- Oxford Health NHS Foundation Trust, Department of Psychiatry, University of Oxford, Oxford, UK
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68
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Nickel K, Joos A, Tebartz van Elst L, Holovics L, Endres D, Zeeck A, Maier S. Altered cortical folding and reduced sulcal depth in adults with anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2019; 27:655-670. [DOI: 10.1002/erv.2685] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/25/2019] [Accepted: 04/17/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Kathrin Nickel
- Section for Experimental Neuropsychiatry, Department of Psychiatry and PsychotherapyMedical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
| | - Andreas Joos
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of FreiburgFaculty of Medicine, University of Freiburg Freiburg Germany
- Psychotherapeutic NeurologyKliniken Schmieder Gailingen Germany
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department of Psychiatry and PsychotherapyMedical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
| | - Lukas Holovics
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of FreiburgFaculty of Medicine, University of Freiburg Freiburg Germany
| | - Dominique Endres
- Section for Experimental Neuropsychiatry, Department of Psychiatry and PsychotherapyMedical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
| | - Almut Zeeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of FreiburgFaculty of Medicine, University of Freiburg Freiburg Germany
| | - Simon Maier
- Section for Experimental Neuropsychiatry, Department of Psychiatry and PsychotherapyMedical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of FreiburgFaculty of Medicine, University of Freiburg Freiburg Germany
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69
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Altered anticipation and processing of aversive interoceptive experience among women remitted from bulimia nervosa. Neuropsychopharmacology 2019; 44:1265-1273. [PMID: 30840983 PMCID: PMC6785154 DOI: 10.1038/s41386-019-0361-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 11/08/2022]
Abstract
Bulimia nervosa (BN) is characterized by dysregulated intake of food, which may indicate homeostatic imbalance. Critically important for homeostatic regulation is interoception, or the sensing and processing of body-relevant information. A well-documented link between avoidance of unpleasant body sensations and BN symptoms suggests that aversive interoceptive experiences may be particularly relevant to BN pathophysiology. This study examined whether individuals with a history of BN show aberrant neural processing of aversive interoceptive stimuli. Using a cued inspiratory breathing load paradigm, we compared women remitted from BN (RBN; n = 24; to reduce the confounding effects of active bulimic symptoms) and control women (CW; n = 25). During breathing load anticipation, the RBN group, relative to CW, showed increased activation in mid-insula, superior frontal gyrus, putamen, dorsal anterior cingulate, posterior cingulate, and amygdala. However, over the course of the aversive experience, neural activation in RBN relative to CW showed an aberrant decline in most of these regions. Exploratory analyses indicated that greater activation during breathing load anticipation was associated with past bulimic symptom severity and the duration of symptom remission. An exaggerated anticipatory response and an abnormally decreasing response during aversive homeostatic perturbations may promote hallmark bulimic behaviors-binge eating, dietary restriction, and purging. Our findings support a role for homeostatic instability in BN, and these altered patterns of brain activation may serve as novel targets for pharmacological, neuromodulatory, and behavioral interventions.
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70
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Verharen JPH, Danner UN, Schröder S, Aarts E, van Elburg AA, Adan RAH. Insensitivity to Losses: A Core Feature in Patients With Anorexia Nervosa? BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:995-1003. [PMID: 31262707 DOI: 10.1016/j.bpsc.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/02/2019] [Accepted: 05/02/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Patients with anorexia nervosa (AN) demonstrate aberrations in choice behavior, including impairments in laboratory measures of decision making. Although a wealth of studies suggest that these aberrations arise from alterations in value processing, it remains unclear by which core component of value processing this is mediated. METHODS We fit trial-by-trial data of patients with AN (n = 60 first cohort, n = 216 second cohort) and healthy control participants (n = 55) performing the Iowa Gambling Task to a computational model based on prospect utility theory. We determined, per participant, the best-fit model parameters and compared these between the groups. RESULTS Analyses revealed a decreased estimate of model parameter λ in patients with AN, indicative of an attenuation of loss-aversive behavior in the Iowa Gambling Task. In comparison, measures of reward sensitivity, value-based learning, and exploration versus exploitation were unaltered in patients with AN. A measurement in a second independent cohort replicated the finding that loss aversion, typically observed in healthy individuals, is reduced in patients with AN. CONCLUSIONS We show that patients with AN, in contrast to healthy control participants, demonstrate reduced loss-aversive behavior. This finding provides important fundamental insights into the decision-making capacity of patients with AN, suggesting alterations in the mechanisms involved in value processing related to negative feedback.
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Affiliation(s)
- Jeroen P H Verharen
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Unna N Danner
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | | | - Emmeke Aarts
- Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands
| | - Annemarie A van Elburg
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - Roger A H Adan
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands; Altrecht Eating Disorders Rintveld, Zeist, The Netherlands; Institute of Physiology and Neuroscience, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
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71
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Associations between brain structure and perceived intensity of sweet and bitter tastes. Behav Brain Res 2019; 363:103-108. [PMID: 30703394 DOI: 10.1016/j.bbr.2019.01.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/12/2019] [Accepted: 01/25/2019] [Indexed: 12/22/2022]
Abstract
Functional neuroimaging studies have identified brain regions associated with human taste perception, but only a few have investigated the associations with brain structure. Here, in this exploratory study, we examined the association between the volumes of 82 regions of interest (ROI) and the perceived intensities of sweet (a weighted mean rating of glucose, fructose, aspartame, neohesperidin dihydrochalcone) and bitter (propylthiouracil, quinine, caffeine) substances in a large Australian healthy cohort from the Queensland Twin IMaging (QTIM, n = 559) study and the perceived intensity of quinine in a large U.S. healthy cohort from the Human Connectome Project (HCP, n = 1101). In QTIM, the volumes of 3 cortical (right cuneus gyrus, left transverse temporal gyrus, right inferior temporal gyrus) and one subcortical structure (both left and right caudate) were associated with more than one taste stimulus (P < 0.05) and tended to be associated with both sweet and bitter tastes in the same direction, suggesting these ROIs were more broadly tuned for taste sensation. A further 11 ROIs were associated with a specific taste (sweetness: 4; propylthiouracil: 3; caffeine: 2; quinine: 2). In HCP, volumes of 5 ROIs were associated with quinine bitterness. The quinine-left entorhinal cortex association was found in both QTIM (r = -0.12, P = 3.7 × 10-3) and HCP (r = -0.06, P = 2.0 × 10-2). This study provides the first evidence that, even in healthy people, variation in brain structure is associated with taste intensity ratings, and provides new insights into the brain gustatory circuit.
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Abstract
Anorexia nervosa is a complex psychiatric illness associated with food restriction and high mortality. Recent brain research in adolescents and adults with anorexia nervosa has used larger sample sizes compared with earlier studies and tasks that test specific brain circuits. Those studies have produced more robust results and advanced our knowledge of underlying biological mechanisms that may contribute to the development and maintenance of anorexia nervosa. It is now recognized that malnutrition and dehydration lead to dynamic changes in brain structure across the brain, which normalize with weight restoration. Some structural alterations could be trait factors but require replication. Functional brain imaging and behavioral studies have implicated learning-related brain circuits that may contribute to food restriction in anorexia nervosa. Most notably, those circuits involve striatal, insular, and frontal cortical regions that drive learning from reward and punishment, as well as habit learning. Disturbances in those circuits may lead to a vicious cycle that hampers recovery. Other studies have started to explore the neurobiology of interoception or social interaction and whether the connectivity between brain regions is altered in anorexia nervosa. All together, these studies build upon earlier research that indicated neurotransmitter abnormalities in anorexia nervosa and help us develop models of a distinct neurobiology that underlies anorexia nervosa.
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Affiliation(s)
- Guido K W Frank
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA.,Neuroscience Program, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Megan E Shott
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Marisa C DeGuzman
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA.,Neuroscience Program, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
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73
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Frank GKW, DeGuzman MC, Shott ME. Motivation to eat and not to eat - The psycho-biological conflict in anorexia nervosa. Physiol Behav 2019; 206:185-190. [PMID: 30980856 DOI: 10.1016/j.physbeh.2019.04.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 12/15/2022]
Abstract
Anorexia nervosa is a severe psychiatric illness with high mortality. Brain imaging research has indicated altered reward circuits in the disorder. Here we propose a disease model for anorexia nervosa, supported by recent studies, that integrates psychological and biological factors. In that model, we propose that there is a conflict between the conscious motivation to restrict food, and a body-homeostasis driven motivation to approach food in response to weight loss. These opposing motivations trigger anxiety, which maintains the vicious cycle of ongoing energy restriction and weight loss.
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Affiliation(s)
- Guido K W Frank
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, CO, USA; Department of Neuroscience, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, CO, USA.
| | - Marisa C DeGuzman
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, CO, USA; Department of Neuroscience, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, CO, USA
| | - Megan E Shott
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, CO, USA
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74
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Berner LA, Wang Z, Stefan M, Lee S, Huo Z, Cyr M, Marsh R. Subcortical Shape Abnormalities in Bulimia Nervosa. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:1070-1079. [PMID: 30846367 DOI: 10.1016/j.bpsc.2018.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 12/24/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Bulimia nervosa (BN) is associated with functional abnormalities in frontostriatal and frontolimbic circuits. Although structural alterations in the frontal portions of these circuits have been observed, this is the first study of subcortical surface morphometry and the largest study of subcortical volume in BN. METHODS Anatomical magnetic resonance scans were acquired from 62 female participants with full and subthreshold BN (mean age ± SD, 18.7 ± 4.0 years) and 65 group-matched healthy control participants (mean age ± SD, 19.3 ± 5.7 years). General linear models were used to compare groups and assess the significance of group-by-age interactions on the shape and total volume of 15 subcortical structures (p < .05, familywise error corrected). Associations with illness severity and duration were assessed in the BN group. RESULTS Subcortical volumes did not differ across groups, but vertexwise analyses revealed inward shape deformations on the anterior surface of the pallidum in BN relative to control participants that were associated with binge-eating frequency and illness duration. Inward deformations on the ventrolateral thalamus and dorsal amygdala were more pronounced with advancing age in the BN group, and inward deformations on the caudate, putamen, and amygdala were associated with self-induced vomiting frequency. CONCLUSIONS Our findings point to localized deformations on the surface of subcortical structures in areas that comprise both reward and cognitive control circuits. These deformations were more pronounced among older BN participants and among those with the most severe symptoms. Such precise localization of alterations in subcortical morphometry may ultimately aid in efforts to identify markers of risk and BN persistence.
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Affiliation(s)
- Laura A Berner
- Department of Psychiatry, University of California, San Diego, San Diego, California.
| | - Zhishun Wang
- Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, New York
| | - Mihaela Stefan
- Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, New York
| | - Seonjoo Lee
- Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, New York
| | - Zhiyong Huo
- Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, New York; Key Laboratory of Image Communication and Image Processing, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Marilyn Cyr
- Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, New York
| | - Rachel Marsh
- Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, New York
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75
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Barona M, Brown M, Clark C, Frangou S, White T, Micali N. White matter alterations in anorexia nervosa: Evidence from a voxel-based meta-analysis. Neurosci Biobehav Rev 2019; 100:285-295. [PMID: 30851283 DOI: 10.1016/j.neubiorev.2019.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/08/2019] [Accepted: 03/05/2019] [Indexed: 02/06/2023]
Abstract
Anorexia nervosa (AN) is a severe psychiatric disorder with a complex and poorly understood etiology. Recent studies have sought to investigate differences in white matter microstructure in AN, with significant results in several brain regions. A systematic literature search of Embase, PubMed and Psychinfo databases was conducted in order to identify Diffusion Tensor Imaging (DTI) studies of patients with AN and controls. We performed a meta-analysis of studies that met our inclusion criteria (N = 13) using effect size-signed differential mapping (AES-SDM) to detect differences in Fractional Anisotropy (FA) in patients with AN (N = 227) compared to healthy controls (N = 243). The quantitative meta-analysis of DTI studies identified decreased FA in the posterior areas of the corpus callosum, the left superior longitudinal fasciculus II, and the left precentral gyrus, as well as increased FA in the right cortico-spinal projections, and lingual gyrus in AN vs. controls. Studies of WM architecture are still limited in AN; further studies with longitudinal design are needed to better understand the complexity of abnormalities, and their persistence.
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Affiliation(s)
- Manuela Barona
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Melanie Brown
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nadia Micali
- UCL Great Ormond Street Institute of Child Health, London, UK; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Psychiatry, University of Geneva, Geneva, Switzerland.
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76
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Abstract
Anorexia nervosa and bulimia nervosa are characterized by severely restricted intake, binge eating, and compensatory behaviors like self-induced vomiting. The neurobiological underpinnings of these maladaptive behaviors are poorly understood, but the application of cognitive neuroscience and neuroimaging to eating disorders has begun to elucidate their pathophysiology. Specifically, this review focuses on 3 areas that suggest paths forward: reward, cognitive and behavioral control, and decision making. Understanding the brain-based mechanisms that promote and maintain these often chronic symptoms could guide the development of new and more effective treatments.
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77
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Um M, Whitt ZT, Revilla R, Hunton T, Cyders MA. Shared Neural Correlates Underlying Addictive Disorders and Negative Urgency. Brain Sci 2019; 9:E36. [PMID: 30744033 PMCID: PMC6406305 DOI: 10.3390/brainsci9020036] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/06/2019] [Indexed: 12/15/2022] Open
Abstract
Negative urgency is a personality trait reflecting the tendency to act rashly in response to extreme negative emotions and is considered a transdiagnostic endophenotype for problematic levels of addictive behaviors. Recent research has begun to identify the neural correlates of negative urgency, many of which appear to overlap with neural circuitry underlying addictive disorders associated with negative urgency. The goal of this qualitative review is to summarize the extant literature concerning the neural correlates of negative urgency, to compare these correlates with those implicated with addictive disorders, and to propose new ways to begin to leverage such findings in treatment and intervention approaches. We also address current limitations in the field and make recommendations for areas for future growth in this research domain. Patterns of structure and function in the ventral striatum, frontal regions, such as the prefrontal cortex (PFC) and orbitofrontal cortex (OFC), and amygdala are common across addictive disorders and are related to both real-world risky behaviors and self-report measures of negative urgency. We propose that the time has come to move past considering this trait and these disorders as completely separate entities, and instead for the field to consider how general patterns of convergence across these disorders can lead to a more transdiagnostic approach to treatment and intervention. We suggest future work utilize these convergent patterns in the development of animal models of negative urgency, in the identification and testing of prime pharmacological and physiological interventions, and as objective biomarkers to be used when testing behavioral, pharmacological, and physiological intervention effectiveness. Little empirical work has been done to date in these areas and advances in these nascent fields would advance understanding and applications of the neuroscience of negative urgency.
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Affiliation(s)
- Miji Um
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
| | - Zachary T Whitt
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
| | - Rebecca Revilla
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
| | - Taylor Hunton
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
| | - Melissa A Cyders
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
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78
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Salzwedel AP, Gao W, Andres A, Badger TM, Glasier CM, Ramakrishnaiah RH, Rowell AC, Ou X. Maternal Adiposity Influences Neonatal Brain Functional Connectivity. Front Hum Neurosci 2019; 12:514. [PMID: 30662399 PMCID: PMC6328446 DOI: 10.3389/fnhum.2018.00514] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 12/06/2018] [Indexed: 12/14/2022] Open
Abstract
The neural mechanisms associated with obesity have been extensively studied, but the impact of maternal obesity on fetal and neonatal brain development remains poorly understood. In this study of full-term neonates, we aimed to detect potential neonatal functional connectivity alterations associated with maternal adiposity, quantified via body-mass-index (BMI) and body-fat-mass (BFM) percentage, based on seed-based and graph theoretical analysis using resting-state fMRI data. Our results revealed significant neonatal functional connectivity alterations in all four functional domains that are implicated in adult obesity: sensory cue processing, reward processing, cognitive control, and motor control. Moreover, some of the detected areas showing regional functional connectivity alterations also showed global degree and efficiency differences. These findings provide important clues to the potential neural basis for cognitive and mental health development in offspring of obese mothers and may lead to the derivation of imaging-based biomarkers for the early identification of risks for timely intervention.
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Affiliation(s)
- Andrew P Salzwedel
- Department of Biomedical Sciences and Imaging, Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, United States
| | - Wei Gao
- Department of Biomedical Sciences and Imaging, Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, United States.,Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Aline Andres
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Thomas M Badger
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Charles M Glasier
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Raghu H Ramakrishnaiah
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Amy C Rowell
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Xiawei Ou
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Arkansas Children's Nutrition Center, Little Rock, AR, United States.,Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Arkansas Children's Research Institute, Little Rock, AR, United States
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79
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Exploration of Shared Genetic Architecture Between Subcortical Brain Volumes and Anorexia Nervosa. Mol Neurobiol 2018; 56:5146-5156. [PMID: 30519816 PMCID: PMC6647452 DOI: 10.1007/s12035-018-1439-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/05/2018] [Indexed: 12/22/2022]
Abstract
In MRI scans of patients with anorexia nervosa (AN), reductions in brain volume are often apparent. However, it is unknown whether such brain abnormalities are influenced by genetic determinants that partially overlap with those underlying AN. Here, we used a battery of methods (LD score regression, genetic risk scores, sign test, SNP effect concordance analysis, and Mendelian randomization) to investigate the genetic covariation between subcortical brain volumes and risk for AN based on summary measures retrieved from genome-wide association studies of regional brain volumes (ENIGMA consortium, n = 13,170) and genetic risk for AN (PGC-ED consortium, n = 14,477). Genetic correlations ranged from − 0.10 to 0.23 (all p > 0.05). There were some signs of an inverse concordance between greater thalamus volume and risk for AN (permuted p = 0.009, 95% CI: [0.005, 0.017]). A genetic variant in the vicinity of ZW10, a gene involved in cell division, and neurotransmitter and immune system relevant genes, in particular DRD2, was significantly associated with AN only after conditioning on its association with caudate volume (pFDR = 0.025). Another genetic variant linked to LRRC4C, important in axonal and synaptic development, reached significance after conditioning on hippocampal volume (pFDR = 0.021). In this comprehensive set of analyses and based on the largest available sample sizes to date, there was weak evidence for associations between risk for AN and risk for abnormal subcortical brain volumes at a global level (that is, common variant genetic architecture), but suggestive evidence for effects of single genetic markers. Highly powered multimodal brain- and disorder-related genome-wide studies are needed to further dissect the shared genetic influences on brain structure and risk for AN.
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80
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Murray SB, Strober M, Craske MG, Griffiths S, Levinson CA, Strigo IA. Fear as a translational mechanism in the psychopathology of anorexia nervosa. Neurosci Biobehav Rev 2018; 95:383-395. [DOI: 10.1016/j.neubiorev.2018.10.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/11/2018] [Accepted: 10/22/2018] [Indexed: 12/30/2022]
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81
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Yue L, Wang Y, Kaye WH, Kang Q, Huang JB, Cheung EFC, Xiao SF, Wang Z, Chen J, Chan RCK. Structural alterations in the caudate nucleus and precuneus in un-medicated anorexia nervosa patients. Psychiatry Res Neuroimaging 2018; 281:12-18. [PMID: 30212787 DOI: 10.1016/j.pscychresns.2018.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 12/15/2022]
Abstract
Anorexia nervosa (AN) is a mental disorder characterized by a preoccupation with thinness and may be associated with brain structural alteration. The aim of the study was to examine the brain structural alteration in AN patients, including subcortical structure volume and cortical thickness. Thirty-five un-medicated AN patients and 20 matched healthy controls underwent structural magnetic resonance imaging brain scans. High resolution structural images were acquired on a SIEMENS 3T scanner and preprocessed using FreeSurfer software. Subcortical structure volume and cortical thickness were compared between the two groups. We found larger percentage of caudate volume relative to total grey matter (GM) volume in the AN group. Reduced cortical thickness at the left precuneus was also observed in AN patients. Moreover, an interaction between group and hemisphere was found, suggesting that cortical thinning was more prominent in the left hemisphere in AN patients. These findings provide further evidence for structural brain abnormalities in patients with AN.
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Affiliation(s)
- Ling Yue
- Department of Clinical Psychology, Shanghai Jiao Tong University School of Medicine, Shanghai Mental Health Centre, Shanghai Clinical Centre for Mental Disorders, Shanghai, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Qing Kang
- Department of Clinical Psychology, Shanghai Jiao Tong University School of Medicine, Shanghai Mental Health Centre, Shanghai Clinical Centre for Mental Disorders, Shanghai, China
| | - Jia-Bin Huang
- Department of Clinical Psychology, Shanghai Jiao Tong University School of Medicine, Shanghai Mental Health Centre, Shanghai Clinical Centre for Mental Disorders, Shanghai, China
| | - Eric F C Cheung
- Department of Adult Psychiatry, Castle Peak Hospital, Hong Kong, China
| | - Shi-Fu Xiao
- Department of Clinical Psychology, Shanghai Jiao Tong University School of Medicine, Shanghai Mental Health Centre, Shanghai Clinical Centre for Mental Disorders, Shanghai, China
| | - Zhen Wang
- Department of Clinical Psychology, Shanghai Jiao Tong University School of Medicine, Shanghai Mental Health Centre, Shanghai Clinical Centre for Mental Disorders, Shanghai, China
| | - Jue Chen
- Department of Clinical Psychology, Shanghai Jiao Tong University School of Medicine, Shanghai Mental Health Centre, Shanghai Clinical Centre for Mental Disorders, Shanghai, China.
| | - Raymond C K Chan
- Department of Clinical Psychology, Shanghai Jiao Tong University School of Medicine, Shanghai Mental Health Centre, Shanghai Clinical Centre for Mental Disorders, Shanghai, China; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; Translational Neuropsychology and Applied Cognitive Neuroscience Laboratory, Shanghai Mental Health Centre, Shanghai Jiaotong University, Shanghai, China.
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82
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Kodama N, Moriguchi Y, Takeda A, Maeda M, Ando T, Kikuchi H, Gondo M, Adachi H, Komaki G. Neural correlates of body comparison and weight estimation in weight-recovered anorexia nervosa: a functional magnetic resonance imaging study. Biopsychosoc Med 2018; 12:15. [PMID: 30450124 PMCID: PMC6208027 DOI: 10.1186/s13030-018-0134-z] [Citation(s) in RCA: 12] [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: 05/19/2018] [Accepted: 10/14/2018] [Indexed: 11/13/2022] Open
Abstract
Background The neural mechanisms underlying body dissatisfaction and emotional problems evoked by social comparisons in patients with anorexia nervosa (AN) are currently unclear. Here, we elucidate patterns of brain activation among recovered patients with AN (recAN) during body comparison and weight estimation with functional magnetic resonance imaging (fMRI). Methods We used fMRI to examine 12 patients with recAN and 13 healthy controls while they performed body comparison and weight estimation tasks with images of underweight, healthy weight, and overweight female bodies. In the body comparison task, participants rated their anxiety levels while comparing their own body with the presented image. In the weight estimation task, participants estimated the weight of the body in the presented image. We used between-group region of interest (ROI) analyses of the blood oxygen level dependent (BOLD) signal to analyze differences in brain activation patterns between the groups. In addition, to investigate activation outside predetermined ROIs, we performed an exploratory whole-brain analysis to identify group differences. Results We found that, compared to healthy controls, patients with recAN exhibited significantly greater activation in the pregenual anterior cingulate cortex (pgACC) when comparing their own bodies with images of underweight female bodies. In addition, we found that, compared with healthy controls, patients with recAN exhibited significantly smaller activation in the middle temporal gyrus corresponding to the extrastriate body area (EBA) when comparing their own bodies, irrespective of weight, during self-other comparisons of body shape. Conclusions Our findings from a group of patients with recAN suggest that the pathology of AN may lie in an inability to regulate negative affect in response to body images via pgACC activation during body comparisons. The findings also suggest that altered body image processing in the brain persists even after recovery from AN. Electronic supplementary material The online version of this article (10.1186/s13030-018-0134-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Naoki Kodama
- 1Division of Psychosomatic Medicine, Department of Neurology, University of Occupational and Environmental Health, Kitakyushu, 807-8555 Japan
| | - Yoshiya Moriguchi
- 2Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553 Japan
| | - Aya Takeda
- NPO Corporation Nobinokai, Yokohama, 236-0014 Japan
| | - Motonari Maeda
- 4College of Art and Design, Joshibi University of Art and Design, Sagamihara, 252-8538 Japan
| | - Tetsuya Ando
- 5Department of Psychosomatic Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553 Japan
| | - Hiroe Kikuchi
- 6Department of Psychosomatic Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, 162-8655 Japan
| | - Motoharu Gondo
- 7Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582 Japan
| | - Hiroaki Adachi
- 8Department of Neurology, University of Occupational and Environmental Health, Kitakyushu, 807-8555 Japan
| | - Gen Komaki
- 9School of Health Sciences Fukuoka, International University of Health and Welfare, Fukuoka, 831-8501 Japan
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83
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Haynos AF, Hall LMJ, Lavender JM, Peterson CB, Crow SJ, Klimes-Dougan B, Cullen KR, Lim KO, Camchong J. Resting state functional connectivity of networks associated with reward and habit in anorexia nervosa. Hum Brain Mapp 2018; 40:652-662. [PMID: 30251758 DOI: 10.1002/hbm.24402] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 08/27/2018] [Accepted: 09/04/2018] [Indexed: 12/18/2022] Open
Abstract
Neurobiological disturbances associated with reward and/or habit learning are theorized to maintain symptoms of anorexia nervosa (AN). Although research has investigated responses in brain regions associated with reward and habit to disorder-specific cues (e.g., food) and presumed rewards (e.g., money), little is known about the functional organization of the circuits underlying these constructs independent of stimulus. This study aimed to provide initial data on the synchrony of networks associated with reward and habit in AN by comparing resting-state functional connectivity (RSFC) patterns between AN and healthy control (HC) participants in these circuits and delineating how these patterns relate to symptoms. Using theoretically selected seeds in the nucleus accumbens (NAcc), ventral caudate, and dorsal caudate, reflecting a continuum from reward- to habit- oriented regions, RSFC patterns were compared between AN restricting subtype (n = 19) and HC (n = 19) participants (cluster threshold: p < .01). Exploratory correlations between RSFC z-scores and Eating Disorder Examination (EDE) scores, BMI, and illness duration were conducted. The AN group demonstrated lower RSFC between the NAcc and superior frontal gyrus, between the ventral caudate and frontal and posterior regions, and between the dorsal caudate and frontal, temporal, and posterior regions. In the AN group, lower NAcc- superior frontal gyrus RSFC correlated with greater EDE Global scores (r = -.58, CI: -.83, -.13). These resting-state synchrony disruptions of the ventral and dorsal frontostriatal circuits, considered in context of the broader literature, support the utility of further investigating possible reward and habit disturbances supporting symptoms in AN.
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Affiliation(s)
- Ann F Haynos
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Leah M J Hall
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota.,Eastern Oklahoma VA Medical Center, Tulsa, Oklahoma
| | - Jason M Lavender
- Department of Psychiatry, University of California, San Diego, California
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.,The Emily Program, St. Paul, Minnesota
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.,The Emily Program, St. Paul, Minnesota
| | | | - Kathryn R Cullen
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Jazmin Camchong
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
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84
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Lewis YD, Gilon Mann T, Enoch‐Levy A, Dubnov‐Raz G, Gothelf D, Weizman A, Stein D. Obsessive–compulsive symptomatology in female adolescent inpatients with restrictive compared with binge–purge eating disorders. EUROPEAN EATING DISORDERS REVIEW 2018; 27:224-235. [DOI: 10.1002/erv.2638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/05/2018] [Accepted: 08/08/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Yael Doreen Lewis
- Hanotrim Eating Disorders UnitShalvata Mental Health Center Hod Hasharon Israel
- Sackler Faculty of MedicineTel Aviv University Tel Aviv Israel
| | - Tal Gilon Mann
- Pediatric Psychosomatic DepartmentSafra Children's Hospital, Sheba Medical Center Tel Hashomer Israel
| | - Adi Enoch‐Levy
- Sackler Faculty of MedicineTel Aviv University Tel Aviv Israel
- Pediatric Psychosomatic DepartmentSafra Children's Hospital, Sheba Medical Center Tel Hashomer Israel
| | - Gal Dubnov‐Raz
- Sackler Faculty of MedicineTel Aviv University Tel Aviv Israel
- Pediatric Psychosomatic DepartmentSafra Children's Hospital, Sheba Medical Center Tel Hashomer Israel
| | - Doron Gothelf
- Sackler Faculty of MedicineTel Aviv University Tel Aviv Israel
- The Child Psychiatry DivisionSafra Children's Hospital, Sheba Medical Center Tel Hashomer Israel
- Sagol School of NeuroscienceTel Aviv University Tel Aviv Israel
| | - Abraham Weizman
- Sackler Faculty of MedicineTel Aviv University Tel Aviv Israel
- Felsenstein Medical Research Center and Geha Mental Health Center Petah Tikva Israel
| | - Daniel Stein
- Sackler Faculty of MedicineTel Aviv University Tel Aviv Israel
- Pediatric Psychosomatic DepartmentSafra Children's Hospital, Sheba Medical Center Tel Hashomer Israel
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85
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Nickel K, Joos A, Tebartz van Elst L, Matthis J, Holovics L, Endres D, Zeeck A, Hartmann A, Tüscher O, Maier S. Recovery of cortical volume and thickness after remission from acute anorexia nervosa. Int J Eat Disord 2018; 51:1056-1069. [PMID: 30212599 DOI: 10.1002/eat.22918] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 06/07/2018] [Accepted: 06/08/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Reduced grey (GM) and white matter (WM) volumes and increased cerebrospinal fluid (CSF) have been frequently reported in anorexia nervosa (AN), but studies focusing on cortical thickness (CT) are scarce and findings inconsistent. We conducted the first study in AN that analyzed both parameters in the same study to gain novel and comprehensive insight. METHOD Voxel-based morphometry (VBM) analysis was performed on T1-weighted magnetic resonance images from 34 predominantly adult women with acute AN, 24 REC participants, and 41 healthy controls (HC). Global brain segment volumes (GM, WM, and CSF), regional GM volume, and cortical thickness measures were obtained from the same study sample. We further focused on recovery by including a REC group. RESULTS The GM and WM volumes were decreased, and correspondingly, the CSF volume increased in the AN in comparison to the HC and REC groups. No significant volume differences between the REC and HC groups could be observed. AN patients showed reduced regional GM volumes in the right hippocampus and the left middle and right inferior frontal gyrus. Cortical thinning occurred in the AN group, which was particularly robust in fronto-parietal areas. The REC and HC groups failed to show any regional GM or cortical thickness differences. DISCUSSION AN is accompanied by severe loss of brain volume and cortical thickness as assessed by complementary investigation tools. However, these changes seem to be largely reversible, which should be encouraging for therapists and patients. The underlying neurobiological mechanisms remain unclear and should be assessed in further studies.
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Affiliation(s)
- Kathrin Nickel
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry, Medical Center, University of Freiburg, Freiburg, Germany
| | - Andreas Joos
- Faculty of Medicine, Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry, Medical Center, University of Freiburg, Freiburg, Germany
| | - Jamila Matthis
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
| | - Lukas Holovics
- Faculty of Medicine, Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry, Medical Center, University of Freiburg, Freiburg, Germany
| | - Almut Zeeck
- Faculty of Medicine, Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
| | - Armin Hartmann
- Faculty of Medicine, Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
| | - Oliver Tüscher
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Medical Center, University of Mainz, Mainz, Germany
| | - Simon Maier
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
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86
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Phillipou A, Carruthers SP, Di Biase MA, Zalesky A, Abel LA, Castle DJ, Gurvich C, Rossell SL. White matter microstructure in anorexia nervosa. Hum Brain Mapp 2018; 39:4385-4392. [PMID: 29964345 DOI: 10.1002/hbm.24279] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/03/2018] [Accepted: 06/05/2018] [Indexed: 01/04/2023] Open
Abstract
The neurobiological underpinnings of anorexia nervosa (AN) are unclear. White matter deficits have been described in the illness, but findings are inconsistent between studies. The aim of this study was to investigate differences in white matter microstructure in AN using diffusion-weighted imaging (DWI). It was hypothesised that people with AN, relative to a healthy control (HC) group, would show decreased functional anisotropy (FA) and increased mean diffusivity (MD) in the fornix and superior longitudinal fasciculus, consistent with previous literature. Analyses were conducted on 23 females with AN and 26 age- and gender-matched HCs using tract-based spatial statistics (TBSS). The results revealed widespread FA decreases and MD increases in the AN group. Our hypothesis was largely supported, although FA differences were not specifically found in the fornix. The findings suggest extensive differences in white matter structure in AN, which may contribute to AN pathophysiology.
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Affiliation(s)
- Andrea Phillipou
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Department of Mental Health, Austin Health, Melbourne, Australia.,Department of Mental Health, St Vincent's Hospital, Melbourne, Australia.,Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Sean P Carruthers
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, Melbourne, Australia
| | - Maria A Di Biase
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard, Medical School, Massachusetts.,Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia
| | - Larry A Abel
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - David J Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Department of Mental Health, St Vincent's Hospital, Melbourne, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, Melbourne, Australia
| | - Susan L Rossell
- Department of Mental Health, St Vincent's Hospital, Melbourne, Australia.,Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, Melbourne, Australia
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87
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Giannunzio V, Degortes D, Tenconi E, Collantoni E, Solmi M, Santonastaso P, Favaro A. Decision-making impairment in anorexia nervosa: New insights into the role of age and decision-making style. EUROPEAN EATING DISORDERS REVIEW 2018; 26:302-314. [PMID: 29665149 DOI: 10.1002/erv.2595] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 02/04/2018] [Accepted: 03/08/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Patients with anorexia nervosa (AN) often report difficulties in decision making, which may interfere with treatment. The aim of this study was to investigate decision making in a large sample of adolescent and adult patients with AN, by using the Iowa gambling task. METHOD Participants were 611 female individuals (310 patients and 301 controls) who underwent neuropsychological and clinical assessment. RESULTS Significantly poorer decision-making performance was observed in adult patients, whereas no difference emerged between affected and nonaffected adolescents. Both adolescent and adult patients were characterized by trends for higher levels of attention to losses in comparison with healthy controls. Although healthy adult women exhibited better decision-making performance than healthy adolescents, in AN, there was no improvement of decision making with age. A cluster analysis identified 2 different styles of decision making in both patients and controls: a conservative style and an impulsive style. DISCUSSION Our study provides evidence of dysfunctional decision making in adult patients with AN and reveals an association between poor decision making and excessive punishment sensitivity in AN. The clinical and scientific implications of these findings merit further exploration.
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Affiliation(s)
- Valeria Giannunzio
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Daniela Degortes
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Elena Tenconi
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Enrico Collantoni
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Marco Solmi
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Paolo Santonastaso
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Angela Favaro
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
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88
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Boehm I, King JA, Bernardoni F, Geisler D, Seidel M, Ritschel F, Goschke T, Haynes JD, Roessner V, Ehrlich S. Subliminal and supraliminal processing of reward-related stimuli in anorexia nervosa. Psychol Med 2018; 48:790-800. [PMID: 28832300 DOI: 10.1017/s0033291717002161] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Previous studies have highlighted the role of the brain reward and cognitive control systems in the etiology of anorexia nervosa (AN). In an attempt to disentangle the relative contribution of these systems to the disorder, we used functional magnetic resonance imaging (fMRI) to investigate hemodynamic responses to reward-related stimuli presented both subliminally and supraliminally in acutely underweight AN patients and age-matched healthy controls (HC). METHODS fMRI data were collected from a total of 35 AN patients and 35 HC, while they passively viewed subliminally and supraliminally presented streams of food, positive social, and neutral stimuli. Activation patterns of the group × stimulation condition × stimulus type interaction were interrogated to investigate potential group differences in processing different stimulus types under the two stimulation conditions. Moreover, changes in functional connectivity were investigated using generalized psychophysiological interaction analysis. RESULTS AN patients showed a generally increased response to supraliminally presented stimuli in the inferior frontal junction (IFJ), but no alterations within the reward system. Increased activation during supraliminal stimulation with food stimuli was observed in the AN group in visual regions including superior occipital gyrus and the fusiform gyrus/parahippocampal gyrus. No group difference was found with respect to the subliminal stimulation condition and functional connectivity. CONCLUSION Increased IFJ activation in AN during supraliminal stimulation may indicate hyperactive cognitive control, which resonates with clinical presentation of excessive self-control in AN patients. Increased activation to food stimuli in visual regions may be interpreted in light of an attentional food bias in AN.
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Affiliation(s)
- I Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - J A King
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - F Bernardoni
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - D Geisler
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - M Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - F Ritschel
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - T Goschke
- Department of Psychology,Technische Universität Dresden,Dresden,Germany
| | - J-D Haynes
- Bernstein Center for Computational Neuroscience, Charité Universitäts-Medizin,Berlin,Germany
| | - V Roessner
- Department of Child and Adolescent Psychiatry,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - S Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
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89
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Björnsdotter M, Davidovic M, Karjalainen L, Starck G, Olausson H, Wentz E. Grey matter correlates of autistic traits in women with anorexia nervosa. J Psychiatry Neurosci 2018; 43:79-86. [PMID: 29481315 PMCID: PMC5837888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/27/2017] [Accepted: 07/11/2017] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Patients with anorexia nervosa exhibit higher levels of behaviours typically associated with autism-spectrum disorder (ASD), but the neural basis is unclear. We sought to determine whether elevated autistic traits in women with anorexia nervosa may be reflected in cortical morphology. METHODS We used voxel-based morphometry (VBM) to examine regional grey matter volumes in high-resolution MRI structural brain scans in women with anorexia nervosa and matched healthy controls. The Autism-spectrum Quotient (AQ) scale was used to assess autistic traits. RESULTS Women with anorexia nervosa (n = 25) had higher AQ scores and lower bilateral superior temporal sulcus (STS) grey matter volumes than the control group (n = 25). The AQ scores correlated negatively with average left STS grey matter volume in women with anorexia nervosa. LIMITATIONS We did not control for cognitive ability and examined only women with ongoing anorexia nervosa. CONCLUSION Elevated autistic traits in women with anorexia nervosa are associated with morphometric alterations of brain areas linked to social cognition. This finding provides neurobiological support for the behavioural link between anorexia nervosa and ASD and emphasizes the importance of recognizing autistic traits in preventing and treating anorexia nervosa.
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Affiliation(s)
- Malin Björnsdotter
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Monika Davidovic
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Louise Karjalainen
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Göran Starck
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Håkan Olausson
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Elisabet Wentz
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
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90
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Lavagnino L, Mwangi B, Cao B, Shott ME, Soares JC, Frank GK. Cortical thickness patterns as state biomarker of anorexia nervosa. Int J Eat Disord 2018; 51:241-249. [PMID: 29412456 PMCID: PMC5843530 DOI: 10.1002/eat.22828] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/08/2018] [Accepted: 01/08/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Only few studies have investigated cortical thickness in anorexia nervosa (AN), and it is unclear whether patterns of altered cortical thickness can be identified as biomarkers for AN. METHOD Cortical thickness was measured in 19 adult women with restricting-type AN, 24 individuals recovered from restricting-type AN (REC-AN) and 24 healthy controls. Those individuals with current or recovered from AN had previously shown altered regional cortical volumes across orbitofrontal cortex and insula. A linear relevance vector machine-learning algorithm estimated patterns of regional thickness across 24 subdivisions of those regions. RESULTS Region-based analysis showed higher cortical thickness in AN and REC-AN, compared to controls, in the right medial orbital (olfactory) sulcus, and greater cortical thickness for short insular gyri in REC-AN versus controls bilaterally. The machine-learning algorithm identified a pattern of relatively higher right orbital, right insular and left middle frontal cortical thickness, but lower left orbital, right middle and inferior frontal, and bilateral superior frontal cortical thickness specific to AN versus controls (74% specificity and 74% sensitivity, χ2 p < .004); predicted probabilities differed significantly between AN and controls (p < .023). No pattern significantly distinguished the REC-AN group from controls. CONCLUSIONS Higher cortical thickness in medial orbitofrontal cortex and insula probably contributes to higher gray matter volume in AN in those regions. The machine-learning algorithm identified a mixed pattern of mostly higher orbital and insular, but relatively lower superior frontal cortical thickness in individuals with current AN. These novel results suggest that regional cortical thickness patterns could be state markers for AN.
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Affiliation(s)
- Luca Lavagnino
- University of Texas Health Sciences Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston, Texas, USA
| | - Benson Mwangi
- University of Texas Health Sciences Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston, Texas, USA
| | - Bo Cao
- University of Texas Health Sciences Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston, Texas, USA
| | - Megan E. Shott
- Departments of Psychiatry and Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jair C. Soares
- University of Texas Health Sciences Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston, Texas, USA
| | - Guido K.W. Frank
- Departments of Psychiatry and Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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91
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Structural Neuroimaging of Anorexia Nervosa: Future Directions in the Quest for Mechanisms Underlying Dynamic Alterations. Biol Psychiatry 2018; 83:224-234. [PMID: 28967386 PMCID: PMC6053269 DOI: 10.1016/j.biopsych.2017.08.011] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/21/2017] [Accepted: 08/14/2017] [Indexed: 02/07/2023]
Abstract
Anorexia nervosa (AN) is a serious eating disorder characterized by self-starvation and extreme weight loss. Pseudoatrophic brain changes are often readily visible in individual brain scans, and AN may be a valuable model disorder to study structural neuroplasticity. Structural magnetic resonance imaging studies have found reduced gray matter volume and cortical thinning in acutely underweight patients to normalize following successful treatment. However, some well-controlled studies have found regionally greater gray matter and persistence of structural alterations following long-term recovery. Findings from diffusion tensor imaging studies of white matter integrity and connectivity are also inconsistent. Furthermore, despite the severity of AN, the number of existing structural neuroimaging studies is still relatively low, and our knowledge of the underlying cellular and molecular mechanisms for macrostructural brain changes is rudimentary. We critically review the current state of structural neuroimaging in AN and discuss the potential neurobiological basis of structural brain alterations in the disorder, highlighting impediments to progress, recent developments, and promising future directions. In particular, we argue for the utility of more standardized data collection, adopting a connectomics approach to understanding brain network architecture, employing advanced magnetic resonance imaging methods that quantify biomarkers of brain tissue microstructure, integrating data from multiple imaging modalities, strategic longitudinal observation during weight restoration, and large-scale data pooling. Our overarching objective is to motivate carefully controlled research of brain structure in eating disorders, which will ultimately help predict therapeutic response and improve treatment.
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92
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Westwater ML, Seidlitz J, Diederen KMJ, Fischer S, Thompson JC. Associations between cortical thickness, structural connectivity and severity of dimensional bulimia nervosa symptomatology. Psychiatry Res Neuroimaging 2018; 271:118-125. [PMID: 29150136 DOI: 10.1016/j.pscychresns.2017.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/18/2017] [Accepted: 11/10/2017] [Indexed: 01/11/2023]
Abstract
Bulimia nervosa (BN) is a psychiatric illness defined by preoccupation with body image (cognitive 'symptoms'), binge eating and compensatory behaviors. Although diagnosed BN has been related to grey matter alterations, characterization of brain structure in women with a range of BN symptoms has not been made. This study examined whether cortical thickness (CT) values scaled with severity of BN cognitions in 33 women with variable BN pathology. We then assessed global structural connectivity (SC) of CT to determine if individual differences in global SC relate to BN symptom severity. We used the Eating Disorder Examination Questionnaire (EDE-Q) as a continuous measure of BN symptom severity. EDE-Q score was negatively related to global CT and local CT in the left middle frontal gyrus, right superior frontal gyrus and bilateral orbitofrontal cortex (OFC) and temporoparietal regions. Moreover, cortical thinning was most pronounced in regions with high global connectivity. Finally, individual contributions to global SC at the group level related to EDE-Q score, where increased EDE-Q score correlated with reduced connectivity of the left OFC and middle temporal cortex and increased connectivity of the right superior parietal lobule. Findings represent the first evidence of cortical thinning that relates to cognitive BN symptoms.
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Affiliation(s)
- Margaret L Westwater
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Addenbrooke's Hospital, Cambridge CB2 0SZ, UK.
| | - Jakob Seidlitz
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Addenbrooke's Hospital, Cambridge CB2 0SZ, UK
| | - Kelly M J Diederen
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Addenbrooke's Hospital, Cambridge CB2 0SZ, UK
| | - Sarah Fischer
- Department of Psychology, George Mason University, Fairfax, VA 22030, USA
| | - James C Thompson
- Department of Psychology, George Mason University, Fairfax, VA 22030, USA
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93
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Cha J, Ide JS, Bowman FD, Simpson HB, Posner J, Steinglass JE. Abnormal reward circuitry in anorexia nervosa: A longitudinal, multimodal MRI study. Hum Brain Mapp 2018; 37:3835-3846. [PMID: 27273474 DOI: 10.1002/hbm.23279] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/18/2016] [Accepted: 05/20/2016] [Indexed: 12/15/2022] Open
Abstract
Anorexia nervosa (AN) is a debilitating illness and existing interventions are only modestly effective. This study aimed to determine whether AN pathophysiology is associated with altered connections within fronto-accumbal circuitry subserving reward processing. Diffusion and resting-state functional MRI scans were collected in female inpatients with AN (n = 22) and healthy controls (HC; n = 18) between the ages of 16 and 25 years. Individuals with AN were scanned during the acute, underweight phase of the illness and again following inpatient weight restoration. HC were scanned twice over the same timeframe. Based on univariate and multivariate analyses of fronto-accumbal circuitry, underweight individuals with AN were found to have increased structural connectivity (diffusion probabilistic tractography), increased white matter anisotropy (tract-based spatial statistics), increased functional connectivity (seed-based correlation in resting-state fMRI), and altered effective connectivity (spectral dynamic causal modeling). Following weight restoration, fronto-accumbal structural connectivity continued to be abnormally increased bilaterally with large (partial η2 = 0.387; right NAcc-OFC) and moderate (partial η2 = 0.197; left NAcc-OFC) effect sizes. Increased structural connectivity within fronto-accumbal circuitry in the underweight state correlated with severity of eating disorder symptoms. Taken together, the findings from this longitudinal, multimodal neuroimaging study offer converging evidence of atypical fronto-accumbal circuitry in AN. Hum Brain Mapp 37:3835-3846, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jiook Cha
- Department of Psychiatry, Columbia University Medical Center, New York, New York. .,Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York.
| | - Jaime S Ide
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - F Dubois Bowman
- Department of Biostatistics, Mailman School of Public Health, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Helen B Simpson
- Department of Psychiatry, Columbia University Medical Center, New York, New York.,Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York
| | - Jonathan Posner
- Department of Psychiatry, Columbia University Medical Center, New York, New York.,Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Joanna E Steinglass
- Department of Psychiatry, Columbia University Medical Center, New York, New York. .,Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York.
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94
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Berner LA, Stefan M, Lee S, Wang Z, Terranova K, Attia E, Marsh R. Altered cortical thickness and attentional deficits in adolescent girls and women with bulimia nervosa. J Psychiatry Neurosci 2018; 43:170070. [PMID: 29336774 PMCID: PMC5915236 DOI: 10.1503/jpn.170070] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/10/2017] [Accepted: 08/08/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Frontostriatal and frontoparietal abnormalities likely contribute to deficits in control and attentional processes in individuals with bulimia nervosa and to the persistence of dysregulated eating across development. This study assessed these processes and cortical thickness in a large sample of adolescent girls and women with bulimia nervosa compared with healthy controls. METHODS We collected anatomical MRI data from adolescent girls and women (ages 12-38 yr) with full or subthreshold bulimia nervosa and age-matched healthy controls who also completed the Conners Continuous Performance Test-II (CPT-II). Groups were compared on task performance and cortical thickness. Mediation analyses explored associations among cortical thickness, CPT-II variables, bulimia nervosa symptoms and age. RESULTS We included 60 girls and women with bulimia nervosa and 54 controls in the analyses. Compared with healthy participants, those with bulimia nervosa showed increased impulsivity and inattention on the CPT-II, along with reduced thickness of the right pars triangularis, right superior parietal and left dorsal posterior cingulate cortices. In the bulimia nervosa group, exploratory analyses revealed that binge eating frequency correlated inversely with cortical thickness of frontoparietal and insular regions and that reduced frontoparietal thickness mediated the association between age and increased symptom severity and inattention. Binge eating frequency also mediated the association between age and lower prefrontal cortical thickness. LIMITATIONS These findings are applicable to only girls and women with bulimia nervosa, and our cross-sectional design precludes understanding of whether cortical thickness alterations precede or result from bulimia nervosa symptoms. CONCLUSION Structural abnormalities in the frontoparietal and posterior cingulate regions comprising circuits that support control and attentional processes should be investigated as potential contributors to the maintenance of bulimia nervosa and useful targets for novel interventions.
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Affiliation(s)
- Laura A Berner
- From the Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego (Berner); the Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Stefan, Lee, Wang, Terranova, Marsh); and the Eating Disorders Research Unit, Division of Clinical Therapeutics, Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Attia, Marsh)
| | - Mihaela Stefan
- From the Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego (Berner); the Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Stefan, Lee, Wang, Terranova, Marsh); and the Eating Disorders Research Unit, Division of Clinical Therapeutics, Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Attia, Marsh)
| | - Seonjoo Lee
- From the Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego (Berner); the Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Stefan, Lee, Wang, Terranova, Marsh); and the Eating Disorders Research Unit, Division of Clinical Therapeutics, Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Attia, Marsh)
| | - Zhishun Wang
- From the Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego (Berner); the Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Stefan, Lee, Wang, Terranova, Marsh); and the Eating Disorders Research Unit, Division of Clinical Therapeutics, Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Attia, Marsh)
| | - Kate Terranova
- From the Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego (Berner); the Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Stefan, Lee, Wang, Terranova, Marsh); and the Eating Disorders Research Unit, Division of Clinical Therapeutics, Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Attia, Marsh)
| | - Evelyn Attia
- From the Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego (Berner); the Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Stefan, Lee, Wang, Terranova, Marsh); and the Eating Disorders Research Unit, Division of Clinical Therapeutics, Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Attia, Marsh)
| | - Rachel Marsh
- From the Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego (Berner); the Division of Child and Adolescent Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Stefan, Lee, Wang, Terranova, Marsh); and the Eating Disorders Research Unit, Division of Clinical Therapeutics, Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute (Attia, Marsh)
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95
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Phillipou A, Rossell SL, Gurvich C, Castle DJ, Abel LA, Nibbs RG, Hughes ME. Differences in regional grey matter volumes in currently ill patients with anorexia nervosa. Eur J Neurosci 2018; 47:177-183. [PMID: 29244231 DOI: 10.1111/ejn.13793] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/29/2017] [Accepted: 12/01/2017] [Indexed: 01/03/2023]
Abstract
Neurobiological findings in anorexia nervosa (AN) are inconsistent, including differences in regional grey matter volumes. Methodological limitations often contribute to the inconsistencies reported. The aim of this study was to improve on these methodologies by utilising voxel-based morphometry (VBM) analysis with the use of diffeomorphic anatomic registration through an exponentiated lie algebra algorithm (DARTEL), in a relatively large group of individuals with AN. Twenty-six individuals with AN and 27 healthy controls underwent a T1-weighted magnetic resonance imaging (MRI) scan. AN participants were found to have reduced grey matter volumes in a number of areas including regions of the basal ganglia (including the ventral striatum), and parietal and temporal cortices. Body mass index (BMI) and global scores on the Eating Disorder Examination Questionnaire (EDE-Q) were also found to correlate with grey matter volumes in a region of the brainstem (including the substantia nigra and ventral tegmental area) in AN, and predicted 56% of the variance in grey matter volumes in this area. The brain regions associated with grey matter reductions in AN are consistent with regions responsible for cognitive deficits associated with the illness including anhedonia, deficits in affect perception and saccadic eye movement abnormalities. Overall, the findings suggest reduced grey matter volumes in AN that are associated with eating disorder symptomatology.
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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.,Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Susan Lee Rossell
- Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, Melbourne, VIC, 3122, Australia.,Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, Melbourne, VIC, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, 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
| | - Larry Allen Abel
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Richard Grant Nibbs
- Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Matthew Edward Hughes
- Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, Melbourne, VIC, 3122, Australia
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Monteleone AM, Castellini G, Volpe U, Ricca V, Lelli L, Monteleone P, Maj M. Neuroendocrinology and brain imaging of reward in eating disorders: A possible key to the treatment of anorexia nervosa and bulimia nervosa. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:132-142. [PMID: 28259721 DOI: 10.1016/j.pnpbp.2017.02.020] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/28/2017] [Indexed: 10/20/2022]
Abstract
Anorexia nervosa and bulimia nervosa are severe eating disorders whose etiopathogenesis is still unknown. Clinical features suggest that eating disorders may develop as reward-dependent syndromes, since eating less food is perceived as rewarding in anorexia nervosa while consumption of large amounts of food during binge episodes in bulimia nervosa aims at reducing the patient's negative emotional states. Therefore, brain reward mechanisms have been a major focus of research in the attempt to contribute to the comprehension of the pathophysiology of these disorders. Structural brain imaging data provided the evidence that brain reward circuits may be altered in patients with anorexia or bulimia nervosa. Similarly, functional brain imaging studies exploring the activation of brain reward circuits by food stimuli as well as by stimuli recognized to be potentially rewarding for eating disordered patients, such as body image cues or stimuli related to food deprivation and physical hyperactivity, showed several dysfunctions in ED patients. Moreover, very recently, it has been demonstrated that some of the biochemical homeostatic modulators of eating behavior are also implicated in the regulation of food-related and non-food-related reward, representing a possible link between the aberrant behaviors of ED subjects and their hypothesized deranged reward processes. In particular, changes in leptin and ghrelin occur in patients with anorexia or bulimia nervosa and have been suggested to represent not only homeostatic adaptations to an altered energy balance but to contribute also to the acquisition and/or maintenance of persistent starvation, binge eating and physical hyperactivity, which are potentially rewarding for ED patients. On the basis of such findings new pathogenetic models of EDs have been proposed, and these models may provide new theoretical basis for the development of innovative treatment strategies, either psychological and pharmacological, with the aim to improve the outcomes of so severe disabling disorders.
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Affiliation(s)
| | - Giovanni Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Umberto Volpe
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - Valdo Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Lorenzo Lelli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Palmiero Monteleone
- Department of Psychiatry, University of Naples SUN, Naples, Italy; Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neurosciences, University of Salerno, Salerno, Italy.
| | - Mario Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
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97
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Seitz J, Konrad K, Herpertz-Dahlmann B. Extend, Pathomechanism and Clinical Consequences of Brain Volume Changes in Anorexia Nervosa. Curr Neuropharmacol 2018; 16:1164-1173. [PMID: 29119931 PMCID: PMC6187749 DOI: 10.2174/1570159x15666171109145651] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 01/01/1970] [Accepted: 11/07/2017] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Brain volume deficits of grey matter (GM) and white matter (WM) are often found in patients with anorexia nervosa (AN). However, until recently, little was known about the influencing factors of these brain volume alterations, nor their exact quantification and rehabilitation. METHODS This review addresses these open questions and further explores what is now known about the underlying pathobiology and the clinical consequences including human studies as well as animal studies mimicking anorexia nervosa in rodents. RESULTS GM was reduced by 3.7% in adults and 7.6% in adolescents with AN. WM was reduced on average 2.2% in adult patients and 3.2% in adolescents. Most volume deficits in adults are reversible after long-term recovery; for adolescents, data are less clear. The main influencing factors for GM were absolute lowest weight at admission and illness duration. Cerebellar and WM reductions at admission predicted clinical outcome at one year follow-up. New studies found GABA receptor changes in GM and astrocyte loss in both GM and WM, as well as a possible role for oestrogen deficit. All three could partly explain clinical symptoms of anxiety, rigidity and learning impairments in patients with AN. CONCLUSION Brain volume deficits in AN seem to play a causal role in the course and the prognosis of AN. A better understanding of these brain changes could lead to more targeted therapies for patients with AN, including astrocyte-directed approaches.
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Affiliation(s)
- Jochen Seitz
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany
| | - Kerstin Konrad
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany
| | - Beate Herpertz-Dahlmann
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany
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98
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Björnsdotter M, Davidovic M, Karjalainen L, Starck G, Olausson H, Wentz E. Grey matter correlates of autistic traits in women with anorexia nervosa. J Psychiatry Neurosci 2017; 43:1-8. [PMID: 29214796 PMCID: PMC5837888 DOI: 10.1503/jpn.170072] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/27/2017] [Accepted: 07/11/2017] [Indexed: 12/27/2022] Open
Abstract
Background Patients with anorexia nervosa exhibit higher levels of behaviours typically associated with autism-spectrum disorder (ASD), but the neural basis is unclear. We sought to determine whether elevated autistic traits in women with anorexia nervosa may be reflected in cortical morphology. Methods We used voxel-based morphometry (VBM) to examine regional grey matter volumes in high-resolution MRI structural brain scans in women with anorexia nervosa and matched healthy controls. The Autism-spectrum Quotient (AQ) scale was used to assess autistic traits. Results Women with anorexia nervosa (n = 25) had higher AQ scores and lower bilateral superior temporal sulcus (STS) grey matter volumes than the control group (n = 25). The AQ scores correlated negatively with average left STS grey matter volume in women with anorexia nervosa. Limitations We did not control for cognitive ability and examined only women with ongoing anorexia nervosa. Conclusion Elevated autistic traits in women with anorexia nervosa are associated with morphometric alterations of brain areas linked to social cognition. This finding provides neurobiological support for the behavioural link between anorexia nervosa and ASD and emphasizes the importance of recognizing autistic traits in preventing and treating anorexia nervosa.
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Affiliation(s)
- Malin Björnsdotter
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Monika Davidovic
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Louise Karjalainen
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Göran Starck
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Håkan Olausson
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Elisabet Wentz
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
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Abstract
Understanding factors that contribute to eating disorders, which affect 13% of females, is critical to developing effective prevention and treatment programs. In this paper, we summarize results from prospective studies that identified factors predicting onset and persistence of eating disorders and core symptom dimensions. Next, implications for intervention targets for prevention, and treatment interventions from the risk- and maintenance-factor findings are discussed. Third, given that evidence suggests eating disorders are highly heritable, implying biological risk and maintenance factors for eating disorders, we offer working hypotheses about biological factors that might contribute to eating disorders, based on extant risk factor findings, theory, and cross-sectional studies. Finally, potentially fruitful directions for future research are presented. We suggest that it would be useful for experimental therapeutics trials to evaluate the effects of reducing the risk factors on future onset of eating pathology and on reducing maintenance factors on the risk for persistence of eating pathology, and encourage researchers to utilize prospective high-risk studies so that knowledge regarding potential intervention targets for prevention and treatment interventions for eating disorders can be advanced. Using the most rigorous research designs should help improve the efficacy of prevention and treatment interventions for eating disorders.
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Affiliation(s)
- Eric Stice
- Heather Shaw Oregon Research Institute, Eugene, USA
| | - Heather Shaw
- Heather Shaw Oregon Research Institute, Eugene, USA
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100
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Klabunde M, Collado D, Bohon C. An interoceptive model of bulimia nervosa: A neurobiological systematic review. J Psychiatr Res 2017; 94:36-46. [PMID: 28651098 PMCID: PMC6026544 DOI: 10.1016/j.jpsychires.2017.06.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/18/2017] [Accepted: 06/19/2017] [Indexed: 12/12/2022]
Abstract
The objective of our study was to examine the neurobiological support for an interoceptive sensory processing model of bulimia nervosa (BN). To do so, we conducted a systematic review of interoceptive sensory processing in BN, using the PRISMA guidelines. We searched PsychInfo, Pubmed, and Web of Knowledge databases to identify biological and behavioral studies that examine interoceptive detection in BN. After screening 390 articles for inclusion and conducting a quality assessment of articles that met inclusion criteria, we reviewed 41 articles. We found that global interoceptive sensory processing deficits may be present in BN. Specifically there is evidence of abnormal brain function, structure and connectivity in the interoceptive neural network, in addition to gastric and pain processing disturbances. These results suggest that there may be a neurobiological basis for global interoceptive sensory processing deficits in BN that remain after recovery. Data from taste and heart beat detection studies were inconclusive; some studies suggest interoceptive disturbances in these sensory domains. Discrepancies in findings appear to be due to methodological differences. In conclusion, interoceptive sensory processing deficits may directly contribute to and explain a variety of symptoms present in those with BN. Further examination of interoceptive sensory processing deficits could inform the development of treatments for those with BN.
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Affiliation(s)
- Megan Klabunde
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States.
| | - Danielle Collado
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Cara Bohon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
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