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Chao AM, Agarwal K, Zhou Y, Grilo CM, Gur RC, Joseph P, Shinohara RT, Richmond TS, Wadden TA. Neural Responses to Auditory Food Stimuli Following Cognitive Behavioral Therapy for Binge-Eating Disorder. Int J Eat Disord 2024. [PMID: 38953334 DOI: 10.1002/eat.24244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE Adults with binge-eating disorder (BED), compared with those without BED, demonstrate higher blood-oxygen-level-dependent (BOLD) response to food cues in reward-related regions of the brain. It is not known whether cognitive behavioral therapy (CBT) can reverse this reward system hyperactivation. This randomized controlled trial (RCT) assessed changes in BOLD response to binge-eating cues following CBT versus wait-list control (WLC). METHOD Females with BED (N = 40) were randomized to CBT or WLC. Participants completed assessments at baseline and 16 weeks including measures of eating and appetite and functional magnetic resonance imaging (fMRI) to measure BOLD response while listening to personalized scripts of binge-eating and neutral-relaxing cues. Data were analyzed using general linear models with mixed effects. RESULTS Overall retention rate was 87.5%. CBT achieved significantly greater reductions in binge-eating episodes than WLC (mean ± standard error decline of 14.6 ± 2.7 vs. 5.7 ± 2.8 episodes in the past 28 days, respectively; p = 0.03). CBT and WLC did not differ significantly in changes in neural responses to binge-eating stimuli during the fMRI sessions. Compared with WLC, CBT had significantly greater improvements in reward-based eating drive, disinhibition, and hunger as assessed by questionnaires (ps < 0.05). DISCUSSION CBT was effective in reducing binge eating, but, contrary to our hypothesis, CBT did not improve BOLD response to auditory binge-eating stimuli in reward regions of the brain. Further studies are needed to assess mechanisms underlying improvements with CBT for BED. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03604172.
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Affiliation(s)
- Ariana M Chao
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USA
- National Institute of Nursing Research, Bethesda, Maryland, USA
| | - Khushbu Agarwal
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USA
- National Institute of Nursing Research, Bethesda, Maryland, USA
| | - Yingjie Zhou
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paule Joseph
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USA
- National Institute of Nursing Research, Bethesda, Maryland, USA
| | - Russell T Shinohara
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Therese S Richmond
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Flynn M, Campbell IC, Schmidt U. Concurrent self-administered transcranial direct current stimulation and attention bias modification training in binge eating disorder: feasibility randomised sham-controlled trial. BJPsych Open 2024; 10:e118. [PMID: 38840537 PMCID: PMC11363089 DOI: 10.1192/bjo.2024.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/19/2024] [Accepted: 03/10/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Binge eating disorder (BED) is a common and disabling condition, typically presenting with multiple psychiatric and obesity-related comorbidities. Evidence-based treatments are either resource-intensive (psychotherapies) or have side-effects (medications): these achieve remission in around 50% of cases. Novel treatments are needed. AIMS This randomised sham-controlled trial aimed to assess feasibility, acceptability and preliminary efficacy of at-home, self-administered transcranial direct current stimulation (tDCS) and attention bias modification training (ABMT) in adults with binge eating disorder. METHOD Eighty-two participants with binge eating disorder were randomly allocated to real tDCS with ABMT, sham tDCS with ABMT, ABMT only or waitlist control. Intervention groups received ten sessions of their allocated treatment over 2-3 weeks. tDCS (2 mA, 20 min) was self-administered using a bilateral (anode right/cathode left) montage targeting the dorsolateral prefrontal cortex. Outcomes were assessed at baseline, post-treatment and 6-week follow-up. RESULTS Prespecified feasibility criteria (recruitment ≥80 participants and retention rate ≥75%) were exceeded, and treatment completion rates were high (98.7%). All interventions reduced binge eating episodes, eating disorder symptoms and related psychopathology between baseline and follow-up, relative to waitlist control (medium-to-large between-group effect sizes for change scores). Small-to-medium effect sizes for change scores favoured real tDCS with ABMT versus comparators, suggesting the verum intervention produces superior outcomes. CONCLUSIONS At-home, self-administered tDCS with ABMT is feasible and acceptable, and preliminary data on efficacy are promising. This approach could be a useful and scalable alternative or adjunct to established treatments for binge eating disorder. Confirmatory trials can, and should, be pursued.
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Affiliation(s)
- Michaela Flynn
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Iain C. Campbell
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Ulrike Schmidt
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Outpatient Eating Disorder Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK
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Geisler CE, Décarie-Spain L, Loh MK, Trumbauer W, Gaisinsky J, Klug ME, Pelletier C, Davis JF, Schmidt HD, Roitman MF, Kanoski SE, Hayes MR. Amylin Modulates a Ventral Tegmental Area-to-Medial Prefrontal Cortex Circuit to Suppress Food Intake and Impulsive Food-Directed Behavior. Biol Psychiatry 2024; 95:938-950. [PMID: 37517705 DOI: 10.1016/j.biopsych.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND A better understanding of the neural mechanisms regulating impaired satiety to palatable foods is essential to treat hyperphagia linked with obesity. The satiation hormone amylin signals centrally at multiple nuclei including the ventral tegmental area (VTA). VTA-to-medial prefrontal cortex (mPFC) projections encode food reward information to influence behaviors including impulsivity. We hypothesized that modulation of VTA-to-mPFC neurons underlies amylin-mediated decreases in palatable food-motivated behaviors. METHODS We used a variety of pharmacological, behavioral, genetic, and viral approaches (n = 4-16/experiment) to investigate the anatomical and functional circuitry of amylin-controlled VTA-to-mPFC signaling in rats. RESULTS To first establish that VTA amylin receptor (calcitonin receptor) activation can modulate mPFC activity, we showed that intra-VTA amylin decreased food-evoked mPFC cFos. VTA amylin delivery also attenuated food-directed impulsive behavior, implicating VTA amylin signaling as a regulator of mPFC functions. Palatable food activates VTA dopamine and mPFC neurons. Accordingly, dopamine receptor agonism in the mPFC blocked the hypophagic effect of intra-VTA amylin, and VTA amylin injection reduced food-evoked phasic dopamine levels in the mPFC, supporting the idea that VTA calcitonin receptor activation decreases dopamine release in the mPFC. Surprisingly, calcitonin receptor expression was not found on VTA-to-mPFC projecting neurons but was instead found on GABAergic (gamma-aminobutyric acidergic) interneurons in the VTA that provide monosynaptic inputs to this pathway. Blocking intra-VTA GABA signaling, through GABA receptor antagonists and DREADD (designer receptor exclusively activated by designer drugs)-mediated GABAergic neuronal silencing, attenuated intra-VTA amylin-induced hypophagia. CONCLUSIONS These results indicate that VTA amylin signaling stimulates GABA-mediated inhibition of dopaminergic projections to the mPFC to mitigate impulsive consumption of palatable foods.
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Affiliation(s)
- Caroline E Geisler
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Léa Décarie-Spain
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California
| | - Maxine K Loh
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
| | - Wolf Trumbauer
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jane Gaisinsky
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Molly E Klug
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California
| | - Caitlyn Pelletier
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jon F Davis
- Novo Nordisk Research Center Seattle, Seattle, Washington
| | - Heath D Schmidt
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mitchell F Roitman
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
| | - Scott E Kanoski
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California
| | - Matthew R Hayes
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
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Luo Y, Xiao M, Chen X, Zeng W, Chen H. Harsh, unpredictable childhood environments are associated with inferior frontal gyrus connectivity and binge eating tendencies in late adolescents. Appetite 2024; 195:107210. [PMID: 38266713 DOI: 10.1016/j.appet.2024.107210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/03/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
Harsh, unpredictable childhood environments (HUCE) are associated with obesity older in life, but knowledge of how HUCE affect binge eating tendencies is lacking. Five hundred and one late adolescents aged 16-22 were recruited to finish resting state functional magnetic resonance imaging scan, behavioral measures including retrospective recall of childhood environmental harshness and unpredictability, binge eating tendencies and demographics. Three hundred and seventy-six of participants further completed the computerized visual probe task designed to evaluate attentional engagement towards high and low calorie food. As right inferior frontal gyrus (IFG) was the key nodes that related to both early life adversity and binge eating tendencies, it was treated as the interest region in the dynamic functional connectivity analyses. Results found that HUCE are associated with significant but modest decreases in connectivity of right inferior frontal gyrus (IFG)- bilateral medial frontal gyrus, right IFG - bilateral inferior parietal lobule (IPL), and right IFG - left superior frontal gyrus connectivity, as well as attentional engagement to high-calorie food and binge eating tendencies. A machine-learning method named linear support vector regression (SVR) and leave one out cross-validation (LOOCV) procedure used to examine the robustness of the brain-behavior relationship further confirm the findings. Mediation analyses suggested that right IFG - left IPL connectivity mediates the association of HUCE and binge eating tendencies. Findings suggest right IFG - left IPL connectivity may serve as a crucial neurobiological underpinning of HUCE to regulate binge eating behaviors. As such, these results contribute to a novel perspective and hypotheses in elucidating developmental neuro-mechanisms related to binge eating.
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Affiliation(s)
- Yijun Luo
- School of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, 400715, China
| | - Minyue Xiao
- School of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, 400715, China
| | - Ximei Chen
- School of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, 400715, China
| | - Weiyu Zeng
- School of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, 400715, China
| | - Hong Chen
- School of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, 400715, China.
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Martin E, Cao M, Schulz KP, Hildebrandt T, Sysko R, Berner LA, Li X. Distinct Topological Properties of the Reward Anticipation Network in Preadolescent Children With Binge Eating Disorder Symptoms. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00120-5. [PMID: 38461893 PMCID: PMC11380707 DOI: 10.1016/j.jaac.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 02/01/2024] [Accepted: 03/01/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE Few studies have considered the neural underpinnings of binge eating disorder (BED) in children, despite clinical and subclinical symptom presentation occurring in this age group. Symptom presentation at this age is of clinical relevance, as early onset of binge eating is linked to negative health outcomes. Studies in adults have highlighted dysfunction in the frontostriatal reward system as a potential candidate for binge eating pathophysiology, although the exact nature of such dysfunction is currently unclear. METHOD Data from 83 children (mean age 9.9 years, SD = 0.60) with symptoms of BED (57% girls) and 123 control participants (mean age 10.0 years, SD = 0.60) (52% girls) were acquired from the 4.0 baseline release of the Adolescent Brain Cognitive Development Study. Task-based graph theoretic techniques were used to analyze data from anticipation trials of the monetary incentive delay task. Network and nodal properties were compared between groups. RESULTS The BED-S group showed alterations in topological properties associated with the frontostriatal subnetwork, such as reduced nodal efficiency in the superior frontal gyrus, nucleus accumbens, putamen, and in normal sex-difference patterns of these properties, such as diminished girls-greater-than-boys pattern of betweenness-centrality in nucleus accumbens observed in controls. CONCLUSION Distinct network properties and sex-difference patterns in preadolescent children with BED-S suggest dysregulation in the reward system compared to those of matched controls. For the first time, these results quantify this dysregulation in terms of systems-level properties during anticipation of monetary reward and significantly inform the early and sex-related brain markers of BED symptoms.
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Affiliation(s)
- Elizabeth Martin
- Icahn School of Medicine at Mount Sinai, New York, New Jersey; New Jersey Institute of Technology, Newark, New Jersey
| | - Meng Cao
- New Jersey Institute of Technology, Newark, New Jersey
| | - Kurt P Schulz
- Icahn School of Medicine at Mount Sinai, New York, New Jersey
| | - Tom Hildebrandt
- Icahn School of Medicine at Mount Sinai, New York, New Jersey
| | - Robyn Sysko
- Icahn School of Medicine at Mount Sinai, New York, New Jersey
| | - Laura A Berner
- Icahn School of Medicine at Mount Sinai, New York, New Jersey
| | - Xiaobo Li
- New Jersey Institute of Technology, Newark, New Jersey.
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Mestre-Bach G, Potenza MN. Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2023; 25:75-91. [PMID: 37594217 PMCID: PMC10444012 DOI: 10.1080/19585969.2023.2242359] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Abstract
The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.
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Affiliation(s)
- Gemma Mestre-Bach
- Centro de Investigación, Transferencia e Innovación (CITEI), Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
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Murray SB, Diaz-Fong JP, Duval CJ, Balkchyan AA, Nagata JM, Lee DJ, Ganson KT, Toga AW, Siegel SJ, Jann K. Sex differences in regional gray matter density in pre-adolescent binge eating disorder: a voxel-based morphometry study. Psychol Med 2023; 53:6077-6089. [PMID: 36305572 DOI: 10.1017/s0033291722003269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Binge eating disorder (BED) is a pernicious psychiatric disorder which is linked with broad medical and psychiatric morbidity, and obesity. While BED may be characterized by altered cortical morphometry, no evidence to date examined possible sex-differences in regional gray matter characteristics among those with BED. This is especially important to consider in children, where BED symptoms often emerge coincident with rapid gray matter maturation. METHODS Pre-adolescent, 9-10-year old boys (N = 38) and girls (N = 33) with BED were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development Study. We investigated sex differences in gray matter density (GMD) via voxel-based morphometry. Control sex differences were also assessed in age and body mass index and developmentally matched control children (boys N = 36; girls N = 38). Among children with BED, we additionally assessed the association between dorsolateral prefrontal (dlPFC) GMD and parent-reported behavioral approach and inhibition tendencies. RESULTS Girls with BED uniquely demonstrate diffuse clusters of greater GMD (p < 0.05, Threshold Free Cluster Enhancement corrected) in the (i) left dlPFC (p = 0.003), (ii) bilateral dmPFC (p = 0.004), (iii) bilateral primary motor and somatosensory cortex (p = 0.0003) and (iv) bilateral precuneus (p = 0.007). Brain-behavioral associations suggest a unique negative correlation between GMD in the left dlPFC and behavioral approach tendencies among girls with BED. CONCLUSIONS Early-onset BED may be characterized by regional sex differences in terms of its underlying gray matter morphometry.
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Affiliation(s)
- Stuart B Murray
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Joel P Diaz-Fong
- Department of Psychiatry & Behavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA, USA
| | - Christina J Duval
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Ane A Balkchyan
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Darrin J Lee
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Arthur W Toga
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Steven J Siegel
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Kay Jann
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
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Xiao M, Luo Y, Zeng W, Chen H. Support from a Best Friend Makes People Eat Less under Stress: Evidence from Two Experiments. Nutrients 2023; 15:3898. [PMID: 37764682 PMCID: PMC10537042 DOI: 10.3390/nu15183898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
When experiencing acute stress, individuals often turn to eating for comfort, as it provides a sense of satiety and satisfaction that can temporarily alleviate the stressful condition. However, this may increase the risk of obesity, diabetes, cardiovascular disease. In this study, we conducted two behavioral experiments to investigate the effectiveness of social support in reducing stress-induced overeating and the mediative role of negative affect and self-efficacy (Experiment 1), as well as the role of reward sensitivity (Experiment 2). Acute stress was induced using a speech preparation task and then participants were asked to regulate their emotions and cognition, either alone or with the help of pictures and supportive sentences provided by a best friend or stranger. Participants in Experiment 1 then completed the food choice task, and participants in Experiment 2 completed the food incentive delay task and the bogus tasting task. The results of both experiments consistently showed that participants who received support from their friends reported lower levels of perceived stress, chose fewer food portions, and consumed fewer snacks during acute stress, compared to the other three groups. Further mediation analysis using the process macro revealed that the differential influence of social support on the choice of high-calorie foods was due to decreased negative affect and increased self-efficacy. This study provides valuable insights for the development of therapeutic interventions for clinical eating disorders.
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Affiliation(s)
- Mingyue Xiao
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Tiansheng Road No. 2, Beibei District, Chongqing 400715, China
- Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Tiansheng Road No. 2, Beibei District, Chongqing 400715, China
| | - Yijun Luo
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Tiansheng Road No. 2, Beibei District, Chongqing 400715, China
- Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Tiansheng Road No. 2, Beibei District, Chongqing 400715, China
| | - Weiyu Zeng
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Tiansheng Road No. 2, Beibei District, Chongqing 400715, China
- Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Tiansheng Road No. 2, Beibei District, Chongqing 400715, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Tiansheng Road No. 2, Beibei District, Chongqing 400715, China
- Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Tiansheng Road No. 2, Beibei District, Chongqing 400715, China
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Colton E, Wilson KE, Chong TTJ, Verdejo-Garcia A. Dysfunctional decision-making in binge-eating disorder: A meta-analysis and systematic review. Neurosci Biobehav Rev 2023; 152:105250. [PMID: 37263530 DOI: 10.1016/j.neubiorev.2023.105250] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/03/2023]
Abstract
Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and guilt. Evidence indicates neurocognitive dysfunctions contribute to BED onset, maintenance, and treatment response. However, an integrated understanding of how cognitive processes underpin BED symptomology is lacking. We utilised a multi-stage decision-making model defining ten cognitive processes underpinning Preference Formation, Choice Implementation, Feedback Processing, and Flexibility/Shifting, to comprehensively review research published since 2013. We used preregistered PICOS criteria to assess 1966 articles identified from PubMed, PsycInfo, and Scopus database searches. This yielded 50 studies reporting behavioural cognitive tasks outcomes, comparing individuals with BED to controls with normal and higher weight. Meta-analyses revealed a unique profile of cognitive dysfunctions that spanned all decision-making stages. Significant deficits were evident in Uncertainty Evaluation, Attentional Inhibition, Choice Consistency, and Cognitive Flexibility/Set-shifting. We propose a novel model of dysfunctional decision-making processes in BED and describe their role in binge-eating behaviour. We further highlight the potential for cognitive interventions to target these processes and address the significant treatment gap in BED.
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Affiliation(s)
- Emily Colton
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia.
| | - Kira-Elise Wilson
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Trevor T-J Chong
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Antonio Verdejo-Garcia
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
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Giddens E, Noy B, Steward T, Verdejo-García A. The influence of stress on the neural underpinnings of disinhibited eating: a systematic review and future directions for research. Rev Endocr Metab Disord 2023; 24:713-734. [PMID: 37310550 PMCID: PMC10404573 DOI: 10.1007/s11154-023-09814-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/14/2023]
Abstract
Disinhibited eating involves overconsumption and loss of control over food intake, and underpins many health conditions, including obesity and binge-eating related disorders. Stress has been implicated in the development and maintenance of disinhibited eating behaviours, but the mechanisms underlying this relationship are unclear. In this systematic review, we examined how the impact of stress on the neurobiological substrates of food-related reward sensitivity, interoception and cognitive control explains its role in disinhibited eating behaviours. We synthesised the findings of functional magnetic resonance imaging studies including acute and/or chronic stress exposures in participants with disinhibited eating. A systematic search of existing literature conducted in alignment with the PRISMA guidelines identified seven studies investigating neural impacts of stress in people with disinhibited eating. Five studies used food-cue reactivity tasks, one study used a social evaluation task, and one used an instrumental learning task to probe reward, interoception and control circuitry. Acute stress was associated with deactivation of regions in the prefrontal cortex implicated in cognitive control and the hippocampus. However, there were mixed findings regarding differences in reward-related circuitry. In the study using a social task, acute stress associated with deactivation of prefrontal cognitive control regions in response to negative social evaluation. In contrast, chronic stress was associated with both deactivation of reward and prefrontal regions when viewing palatable food-cues. Given the small number of identified publications and notable heterogeneity in study designs, we propose several recommendations to strengthen future research in this emerging field.
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Affiliation(s)
- Emily Giddens
- Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton, VIC 3800 Australia
| | - Brittany Noy
- Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton, VIC 3800 Australia
| | - Trevor Steward
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC Australia
| | - Antonio Verdejo-García
- Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton, VIC 3800 Australia
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11
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Hagan K, Datta N, Stern M, Bohon C. Aberrant reward-related neural activation: Dimensional correlate of binge-eating severity or categorical marker of binge eating? J Psychiatr Res 2023; 161:54-61. [PMID: 36898327 PMCID: PMC10149604 DOI: 10.1016/j.jpsychires.2023.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/08/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023]
Abstract
Binge eating (BE) is characterized by consuming an objectively large amount of food in a short period of time and experiencing loss of control over one's eating. The neural underpinnings of monetary reward anticipation and their association with BE severity remain poorly understood. Fifty-nine women aged 18 to 35 (M = 25.67, SD = 5.11) with a range of average weekly BE frequency (M = 1.96, SD = 1.89, range = 0-7) completed the Monetary Incentive Delay Task during fMRI scanning. Mean percent signal change within the left and right nucleus accumbens (NAc) during anticipation of monetary gain (versus non-gain) was extracted from a priori-defined functional 5 mm spheres and correlated with average weekly BE frequency. Exploratory voxel-wise whole-brain analyses examined the association between neural activation during anticipation of monetary reward and average weekly BE frequency. Body mass index and depression severity were covariates of non-interest in analyses. Mean percent signal change in the left and right NAc inversely correlated with average weekly BE frequency. Whole-brain analysis revealed no significant associations between neural activation during reward anticipation and average weekly BE frequency. In exploratory case-control analyses, mean percent signal change in the right NAc was significantly lower in women with BE (n = 41) versus women without BE (n = 18), but whole-brain analyses revealed no significant group differences in neural activation during reward anticipation. Decreased right NAc activity during monetary reward anticipation may distinguish women with and without BE.
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Affiliation(s)
- Kelsey Hagan
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA.
| | - Nandini Datta
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - May Stern
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Cara Bohon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Equip Health, Inc., Carlsbad, CA, USA
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12
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Boswell RG, Gueorguieva R, Grilo CM. Change in impulsivity is prospectively associated with treatment outcomes for binge-eating disorder. Psychol Med 2023; 53:2789-2797. [PMID: 34812713 PMCID: PMC9124732 DOI: 10.1017/s003329172100475x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Impulsivity may be a process underlying binge-eating disorder (BED) psychopathology and its treatment. This study examined change in impulsivity during cognitive-behavioral therapy (CBT) and/or pharmacological treatment for BED and associations with treatment outcomes. METHODS In total, 108 patients with BED (NFEMALE = 84) in a randomized placebo-controlled clinical trial evaluating the efficacy of CBT and/or fluoxetine were assessed before treatment, monthly throughout treatment, at post-treatment (16 weeks), and at 12-month follow-up after completing treatment. Patients completed established measures of impulsivity, eating-disorder psychopathology, and depression, and were measured for height and weight [to calculate body mass index (BMI)] during repeated assessments by trained/monitored doctoral research-clinicians. Mixed-effects models using all available data examined changes in impulsivity and the association of rapid and overall changes in impulsivity on treatment outcomes. Exploratory analyses examined whether baseline impulsivity predicted/moderated outcomes. RESULTS Impulsivity declined significantly throughout treatment and follow-up across treatment groups. Rapid change in impulsivity and overall change in impulsivity during treatment were significantly associated with reductions in eating-disorder psychopathology, depression scores, and BMI during treatment and at post-treatment. Overall change in impulsivity during treatment was associated with subsequent reductions in depression scores at 12-month follow-up. Baseline impulsivity did not moderate/predict eating-disorder outcomes or BMI but did predict change in depression scores. CONCLUSIONS Rapid and overall reductions in impulsivity during treatment were associated with improvements in specific eating-disorder psychopathology and associated general outcomes. These effects were found for both CBT and pharmacological treatment for BED. Change in impulsivity may be an important process prospectively related to treatment outcome.
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Affiliation(s)
- Rebecca G Boswell
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Princeton Center for Eating Disorders, Penn Medicine, Princeton, NJ, USA
| | - Ralitza Gueorguieva
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
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13
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Mestre-Bach G, Potenza MN. Potential Biological Markers and Treatment Implications for Binge Eating Disorder and Behavioral Addictions. Nutrients 2023; 15:827. [PMID: 36839185 PMCID: PMC9962023 DOI: 10.3390/nu15040827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 02/04/2023] [Indexed: 02/08/2023] Open
Abstract
The reward system is highly relevant to behavioral addictions such as gambling disorder (GD), internet gaming disorder (IGD), and food addiction/binge eating disorder (FA/BED). Among other brain regions, the ventral striatum (VS) has been implicated in reward processing. The main objective of the present state-of-the-art review was to explore in depth the specific role of the VS in GD, IGD and FA/BED, understanding it as a possible biomarker of these conditions. Studies analyzing brain changes following interventions for these disorders, and especially those that had explored possible treatment-related changes in VS, are discussed. More evidence is needed on how existing treatments (both pharmacological and psychobehavioral) for behavioral addictions affect the activation of the VS and related circuitry.
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Affiliation(s)
- Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, 26006 Logroño, Spain
| | - Marc N. Potenza
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT 06510, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06510, USA
- Yale Child Study Center, School of Medicine, Yale University, New Haven, CT 06510, USA
- Department of Neuroscience, School of Medicine, Yale University, New Haven, CT 06510, USA
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14
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Sena KD, Beierle JA, Richardson KT, Kantak KM, Bryant CD. Assessment of Binge-Like Eating of Unsweetened vs. Sweetened Chow Pellets in BALB/c Substrains. Front Behav Neurosci 2022; 16:944890. [PMID: 35910681 PMCID: PMC9337213 DOI: 10.3389/fnbeh.2022.944890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Binge eating disorder (BED) is defined as chronic episodes of consuming large amounts of food in less than 2 h. Binge eating disorder poses a serious public health problem, as it increases the risk of obesity, type II diabetes, and heart disease. Binge eating is a highly heritable trait; however, its genetic basis remains largely unexplored. We employed a mouse model for binge eating that focused on identifying heritable differences between inbred substrains in acute and escalated intake of sucrose-sweetened palatable food vs. unsweetened chow pellets in a limited, intermittent access paradigm. In the present study, we examined two genetically similar substrains of BALB/c mice for escalation in food consumption, incubation of craving after a no-food training period, and compulsive-like food consumption in an aversive context. BALB/cJ and BALB/cByJ mice showed comparable levels of acute and escalated consumption of palatable food across training trials. Surprisingly, BALB/cByJ mice also showed binge-like eating of the unsweetened chow pellets similar to the escalation in palatable food intake of both substrains. Finally, we replicated the well-documented decrease in anxiety-like behavior in BALB/cByJ mice in the light-dark conflict test that likely contributed to greater palatable food intake than BALB/cJ in the light arena. To summarize, BALB/cByJ mice show binge-like eating in the presence and absence of sucrose. Possible explanations for the lack of selectivity in binge-like eating across diets (e.g., novelty preference, taste) are discussed.
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Affiliation(s)
- Katherine D. Sena
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States
| | - Jacob A. Beierle
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States
| | - Kayla T. Richardson
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States
| | - Kathleen M. Kantak
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States
| | - Camron D. Bryant
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States
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15
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Aruta SF, Pruccoli J, Bandini N, Rucci P, Parmeggiani A. Specific Learning Disorders and Eating Disorders: an Italian retrospective study. Ital J Pediatr 2022; 48:96. [PMID: 35701832 PMCID: PMC9195414 DOI: 10.1186/s13052-022-01289-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although Anorexia Nervosa (AN) patients show dysfunctional behaviour in information processing, visual and verbal memory performance, and different cognitive fields, regardless of their BMI, the literature on the correlations between Eating Disorders (ED) and Neurodevelopmental Disorders (NDD) does not provide conclusive data. Rather than a consequence of the mental disorder, cognitive dysfunctions may be a risk factor for AN. METHODS Our retrospective study investigates the prevalence of Specific Learning Disorder (SLD) among patients with ED. We considered 262 patients being treated at the Emilia Romagna Feeding and Eating Disorders Outpatient Service in Bologna, Italy. We compared the results with the Italian reference values, according to the most recent data provided by the Italian Ministry of Education. RESULTS We found that 25 patients out of 262 (9.54%) presented a comorbid diagnosis of SLD. This SLD prevalence is higher than the Italian reference values (4.9% in the school year 2018/19, p < 0.001). Comorbidity with SLD was significantly more frequent in males. A diagnosis of SLD was not associated with a higher frequency of any specific ED diagnosis or with psychiatric comorbidity in general. Positive family history for SLD was not significantly associated with either a positive family history for ED or a diagnosis of SLD. CONCLUSIONS This is the first Italian study to investigate the prevalence of SLD in ED patients during childhood and adolescence. Our data support previous research documenting that neuropsychological deficit could lead to the development of ED.
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Affiliation(s)
- Salvatore Ferdinando Aruta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO di Neuropsichiatria dell'Età Pediatrica, Bologna, Italy.,Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Jacopo Pruccoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO di Neuropsichiatria dell'Età Pediatrica, Bologna, Italy.,Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Nicole Bandini
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Paola Rucci
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Antonia Parmeggiani
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell'Alimentazione in Età Evolutiva, UO di Neuropsichiatria dell'Età Pediatrica, Bologna, Italy. .,Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Via Massarenti 9, 40138, Bologna, Italy.
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16
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Heal DJ, Smith SL. Prospects for new drugs to treat binge-eating disorder: Insights from psychopathology and neuropharmacology. J Psychopharmacol 2022; 36:680-703. [PMID: 34318734 PMCID: PMC9150143 DOI: 10.1177/02698811211032475] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Binge-eating disorder (BED) is a common psychiatric condition with adverse psychological and metabolic consequences. Lisdexamfetamine (LDX) is the only approved BED drug treatment. New drugs to treat BED are urgently needed. METHODS A comprehensive review of published psychopathological, pharmacological and clinical findings. RESULTS The evidence supports the hypothesis that BED is an impulse control disorder with similarities to ADHD, including responsiveness to catecholaminergic drugs, for example LDX and dasotraline. The target product profile (TPP) of the ideal BED drug combines treating the psychopathological drivers of the disorder with an independent weight-loss effect. Drugs with proven efficacy in BED have a common pharmacology; they potentiate central noradrenergic and dopaminergic neurotransmission. Because of the overlap between pharmacotherapy in attention deficit hyperactivity disorder (ADHD) and BED, drug-candidates from diverse pharmacological classes, which have already failed in ADHD would also be predicted to fail if tested in BED. The failure in BED trials of drugs with diverse pharmacological mechanisms indicates many possible avenues for drug discovery can probably be discounted. CONCLUSIONS (1) The efficacy of drugs for BED is dependent on reducing its core psychopathologies of impulsivity, compulsivity and perseveration and by increasing cognitive control of eating. (2) The analysis revealed a large number of pharmacological mechanisms are unlikely to be productive in the search for effective new BED drugs. (3) The most promising areas for new treatments for BED are drugs, which augment noradrenergic and dopaminergic neurotransmission and/or those which are effective in ADHD.
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Affiliation(s)
- David J Heal
- David J Heal, DevelRx Ltd, BioCity, Nottingham, NG1 1GF, UK.
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17
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Volume and Connectivity Differences in Brain Networks Associated with Cognitive Constructs of Binge Eating. eNeuro 2022; 9:ENEURO.0080-21.2021. [PMID: 35064023 PMCID: PMC8856709 DOI: 10.1523/eneuro.0080-21.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 11/14/2021] [Accepted: 11/29/2021] [Indexed: 12/16/2022] Open
Abstract
Bulimia nervosa (BN) and binge eating disorder (BED) are characterized by episodes of eating large amounts of food while experiencing a loss of control. Recent studies suggest that the underlying causes of BN/BED consist of a complex system of environmental cues, atypical processing of food stimuli, altered behavioral responding, and structural/functional brain differences compared with healthy controls (HC). In this narrative review, we provide an integrative account of the brain networks associated with the three cognitive constructs most integral to BN and BED, namely increased reward sensitivity, decreased cognitive control, and altered negative affect and stress responding. We show altered activity in BED/BN within several brain networks, specifically in the striatum, insula, prefrontal cortex (PFC) and orbitofrontal cortex (OFC), and cingulate gyrus. Numerous key nodes in these networks also differ in volume and connectivity compared with HC. We provide suggestions for how this integration may guide future research into these brain networks and cognitive constructs.
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18
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Abstract
Anhedonia is frequently observed among individuals with eating disorders (ED), though its relevance to ED pathology and clinical outcomes remain poorly understood. This chapter will present the latest findings regarding anhedonia in ED, with the majority of data available for anorexia nervosa (AN) and bulimia nervosa (BN). We consider anhedonia from the mechanistic lens of altered reward processing, with attention given to subjective experience, neurotransmitter function, neural correlates, and cognitive performance corresponding to distinct components of reward (i.e., liking, wanting, and learning). Findings from animal models are also highlighted. The chapter concludes with a discussion of implications for treatment and future directions aimed at better understanding anhedonia in ED.
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Affiliation(s)
- Susan M Murray
- Department of Psychiatry, University of California San Diego, UCSD Eating Disorders Center for Treatment and Research, San Diego, CA, USA
| | - Carina S Brown
- Department of Psychiatry, University of California San Diego, UCSD Eating Disorders Center for Treatment and Research, San Diego, CA, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California San Diego, UCSD Eating Disorders Center for Treatment and Research, San Diego, CA, USA
| | - Christina E Wierenga
- Department of Psychiatry, University of California San Diego, UCSD Eating Disorders Center for Treatment and Research, San Diego, CA, USA.
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19
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Quansah Amissah R, Basha D, Bukhtiyarova O, Timofeeva E, Timofeev I. Neuronal activities during palatable food consumption in the reward system of binge-like eating female rats. Physiol Behav 2021; 242:113604. [PMID: 34563545 DOI: 10.1016/j.physbeh.2021.113604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/01/2022]
Abstract
Binge eating disorder (BED), characterized by bingeing episodes and compulsivity, is the most prevalent eating disorder; however, little is known about its neurobiological underpinnings. In humans, BED is associated with desensitization of the reward system, specifically, the medial prefrontal cortex (mPFC), nucleus accumbens (Acb), and ventral tegmental area (VTA). Additionally, BED patients feel relieved during bingeing, suggesting that bingeing helps to decrease the negative emotions they were feeling prior to the binge episode. However, the mechanisms that underlie this feeling of relief in BED patients have not been well investigated. To investigate neuronal activity before and during palatable food consumption in BED, we performed in vivo electrophysiological recordings in a binge-like eating rat model (bingeing, n = 12 and non-bingeing, n = 14) and analyzed the firing rate of neurons in the mPFC, Acb, and VTA before and during access to sucrose solution. We also investigated changes in the firing rate of neurons in these regions during and between active bingeing, which may underlie the feeling of relief in BED patients. We found that neuronal firing rates of mPFC and VTA neurons in bingeing rats were lower than those in non-bingeing rats before and during sucrose consumption. Palatable food consumption increased neuronal firing rates during and between active bingeing in bingeing rats. Our results suggest a desynchronization in the activity of reward system regions, specifically in the mPFC, in bingeing rats, which may also contribute to BED. These results are consistent with those of functional magnetic resonance imaging (fMRI) studies that reported decreased activity in the reward system in BED patients. We propose that increased neuronal activity in the mPFC, Acb, or VTA produces an antidepressant effect in rats, which may underlie the sense of relief patients express during bingeing episodes.
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Affiliation(s)
- Richard Quansah Amissah
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche CERVO, Université Laval, Québec, QC G1J2G3, Canada
| | - Diellor Basha
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche CERVO, Université Laval, Québec, QC G1J2G3, Canada
| | - Olga Bukhtiyarova
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche CERVO, Université Laval, Québec, QC G1J2G3, Canada
| | - Elena Timofeeva
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche CERVO, Université Laval, Québec, QC G1J2G3, Canada
| | - Igor Timofeev
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche CERVO, Université Laval, Québec, QC G1J2G3, Canada.
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20
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Carr MM, Wiedemann AA, Macdonald-Gagnon G, Potenza MN. Impulsivity and compulsivity in binge eating disorder: A systematic review of behavioral studies. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110318. [PMID: 33794320 PMCID: PMC8222068 DOI: 10.1016/j.pnpbp.2021.110318] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 01/15/2021] [Accepted: 03/25/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Binge eating disorder (BED) often includes impulsive and compulsive behaviors related to eating behavior and food. Impulsivity and compulsivity generally may contribute to the etiology and maintenance of multiple psychiatric disorders including BED. This review aimed to identify and synthesize available behavioral studies of impulsivity and compulsivity among individuals with BED. METHOD A systematic search was performed focusing on BED and specific facets of impulsivity (rapid response and choice) and compulsivity (set-shifting, cognitive flexibility, and/or habit learning). All case-control studies comparing adults with either full-threshold or subthreshold BED to individuals with normal weight, overweight/obesity, or other eating disorders (e.g., bulimia nervosa) were included. RESULTS Thirty-two studies representing 29 unique samples met inclusion criteria. Increased choice impulsivity was observed among individuals with BED relative to individuals with normal weight. There were mixed findings and/or a lack of available evidence regarding rapid response impulsivity and compulsivity. The presence of between-group differences was not dependent on sample characteristics (e.g., full or sub threshold BED diagnosis, or treatment-seeking status). Heterogeneity relating to covariates, task methodologies, and power limited conclusions. CONCLUSIONS Literature supports a postive association between choice impulsivity and BED. More research is needed to determine if individuals with BED demonstrate elevated levels of either rapid response impulsivity or types of compulsivity. Careful selection of covariates and consideration of task methodologies and power would aid future research.
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Affiliation(s)
- Meagan M Carr
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America
| | - Ashley A Wiedemann
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America
| | - Grace Macdonald-Gagnon
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America; Connecticut Mental Health Center, 34 Park St., New Haven, CT 06511, United States of America; Connecticut Council on Problem Gambling, 100 Great Meadow Rd, Wethersfield, CT 06109, United States of America; Child Study Center, Yale School of Medicine, 230 S Frontage Rd., New Haven, CT 06519, United States of America; Department of Neuroscience, Yale University, One Church Street, New Haven, CT 06510, United States of America.
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21
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Veit R, Schag K, Schopf E, Borutta M, Kreutzer J, Ehlis AC, Zipfel S, Giel KE, Preissl H, Kullmann S. Diminished prefrontal cortex activation in patients with binge eating disorder associates with trait impulsivity and improves after impulsivity-focused treatment based on a randomized controlled IMPULS trial. NEUROIMAGE-CLINICAL 2021; 30:102679. [PMID: 34215149 PMCID: PMC8102655 DOI: 10.1016/j.nicl.2021.102679] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 01/18/2023]
Abstract
Persons with binge eating disorder show increased impulsivity. We investigated cognitive control to food cues using fNIRS. Compared to healthy controls, binge eaters show weaker activation of the prefrontal cortex. After behavioral therapy, binge eaters increase prefrontal cortex activation.
Background Behavioral and cognitive control are vital for healthy eating behavior. Patients with binge eating disorder (BED) suffer under recurrent binge eating episodes accompanied by subjective loss of control that results, among other factors, from increased impulsivity. Methods In the current study, we investigated the frontal network using functional near-infrared spectroscopy (fNIRS) during a food specific go/nogo task to assess response inhibition in 24 patients with BED (BMI range 22.6–59.7 kg/m2) compared to 12 healthy controls (HC) (BMI range 20.9–27 kg/m2). Patients with BED were invited to undergo fNIRS measurements before an impulsivity-focused cognitive behavioral group treatment, directly after this treatment and 3 months afterwards. As this was a planned subgroup analysis of the randomized controlled IMPULS trial, patients with BED were randomized either to the treatment group (n = 14) or to a control group (n = 10). The treatment group received 8 weekly sessions of the IMPULS treatment. Results We found a significant response inhibition effect (nogo minus go), in terms of an increased oxygenated hemoglobin response in the bilateral prefrontal cortex in both groups. The greatest response was observed when participants were instructed to go for healthy and withhold their response to unhealthy high caloric food cues. The healthy nogo condition failed to show a significant prefrontal inhibitory response, which was probably related to the task design, as the condition was considered more demanding. BED patients, especially those with higher trait impulsivity, showed a weaker activation of the prefrontal cortex during response inhibition, predominantly in the right hemisphere. Interestingly, three months after the treatment, patients of the treatment group increased their right prefrontal cortex activity during response inhibition. Likewise, increased prefrontal cortex activation correlated with decreased trait impulsivity after treatment. Conclusions Our results suggest that patients with BED have limited resources to activate the prefrontal cortex when asked to inhibit a reaction onto food-specific stimuli. However, this effect could be partly driven by differences in BMI between the HC and BED group. Cognitive-behavioral therapy targeting impulsive eating behavior may improve prefrontal cortex recruitment during response inhibition.
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Affiliation(s)
- Ralf Veit
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany
| | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Center of Excellence for Eating Disorders Tübingen (COMET), Tübingen, Germany
| | - Eric Schopf
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Maike Borutta
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany
| | - Jann Kreutzer
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Center of Excellence for Eating Disorders Tübingen (COMET), Tübingen, Germany
| | - Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Center of Excellence for Eating Disorders Tübingen (COMET), Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany; Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Institute of Pharmaceutical Sciences, Department of Pharmacy and Biochemistry, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany.
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22
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Food-related impulsivity assessed by longitudinal laboratory tasks is reduced in patients with binge eating disorder in a randomized controlled trial. Sci Rep 2021; 11:8225. [PMID: 33859214 PMCID: PMC8050257 DOI: 10.1038/s41598-021-87231-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 03/23/2021] [Indexed: 01/12/2023] Open
Abstract
Food-related impulsivity, i.e. a food-related attentional bias proposed to be due to increased reward sensitivity and diminished inhibitory control, has been cross-sectionally associated with binge eating disorder. To analyze changes in food-related impulsivity, we implemented longitudinal analyses of objective laboratory tasks in a randomized controlled trial called IMPULS. Patients who attended an impulsivity-focused group intervention (IG N = 31) and control patients who did not take part in the intervention (CG N = 25) were compared before (T0) and after the intervention period (T1) and at three months follow-up (T2). Patients’ impulsive gaze behavior towards food vs. neutral stimuli was measured in two eye tracking paradigms, one addressing reward sensitivity and another addressing inhibitory control. Initial fixations of food vs. neutral stimuli were increased at T0 (IG: p = .014, CG: p = .001), but not at T1 and T2 in IG (T1: p = .178, T2: p = .203) and in CG after Bonferroni correction only at T2 (T1: p = .031, T2: p = .002). Patients from IG increased dwell time on neutral stimuli at T1 contrary to patients from CG (p = .016) and rated the presented food stimuli as less positive (e.g. pleasantness p < .001 at T1 and T2). A possible explanation for this observation is reduced reward sensitivity, which implies a short-term treatment effect. Both groups showed improvement in inhibiting eye movements towards food and neutral stimuli over time (i.e. first saccade errors overall p < .001, second saccade errors overall p < .003). This could indicate increased inhibitory control due to training effects from the study paradigm. The results suggest that food-related impulsivity represents an underlying mechanism of BED and that it is modifiable by cognitive behavioral interventions.
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23
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Haynos AF, Camchong J, Pearson CM, Lavender JM, Mueller BA, Peterson CB, Specker S, Raymond N, Lim KO. Resting State Hypoconnectivity of Reward Networks in Binge Eating Disorder. Cereb Cortex 2021; 31:2494-2504. [PMID: 33415334 DOI: 10.1093/cercor/bhaa369] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022] Open
Abstract
The clinical presentation of binge eating disorder (BED) and data emerging from task-based functional neuroimaging research suggests that this disorder may be associated with alterations in reward processing. However, there is a dearth of research investigating the functional organization of brain networks that mediate reward in BED. To address this gap, 27 adults with BED and 21 weight-matched healthy controls (WMC) completed a multimodel assessment consisting of a resting functional magnetic resonance imaging scan, behavioral tasks measuring reward-based decision-making (i.e., delay discounting and reversal learning), and self-report assessing clinical symptoms. A seed-based approach was employed to examine the resting state functional connectivity (rsFC) of the striatum (nucleus accumbens [NAcc] and ventral and dorsal caudate), a collection of regions implicated in reward processing. Compared with WMC, the BED group exhibited lower rsFC of striatal seeds, with frontal regions mediating executive functioning (e.g., superior frontal gyrus [SFG]) and posterior, parietal, and temporal regions implicated in emotional processing. Lower NAcc-SFG rsFC was associated with more difficulties with reversal learning and binge eating frequency in the BED group. Results suggest that hypoconnectivity of striatal networks that integrate self-regulation and reward processing may promote the clinical phenomenology of BED. Interventions for BED may benefit from targeting these circuit-based disturbances.
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Affiliation(s)
- Ann F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Jazmin Camchong
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Carolyn M Pearson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, 20814 MD, USA.,Metis Foundation, San Antonio, 78205 TX, USA
| | - Bryon A Mueller
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Sheila Specker
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Nancy Raymond
- Department of Psychiatry, University of Wisconsin, Madison, 53719 WI, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA.,Minneapolis VA Health Care System, Minneapolis, 55417 MN, USA
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24
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Juarascio AS, Felonis CR, Manasse SM, Srivastava P, Boyajian L, Forman EM, Zhang F. The project COMPASS protocol: Optimizing mindfulness and acceptance-based behavioral treatment for binge-eating spectrum disorders. Int J Eat Disord 2021; 54:451-458. [PMID: 33285016 PMCID: PMC8101007 DOI: 10.1002/eat.23426] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/09/2020] [Accepted: 11/18/2020] [Indexed: 12/30/2022]
Abstract
Outcomes from cognitive behavioral therapy for binge-eating spectrum disorders are suboptimal, possibly due in part to deficits in self-regulation (i.e., the ability to control behavior in pursuit of long-term goals despite internal challenges). Mindfulness and acceptance-based treatments (MABTs) integrate behavioral treatment with psychological strategies designed to enhance self-regulation, yet little is known about how and for whom they are effective. The present study will utilize the multiphase optimization strategy to identify which of four MABT components (mindful awareness, distress tolerance, emotion modulation, values-based decision making) to include in a fully powered clinical trial. Participants (n = 256) will be randomized to 16 sessions in one of 16 conditions, each a different combination of MABT components being included or excluded from a base behavioral treatment. Our primary aim is to evaluate each component's independent efficacy on disordered eating symptoms. Our secondary aims are to confirm each component's target engagement (i.e., whether each component improves the targeted variable and outcomes), and test that each component's efficacy is moderated by baseline weaknesses in the same component (e.g., that participants with poor distress tolerance at baseline benefit most from the distress tolerance component). Our exploratory aim is to quantify the component interaction effects.
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Affiliation(s)
- Adrienne S. Juarascio
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania
| | - Christina R. Felonis
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania
| | - Stephanie M. Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania
| | - Paakhi Srivastava
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania
| | - Laura Boyajian
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania
| | - Evan M. Forman
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania
| | - Fengqing Zhang
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
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25
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Wypych M, Potenza MN. Impaired Learning From Errors and Punishments and Maladaptive Avoidance-General Mechanisms Underlying Self-Regulation Disorders? Front Psychiatry 2021; 11:609874. [PMID: 33574773 PMCID: PMC7870682 DOI: 10.3389/fpsyt.2020.609874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/30/2020] [Indexed: 11/13/2022] Open
Abstract
Self-regulation (SR) is an important human function that relates to quality of life in multiple domains including mental health. Previous studies have found important correlates of low SR including impulsivity and poor emotional regulation; however, underpinnings of low SR are incompletely understood. Individuals low in SR frequently engage in maladaptive behaviors (substance abuse, procrastination, etc.) despite negative consequences. This phenomenon suggests that impaired learning from errors and punishments may be important mechanisms underlying low SR. Consistently, previous studies observed impaired error processing in a wide spectrum of individuals with low SR and impaired learning from errors and punishments in SR-related disorders. We also note a possible role for poor emotional regulation and refer to concepts suggesting that engaging in maladaptive behaviors may serve as short term emotion regulation strategies aimed at avoiding or alleviating negative affect. We speculate on transdiagnostic factors underlying poor SR. We propose that impaired error processing (possibly related to striatal functioning) may prevent subjects with low SR from learning from errors and punishments and thus learning better SR skills or tendencies. Additionally, impaired coping in emotionally challenging situations, possibly related to prefrontal-cortical functioning, may lead to maladaptive avoidance. Moreover, maladaptive behaviors may be reinforced by the temporary decreases in negative affect and rewarding values of behaviors. Given existing knowledge gaps, we call for more extensive research and describe possible directions and challenges for future studies.
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Affiliation(s)
- Marek Wypych
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology of Polish Academy of Sciences, Warsaw, Poland
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Department of Neuroscience, Yale University, New Haven, CT, United States
- Connecticut Mental Health Center, New Haven, CT, United States
- Connecticut Council on Problem Gambling, Wethersfield, CT, United States
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26
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Boswell RG, Potenza MN, Grilo CM. The Neurobiology of Binge-eating Disorder Compared with Obesity: Implications for Differential Therapeutics. Clin Ther 2021; 43:50-69. [PMID: 33257092 PMCID: PMC7902428 DOI: 10.1016/j.clinthera.2020.10.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Emerging work indicates divergence in the neurobiologies of binge-eating disorder (BED) and obesity despite their frequent co-occurrence. This review highlights specific distinguishing aspects of BED, including elevated impulsivity and compulsivity possibly involving the mesocorticolimbic dopamine system, and discusses implications for differential therapeutics for BED. METHODS This narrative review describes epidemiologic, clinical, genetic, and preclinical differences between BED and obesity. Subsequently, this review discusses human neuroimaging work reporting differences in executive functioning, reward processing, and emotion reactivity in BED compared with obesity. Finally, on the basis of the neurobiology of BED, this review identifies existing and new therapeutic agents that may be most promising given their specific targets based on putative mechanisms of action relevant specifically to BED. FINDINGS BED is characterized by elevated impulsivity and compulsivity compared with obesity, which is reflected in divergent neurobiological characteristics and effective pharmacotherapies. Therapeutic agents that influence both reward and executive function systems may be especially effective for BED. IMPLICATIONS Greater attention to impulsivity/compulsivity-related, reward-related, and emotion reactivity-related processes may enhance conceptualization and treatment approaches for patients with BED. Consideration of these distinguishing characteristics and processes could have implications for more targeted pharmacologic treatment research and interventions.
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Affiliation(s)
- Rebecca G Boswell
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA.
| | - Marc N Potenza
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Yale School of Medicine, Child Study Center, New Haven, CT, USA; Yale University, Department of Neuroscience, New Haven, CT, USA
| | - Carlos M Grilo
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA; Yale University, Department of Psychology, New Haven, CT, USA
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27
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Hildebrandt BA, Ahmari SE. Breaking It Down: Investigation of Binge Eating Components in Animal Models to Enhance Translation. Front Psychiatry 2021; 12:728535. [PMID: 34484010 PMCID: PMC8414642 DOI: 10.3389/fpsyt.2021.728535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/19/2021] [Indexed: 12/28/2022] Open
Abstract
Binge eating (BE) is a core eating disorder behavior that is present across nearly all eating disorder diagnoses (e. g., bulimia nervosa, binge eating disorder, anorexia nervosa binge/purge subtype), and is also widely present in the general population. Despite the prevalence of BE, limited treatment options exist and there are often high rates of relapse after treatment. There is evidence showing that genetic factors contribute to the heritability of BE and support for biological contributions to BE. However, more work is needed to fully understand neurobiological mechanisms underlying BE. One approach to target this problem is to separate BE into its distinct clinical components that can be more easily modeled using pre-clinical approaches. To date, a variety of animal models for BE have been used in pre-clinical studies; but there have been challenges translating this work to human BE. Here, we review these pre-clinical approaches by breaking them down into three clinically-significant component parts (1) consumption of a large amount of food; (2) food consumption within a short period of time; and (3) loss of control over eating. We propose that this rubric identifies the most frequently used and effective ways to model components of BE behavior using pre-clinical approaches with the strongest clinical relevance. Finally, we discuss how current pre-clinical models have been integrated with techniques using targeted neurobiological approaches and propose ways to improve translation of pre-clinical work to human investigations of BE that could enhance our understanding of BE behavior.
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Affiliation(s)
- Britny A Hildebrandt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Susanne E Ahmari
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
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28
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Quansah Amissah R, Chometton S, Calvez J, Guèvremont G, Timofeeva E, Timofeev I. Differential Expression of DeltaFosB in Reward Processing Regions Between Binge Eating Prone and Resistant Female Rats. Front Syst Neurosci 2020; 14:562154. [PMID: 33177996 PMCID: PMC7596303 DOI: 10.3389/fnsys.2020.562154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/10/2020] [Indexed: 12/24/2022] Open
Abstract
Binge eating (BE) is characterized by the consumption of large amounts of palatable food in a discrete period and compulsivity. Even though BE is a common symptom in bulimia nervosa (BN), binge eating disorder (BED), and some cases of other specified feeding or eating disorders, little is known about its pathophysiology. We aimed to identify brain regions and neuron subtypes implicated in the development of binge-like eating in a female rat model. We separated rats into binge eating prone (BEP) and binge eating resistant (BER) phenotypes based on the amount of sucrose they consumed following foot-shock stress. We quantified deltaFosB (ΔFosB) expression, a stably expressed Fos family member, in different brain regions involved in reward, taste, or stress processing, to assess their involvement in the development of the phenotype. The number of ΔFosB-expressing neurons was: (1) higher in BEP than BER rats in reward processing areas [medial prefrontal cortex (mPFC), nucleus accumbens (Acb), and ventral tegmental area (VTA)]; (2) similar in taste processing areas [insular cortex, IC and parabrachial nucleus (PBN)]; and (3) higher in the paraventricular nucleus of BEP than BER rats, but not different in the locus coeruleus (LC), which are stress processing structures. To study subtypes of ΔFosB-expressing neurons in the reward system, we performed in situ hybridization for glutamate decarboxylase 65 and tyrosine hydroxylase (TH) mRNA after ΔFosB immunohistochemistry. In the mPFC and Acb, the proportions of γ-aminobutyric acidergic (GABAergic) and non-GABAergic ΔFosB-expressing neurons were similar in BER and BEP rats. In the VTA, while the proportion of dopaminergic ΔFosB-expressing neurons was similar in both phenotypes, the proportion of GABAergic ΔFosB-expressing neurons was higher in BER than BEP rats. Our results suggest that reward processing brain regions, particularly the VTA, are important for the development of binge-like eating.
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Affiliation(s)
- Richard Quansah Amissah
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche de L'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada.,Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche du CERVO, Université Laval, Québec, QC, Canada
| | - Sandrine Chometton
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche de L'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Juliane Calvez
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche de L'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Genevieve Guèvremont
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche de L'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Elena Timofeeva
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche de L'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Igor Timofeev
- Faculté de Médecine, Département de Psychiatrie et de Neurosciences, Centre de Recherche du CERVO, Université Laval, Québec, QC, Canada
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29
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Estella NM, Sanches LG, Maranhão MF, Hoexter MQ, Schmidt U, Campbell IC, Amaro E, Claudino AM. Brain white matter microstructure in obese women with binge eating disorder. EUROPEAN EATING DISORDERS REVIEW 2020; 28:525-535. [PMID: 32705772 DOI: 10.1002/erv.2758] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 05/09/2020] [Accepted: 06/13/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Research on potential brain circuit abnormalities in binge eating disorder (BED) is limited. Here, we assess white matter (WM) microstructure in obese women with BED. METHOD Diffusion tensor imaging data were acquired, and tract-based spatial statistics used to examine WM in women with BED who were obese (n = 17) compared to normal-weight (NWC) (n = 17) and to women who were obese (OBC) (n = 13). Body mass index (BMI) was a covariate in the analyses. RESULTS The BED group (vs. NWC) had greater axial diffusion (AD) in the forceps minor, anterior thalamic radiation, superior and inferior longitudinal fasciculus, that is, in pathways connecting fronto-limbic regions. Microstructures differences in AD between the BED and OBC groups were seen in fronto-limbic pathways extending to temporoparietal pathways. The BED (vs. OBC) group had greater fractional anisotropy in the forceps minor and greater AD in the superior longitudinal fasciculus, cingulate gyrus, and corpus callosum, consistent with fronto-tempoparietal pathways. CONCLUSION Women with BED show WM alterations in AD in fronto-limbic and parietal pathways that are important in decision-making processes. As BMI was a covariate in the analyses, alterations in BED may be part of the pathology, but whether they are a cause or effect of illness is unclear.
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Affiliation(s)
- Nara Mendes Estella
- Eating Disorder Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Mara Fernandes Maranhão
- Eating Disorder Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marcelo Queiroz Hoexter
- Eating Disorder Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, King's College London (KCL), London, UK
| | - Iain C Campbell
- Institute of Psychiatry, Psychology and Neuroscience, King's College London (KCL), London, UK
| | - Edson Amaro
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Angélica Medeiros Claudino
- Eating Disorder Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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30
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Horn SR, Fisher PA, Pfeifer JH, Allen NB, Berkman ET. Levers and barriers to success in the use of translational neuroscience for the prevention and treatment of mental health and promotion of well-being across the lifespan. JOURNAL OF ABNORMAL PSYCHOLOGY 2020; 129:38-48. [PMID: 31868386 DOI: 10.1037/abn0000465] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Neuroscientific tools and approaches such as neuroimaging, measures of neuroendocrine and psychoneuroimmune activity, and peripheral physiology are increasingly used in clinical science and health psychology research. We define translational neuroscience (TN) as a systematic, theory-driven approach that aims to develop and leverage basic and clinical neuroscientific knowledge to aid the development and optimization of clinical and public health interventions. There is considerable potential across basic and clinical science fields for this approach to provide insights into mental and physical health pathology that had previously been inaccessible. For example, TN might hold the potential to enhance diagnostic specificity, better recognize increased vulnerability in at-risk populations, and augment intervention efficacy. Despite this potential, there has been limited consideration of the advantages and limitations of such an approach. In this article, we articulate extant challenges in defining TN and propose a unifying conceptualization. We illustrate how TN can inform the application of neuroscientific tools to realistically guide clinical research and inform intervention design. We outline specific leverage points of the TN approach and barriers to progress. Ten principles of TN are presented to guide and shape the emerging field. We close by articulating ongoing issues facing TN research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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31
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Schag K, Rennhak SK, Leehr EJ, Skoda EM, Becker S, Bethge W, Martus P, Zipfel S, Giel KE. IMPULS: Impulsivity-Focused Group Intervention to Reduce Binge Eating Episodes in Patients with Binge Eating Disorder - A Randomised Controlled Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 88:141-153. [PMID: 31108488 DOI: 10.1159/000499696] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 03/19/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Impulsivity is a risk factor for binge eating disorder, and binge eating (BE) equates to impulsive eating behaviour. Hence, we developed IMPULS, a cognitive behavioural group intervention focusing on impulsive eating. METHODS We randomised 41 patients to the IMPULS group and 39 to the control group. The IMPULS group participated in the IMPULS treatment, while both groups completed weekly self-observations. We compared both groups concerning BE episodes in the past 4 weeks at the end of treatment (primary outcome). As secondary outcomes, we investigated eating pathology, depression, general impulsivity and body mass index (BMI) at the end of treatment and in a 3-month follow-up. RESULTS The primary outcome failed, because BE episodes in the past 4 weeks were reduced in both groups at the end of treatment. At follow-up, the IMPULS group showed further improvement, contrary to the control group. The BE days/episodes in the 2 months before were overall reduced in both groups. Eating pathology was reduced in the IMPULS group at the end of treatment and partly in both groups at the follow-up. Depression was only reduced in the IMPULS group. General impulsivity and BMI did not change. CONCLUSIONS The IMPULS study has a negative primary outcome. However, secondary outcomes indicate that the IMPULS treatment might be promising, as BE, eating pathology and depression were reduced in the IMPULS group. The initially reduced BE in the control group might represent a short-term effect from the self-observations. General impulsivity and BMI might need a longer time or more intensive treatment to change.
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Affiliation(s)
- Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany,
| | - Sina K Rennhak
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Elisabeth J Leehr
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Eva-Maria Skoda
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, LVR-Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Sandra Becker
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Wolfgang Bethge
- Centre for Clinical Studies, Medical University Hospital Tübingen, Tübingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, Medical University Hospital Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
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32
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Bupropion increases activation in nucleus accumbens during anticipation of monetary reward. Psychopharmacology (Berl) 2019; 236:3655-3665. [PMID: 31342097 DOI: 10.1007/s00213-019-05337-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/16/2019] [Indexed: 12/21/2022]
Abstract
RATIONALE Bupropion is used for major depressive disorder, smoking cessation aid, and obesity. It blocks reuptake of dopamine and noradrenaline and antagonizes nicotinic acetylcholine receptor. Animal studies showed that bupropion enhanced rewarding effects. In addition, bupropion has the potential to treat patients with reward processing dysfunction. However, neural substrates underlying the bupropion effects on reward function in human subjects are not fully understood. OBJECTIVES We investigated single-dose administration of bupropion on neural response of reward anticipation in healthy subjects using a monetary incentive delay (MID) task by functional magnetic resonance imaging (fMRI), especially focusing on nucleus accumbens (NAc) activity to non-drug reward stimuli under bupropion treatment. METHODS We used a randomized placebo-controlled within-subject crossover design. Fifteen healthy adults participated in two series of an fMRI study, taking either placebo or bupropion. The participants performed the MID task during the fMRI scanning. The effects of bupropion on behavioral performance and blood oxygenation level-dependent (BOLD) signal in NAc during anticipation of monetary gain were analyzed. RESULTS We found that bupropion significantly increased BOLD responses in NAc during monetary reward anticipation. The increased BOLD responses in NAc were observed with both low and high reward incentive cues. There was no significant difference between placebo and bupropion in behavioral performance. CONCLUSIONS Our findings provide support for the notion that bupropion enhances non-drug rewarding effects, suggesting a possible mechanism underlying therapeutic effects for patients with motivational deficit.
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Anastasio NC, Stutz SJ, Price AE, Davis-Reyes BD, Sholler DJ, Ferguson SM, Neumaier JF, Moeller FG, Hommel JD, Cunningham KA. Convergent neural connectivity in motor impulsivity and high-fat food binge-like eating in male Sprague-Dawley rats. Neuropsychopharmacology 2019; 44:1752-1761. [PMID: 31003231 PMCID: PMC6785029 DOI: 10.1038/s41386-019-0394-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/05/2019] [Accepted: 04/13/2019] [Indexed: 12/27/2022]
Abstract
Food intake is essential for survival, but maladaptive patterns of intake, possibly encoded by a preexisting vulnerability coupled with the influence of environmental variables, can modify the reward value of food. Impulsivity, a predisposition toward rapid unplanned reactions to stimuli, is one of the multifaceted determinants underlying the etiology of dysregulated eating and its evolving pathogenesis. The medial prefrontal cortex (mPFC) is a major neural director of reward-driven behavior and impulsivity. Compromised signaling between the mPFC and nucleus accumbens shell (NAcSh) is thought to underlie the cognitive inability to withhold prepotent responses (motor impulsivity) and binge intake of high-fat food (HFF) seen in binge eating disorder. To explore the relationship between motor impulsivity and binge-like eating in rodents, we identified high (HI) and low impulsive (LI) rats in the 1-choice serial reaction time task and employed a rat model of binge-like eating behavior. HFF binge rats consumed significantly greater calories relative to control rats maintained on continual access to standard food or HFF. HI rats repeatedly exhibited significantly higher bingeing on HFF vs. LI rats. Next, we employed dual viral vector chemogenetic technology which allows for the targeted and isolated modulation of ventral mPFC (vmPFC) neurons that project to the NAcSh. Chemogenetic activation of the vmPFC to NAcSh pathway significantly suppressed motor impulsivity and binge-like intake for high-fat food. Thus, inherent motor impulsivity and binge-like eating are linked and the vmPFC to NAcSh pathway serves as a 'brake' over both behaviors.
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Affiliation(s)
- Noelle C. Anastasio
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Sonja J. Stutz
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Amanda E. Price
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Brionna D. Davis-Reyes
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Dennis J. Sholler
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Susan M. Ferguson
- 0000 0000 9026 4165grid.240741.4Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA USA ,0000000122986657grid.34477.33Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | - John F. Neumaier
- 0000000122986657grid.34477.33Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | - F. Gerard Moeller
- 0000 0004 0458 8737grid.224260.0Department of Psychiatry and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA USA
| | - Jonathan D. Hommel
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Kathryn A. Cunningham
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
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Fleck DE, Eliassen JC, Guerdjikova AI, Mori N, Williams S, Blom TJ, Beckwith T, Tallman MJ, Adler CM, DelBello MP, Strakowski SM, McElroy SL. Effect of lisdexamfetamine on emotional network brain dysfunction in binge eating disorder. Psychiatry Res Neuroimaging 2019; 286:53-59. [PMID: 30903953 DOI: 10.1016/j.pscychresns.2019.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 01/18/2019] [Accepted: 03/04/2019] [Indexed: 10/27/2022]
Abstract
We examined the effects of lisdexamfetamine (LDX) treatment on ventral prefrontal cortex (VPFC) and striatal brain activation in binge eating disorder (BED). We hypothesized that participants with BED have an abnormal brain response to palatable food cues, and that VPFC and striatal regions would respond to such cues after LDX treatment. Twenty women with moderate to severe BED consented to a 12-week, open-label trial of LDX with fMRI before and after treatment. Twenty obese women without BED served as healthy controls and received one fMRI. LDX was started at 30 mg/d with a target of 70 mg/d at week 12. At baseline, women with BED showed greater activation in ventrolateral prefrontal cortex (VLPFC), striatum, and globus pallidus to food pictures and brain activation to food pictures predicted clinical outcome at 12 weeks. After 12 weeks of LDX treatment, BED women showed significant reductions in globus pallidus activation. Reductions in ventromedial prefrontal cortex (VMPFC) and thalamus activation specifically correlated with binge eating and obsessive-compulsive symptom reductions, respectively. Results suggest that BED is characterized by an abnormally large VPFC-subcortical brain response to palatable foods that LDX treatment helps modify. Moreover, VPFC-subcortical activation at baseline is a potential biomarker of LDX response.
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Affiliation(s)
- David E Fleck
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA.
| | - James C Eliassen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA
| | - Anna I Guerdjikova
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA; Lindner Center of Hope, Mason OH, USA
| | - Nicole Mori
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA; Lindner Center of Hope, Mason OH, USA
| | | | - Thomas J Blom
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA; Lindner Center of Hope, Mason OH, USA
| | - Travis Beckwith
- Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Maxwell J Tallman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA
| | - Caleb M Adler
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA
| | - Stephen M Strakowski
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA
| | - Susan L McElroy
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0559, USA; Lindner Center of Hope, Mason OH, USA
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Relationships between eating disorder-specific and transdiagnostic risk factors for binge eating: An integrative moderated mediation model of emotion regulation, anticipatory reward, and expectancy. Eat Behav 2018; 31:131-136. [PMID: 30359908 PMCID: PMC6320675 DOI: 10.1016/j.eatbeh.2018.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 09/29/2018] [Accepted: 10/14/2018] [Indexed: 11/22/2022]
Abstract
Although relationships between negative affect, emotion dysregulation, and binge eating have been well-established, the mechanisms and individual risk factors that account for this relationship have yet to be elucidated. In addition to emotion dysregulation, altered reward functioning and negative affect eating expectancies (i.e., the expectancy that eating will relieve negative affect) are factors that have been previously linked to binge eating, though theoretical frameworks have not provided an integrated conceptualization of relationships between these domains. Therefore, the present study examined an integrative moderated mediation model among a sample of 101 adults with self-reported eating disorder (ED) symptoms who completed a battery of online questionnaires. Results supported the hypothesized model, which demonstrated that eating expectancies mediated the relationship between emotion dysregulation and binge eating frequency, and there was a positive association between emotion dysregulation and eating expectancies among individuals high in anticipatory reward. These findings provide preliminary support for an integrated approach to understanding transdiagnostic and ED-specific risk factors that potentiate binge eating.
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Naish KR, Laliberte M, MacKillop J, Balodis IM. Systematic review of the effects of acute stress in binge eating disorder. Eur J Neurosci 2018; 50:2415-2429. [DOI: 10.1111/ejn.14110] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/03/2018] [Accepted: 08/07/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Katherine R. Naish
- Peter Boris Centre for Addictions Research Department of Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
| | - Michele Laliberte
- Peter Boris Centre for Addictions Research Department of Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
- Eating Disorders Clinic St. Joseph's Healthcare Hamilton Hamilton ON Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research Michael G. DeGroote School of Medicine McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research Department of Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research Michael G. DeGroote School of Medicine McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
| | - Iris M. Balodis
- Peter Boris Centre for Addictions Research Department of Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research Michael G. DeGroote School of Medicine McMaster University and St. Joseph's Healthcare Hamilton Hamilton ON Canada
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Atalayer D. Dürtüsellik ve Aşırı Yeme Arasındaki İlişki: Psikolojik ve Nörobiyolojik Yaklaşımlar. PSIKIYATRIDE GUNCEL YAKLASIMLAR 2018. [DOI: 10.18863/pgy.358090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Oldham S, Murawski C, Fornito A, Youssef G, Yücel M, Lorenzetti V. The anticipation and outcome phases of reward and loss processing: A neuroimaging meta-analysis of the monetary incentive delay task. Hum Brain Mapp 2018; 39:3398-3418. [PMID: 29696725 PMCID: PMC6055646 DOI: 10.1002/hbm.24184] [Citation(s) in RCA: 261] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/28/2018] [Accepted: 04/09/2018] [Indexed: 12/19/2022] Open
Abstract
The processing of rewards and losses are crucial to everyday functioning. Considerable interest has been attached to investigating the anticipation and outcome phases of reward and loss processing, but results to date have been inconsistent. It is unclear if anticipation and outcome of a reward or loss recruit similar or distinct brain regions. In particular, while the striatum has widely been found to be active when anticipating a reward, whether it activates in response to the anticipation of losses as well remains ambiguous. Furthermore, concerning the orbitofrontal/ventromedial prefrontal regions, activation is often observed during reward receipt. However, it is unclear if this area is active during reward anticipation as well. We ran an Activation Likelihood Estimation meta‐analysis of 50 fMRI studies, which used the Monetary Incentive Delay Task (MIDT), to identify which brain regions are implicated in the anticipation of rewards, anticipation of losses, and the receipt of reward. Anticipating rewards and losses recruits overlapping areas including the striatum, insula, amygdala and thalamus, suggesting that a generalised neural system initiates motivational processes independent of valence. The orbitofrontal/ventromedial prefrontal regions were recruited only during the reward outcome, likely representing the value of the reward received. Our findings help to clarify the neural substrates of the different phases of reward and loss processing, and advance neurobiological models of these processes.
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Affiliation(s)
- Stuart Oldham
- Brain and Mental Health Research Hub, School of Psychological Sciences and the Monash Institute of Cognitive and Clinical Neurosciences (MICCN), Monash University, Clayton, Victoria, Australia
| | - Carsten Murawski
- Department of Finance, The University of Melbourne, Parkville, Victoria, Australia
| | - Alex Fornito
- Brain and Mental Health Research Hub, School of Psychological Sciences and the Monash Institute of Cognitive and Clinical Neurosciences (MICCN), Monash University, Clayton, Victoria, Australia
| | - George Youssef
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
| | - Murat Yücel
- Brain and Mental Health Research Hub, School of Psychological Sciences and the Monash Institute of Cognitive and Clinical Neurosciences (MICCN), Monash University, Clayton, Victoria, Australia
| | - Valentina Lorenzetti
- Brain and Mental Health Research Hub, School of Psychological Sciences and the Monash Institute of Cognitive and Clinical Neurosciences (MICCN), Monash University, Clayton, Victoria, Australia.,School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia.,Department of Psychological Sciences, Institute of Psychology Health and Society, University of Liverpool, Liverpool, United Kingdom
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39
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Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment. Clin Psychol Rev 2018; 60:32-44. [DOI: 10.1016/j.cpr.2017.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 02/08/2023]
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Steward T, Menchón JM, Jiménez-Murcia S, Soriano-Mas C, Fernández-Aranda F. Neural Network Alterations Across Eating Disorders: A Narrative Review of fMRI Studies. Curr Neuropharmacol 2018; 16:1150-1163. [PMID: 29046154 PMCID: PMC6187750 DOI: 10.2174/1570159x15666171017111532] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 08/18/2017] [Accepted: 10/10/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Functional magnetic resonance imaging (fMRI) has provided insight on how neural abnormalities are related to the symptomatology of the eating disorders (EDs): anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). More specifically, an increasingly growing number of brain imaging studies has shed light on how functionally connected brain networks contribute not only to disturbed eating behavior, but also to transdiagnostic alterations in body/interoceptive perception, reward processing and executive functioning. METHODS This narrative review aims to summarize recent advances in fMRI studies of patients with EDs by highlighting studies investigating network alterations that are shared across EDs. RESULTS AND CONCLUSION Findings on reward processing in both AN and BN patients point to the presence of altered sensitivity to salient food stimuli in striatal regions and to the possibility of hypothalamic inputs being overridden by top-down emotional-cognitive control regions. Additionally, innovative new lines of research suggest that increased activations in fronto-striatal circuits are strongly associated with the maintenance of restrictive eating habits in AN patients. Although significantly fewer studies have been carried out in patients with BN and BED, aberrant neural responses to both food cues and anticipated food receipt appear to occur in these populations. These altered responses, coupled with diminished recruitment of prefrontal cognitive control circuitry, are believed to contribute to the binge eating of palatable foods. Results from functional network connectivity studies are diverse, but findings tend to converge on indicating disrupted resting-state connectivity in executive networks, the default-mode network and the salience network across EDs.
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Affiliation(s)
| | | | | | - Carles Soriano-Mas
- Address correspondence to these authors at the Department of Psychiatry, Bellvitge University Hospital-IDIBELL, CIBEROBN and CIBERSAM, c/ Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat Barcelona, Spain; Tel: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mails: &
| | - Fernando Fernández-Aranda
- Address correspondence to these authors at the Department of Psychiatry, Bellvitge University Hospital-IDIBELL, CIBEROBN and CIBERSAM, c/ Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat Barcelona, Spain; Tel: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mails: &
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Abstract
Binge-eating disorder (BED) is the most prevalent eating disorder with estimates of 2-5% of the general adult population. Nonetheless, its pathophysiology is poorly understood. Furthermore, there exist few therapeutic options for its effective treatment. Here we review the current state of binge-eating neurobiology and pharmacology, drawing from clinical therapeutic, neuroimaging, cognitive, human genetic and animal model studies. These studies, which are still in their infancy, indicate that while there are many gaps in our knowledge, several key neural substrates appear to underpin binge-eating and may be conserved between human and animals. This observation suggests that behavioral intermediate phenotypes or endophenotypes relevant to BED may be modeled in animals, facilitating the identification and testing of novel pharmacological targets. The development of novel, safe and effective pharmacological therapies for the treatment of BED will enhance the ability of clinicians to provide optimal care for people with BED.
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Affiliation(s)
- Peter H Hutson
- Department of Neurobiology, CNS Discovery, Teva Pharmaceuticals, West Chester, PA, USA.
| | - Iris M Balodis
- Peter Boris Centre for Addiction Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Marc N Potenza
- Department of Psychiatry, Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA; National Center on Addiction and Substance Abuse, USA; Connecticut Mental Health Center, New Haven, CT, USA
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Pathological Overeating: Emerging Evidence for a Compulsivity Construct. Neuropsychopharmacology 2017; 42:1375-1389. [PMID: 27922596 PMCID: PMC5436113 DOI: 10.1038/npp.2016.269] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/18/2016] [Accepted: 11/22/2016] [Indexed: 12/11/2022]
Abstract
Compulsive eating behavior is a transdiagnostic construct that is characteristic of medical and psychiatric conditions such as forms of obesity and eating disorders. Although feeding research is moving toward a better understanding of the proposed addictive properties of food, the components and the mechanisms contributing to compulsive eating are not yet clearly defined or understood. Current understanding highlights three elements of compulsive behavior as it applies to pathological overeating: (1) habitual overeating; (2) overeating to relieve a negative emotional state; and (3) overeating despite aversive consequences. These elements emerge through mechanisms involving pathological habit formation through an aberrant learning process, the emergence of a negative emotional state, and dysfunctions in behavioral control. Dysfunctions in systems within neurocircuitries that comprise the basal ganglia, the extended amygdala, and the prefrontal cortex result in compulsive eating behaviors. Here, we present evidence to relate compulsive eating behavior and addiction and to characterize their underlying neurobiological mechanisms. A major need to improve understanding of compulsive eating through the integration of complex motivational, emotional, and cognitive constructs is warranted.
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43
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Impaired prefrontal cognitive control over interference by food images in binge-eating disorder and bulimia nervosa. Neurosci Lett 2017; 651:95-101. [DOI: 10.1016/j.neulet.2017.04.054] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 04/05/2017] [Accepted: 04/26/2017] [Indexed: 12/23/2022]
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Davis C, Mackew L, Levitan RD, Kaplan AS, Carter JC, Kennedy JL. Binge Eating Disorder (BED) in Relation to Addictive Behaviors and Personality Risk Factors. Front Psychol 2017; 8:579. [PMID: 28487663 PMCID: PMC5403820 DOI: 10.3389/fpsyg.2017.00579] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 03/28/2017] [Indexed: 11/23/2022] Open
Abstract
While there is good evidence that binge eating disorder (BED) is linked to higher-than-expected use of a broad range of addictive behaviors, mechanisms underlying this association are not well understood. Using a mediation-analytical approach with three age- and gender-matched groups – overweight/obese adults with (n = 42) and without (n = 104) BED, and normal-weight control participants (n = 73) – we tested the hypothesis that adults with BED would engage in more addictive behaviors and have higher scores on a personality-risk index than the two control groups. We also anticipated that the relationship between BED and addictive behaviors would be mediated by a high-risk personality profile. The predicted mediation effect was strongly supported. Contrary to expectation, BED participants did not engage in more addictive behaviors or have higher personality-risk scores than their weight-matched counterparts. However, both overweight/obese groups did have significantly higher scores than the normal-weight group. The relationships among personality risk, elevated body mass index (BMI), and addictive behaviors have important clinical implications, especially for treatments that target psycho-behavioral intervention for compulsive overeating and substance-use disorders.
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Affiliation(s)
- Caroline Davis
- Kinesiology & Health Science, York University, TorontoON, Canada
| | - Laura Mackew
- Kinesiology & Health Science, York University, TorontoON, Canada
| | - Robert D Levitan
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ONCanada
| | - Allan S Kaplan
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ONCanada
| | - Jacqueline C Carter
- Department of Psychology, Memorial University of Newfoundland, St. John'sNF, Canada
| | - James L Kennedy
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ONCanada
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Corwin RLW, Wojnicki FHE, Zimmer DJ, Babbs RK, McGrath LE, Olivos DR, Mietlicki-Baase EG, Hayes MR. Binge-type eating disrupts dopaminergic and GABAergic signaling in the prefrontal cortex and ventral tegmental area. Obesity (Silver Spring) 2016; 24:2118-25. [PMID: 27558648 DOI: 10.1002/oby.21626] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 06/14/2016] [Accepted: 06/17/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Binge eating is characterized by repeated intermittent bouts of compulsive overconsumption of food. Treatment is challenging given limited understanding of the mechanisms underlying this type of disordered eating. The hypothesis that dysregulation of mesocortical dopaminergic and GABAergic systems underlie binge eating was tested. METHODS Analysis of gene expression within the ventral tegmental area and its terminal mesocortical regions was examined in bingeing rats before and after bingeing occurred. In addition, alterations in binge-type behavior induced by pharmacological inactivation of subnuclei of the prefrontal cortex (PFC) and by pharmacological activation and inhibition of cortical D1 and D2 receptors were examined. RESULTS Correlative and functional evidence demonstrates dysregulated neurotransmitter processing by the PFC and ventral tegmental area, but not the amygdala or nucleus accumbens, in bingeing rats. Either GABAergic inactivation or D2-like receptor activation within the PFC increased consumption in bingeing rats, but not controls, suggesting that the PFC, and D2 receptors in particular, functions as a behavioral brake to limit bingeing. CONCLUSIONS The act of bingeing resolved some gene expression differences that preceded binge onset, further suggesting that bingeing may partially serve to self-medicate a system driving this maladaptive behavior. However, the failure of bingeing to resolve other dopaminergic/GABAergic differences may render individuals vulnerable to future binge episodes.
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Affiliation(s)
- Rebecca L W Corwin
- Nutritional Sciences Department, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA.
| | - Francis H E Wojnicki
- Nutritional Sciences Department, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Derek J Zimmer
- Department of Psychiatry, Translational Neuroscience Program, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - R Keith Babbs
- Nutritional Sciences Department, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Lauren E McGrath
- Department of Psychiatry, Translational Neuroscience Program, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Diana R Olivos
- Department of Psychiatry, Translational Neuroscience Program, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elizabeth G Mietlicki-Baase
- Department of Psychiatry, Translational Neuroscience Program, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Matthew R Hayes
- Department of Psychiatry, Translational Neuroscience Program, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Manasse SM, Espel HM, Schumacher LM, Kerrigan SG, Zhang F, Forman EM, Juarascio AS. Does impulsivity predict outcome in treatment for binge eating disorder? A multimodal investigation. Appetite 2016; 105:172-9. [PMID: 27230611 DOI: 10.1016/j.appet.2016.05.026] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/19/2016] [Accepted: 05/20/2016] [Indexed: 01/20/2023]
Abstract
Multiple dimensions of impulsivity (e.g., affect-driven impulsivity, impulsive inhibition - both general and food-specific, and impulsive decision-making) are associated with binge eating pathology cross-sectionally, yet the literature on whether impulsivity predicts treatment outcome is limited. The present pilot study explored impulsivity-related predictors of 20-week outcome in a small open trial (n = 17) of a novel treatment for binge eating disorder. Overall, dimensions of impulsivity related to emotions (i.e., negative urgency) and food cues emerged as predictors of treatment outcomes (i.e., binge eating frequency and global eating pathology as measured by the Eating Disorders Examination), while more general measures of impulsivity were statistically unrelated to global eating pathology or binge frequency. Specifically, those with higher levels of negative urgency at baseline experienced slower and less pronounced benefit from treatment, and those with higher food-specific impulsivity had more severe global eating pathology at baseline that was consistent at post-treatment and follow-up. These preliminary findings suggest that patients high in negative urgency and with poor response inhibition to food cues may benefit from augmentation of existing treatments to achieve optimal outcomes. Future research will benefit from replication with a larger sample, parsing out the role of different dimensions of impulsivity in treatment outcome for eating disorders, and identifying how treatment can be improved to accommodate higher levels of baseline impulsivity.
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Affiliation(s)
| | - Hallie M Espel
- Drexel University, Department of Psychology, Philadelphia, PA, USA
| | | | | | - Fengqing Zhang
- Drexel University, Department of Psychology, Philadelphia, PA, USA
| | - Evan M Forman
- Drexel University, Department of Psychology, Philadelphia, PA, USA
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Dunlop KA, Woodside B, Downar J. Targeting Neural Endophenotypes of Eating Disorders with Non-invasive Brain Stimulation. Front Neurosci 2016; 10:30. [PMID: 26909013 PMCID: PMC4754427 DOI: 10.3389/fnins.2016.00030] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/25/2016] [Indexed: 12/14/2022] Open
Abstract
The term "eating disorders" (ED) encompasses a wide variety of disordered eating and compensatory behaviors, and so the term is associated with considerable clinical and phenotypic heterogeneity. This heterogeneity makes optimizing treatment techniques difficult. One class of treatments is non-invasive brain stimulation (NIBS). NIBS, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), are accessible forms of neuromodulation that alter the cortical excitability of a target brain region. It is crucial for NIBS to be successful that the target is well selected for the patient population in question. Targets may best be selected by stepping back from conventional DSM-5 diagnostic criteria to identify neural substrates of more basic phenotypes, including behavior related to rewards and punishment, cognitive control, and social processes. These phenotypic dimensions have been recently laid out by the Research Domain Criteria (RDoC) initiative. Consequently, this review is intended to identify potential dimensions as outlined by the RDoC and the underlying behavioral and neurobiological targets associated with ED. This review will also identify candidate targets for NIBS based on these dimensions and review the available literature on rTMS and tDCS in ED. This review systematically reviews abnormal neural circuitry in ED within the RDoC framework, and also systematically reviews the available literature investigating NIBS as a treatment for ED.
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Affiliation(s)
- Katharine A. Dunlop
- Institute of Medical Sciences, University of TorontoToronto, ON, Canada
- MRI-Guided rTMS Clinic, University Health NetworkToronto, ON, Canada
| | - Blake Woodside
- Institute of Medical Sciences, University of TorontoToronto, ON, Canada
- Department of Psychiatry, University Health NetworkToronto, ON, Canada
- Department of Psychiatry, University of TorontoToronto, ON, Canada
- Eating Disorders Program, University Health NetworkToronto, ON, Canada
| | - Jonathan Downar
- Institute of Medical Sciences, University of TorontoToronto, ON, Canada
- MRI-Guided rTMS Clinic, University Health NetworkToronto, ON, Canada
- Department of Psychiatry, University Health NetworkToronto, ON, Canada
- Department of Psychiatry, University of TorontoToronto, ON, Canada
- Toronto Western Research Institute, University Health NetworkToronto, ON, Canada
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Kessler RM, Hutson PH, Herman BK, Potenza MN. The neurobiological basis of binge-eating disorder. Neurosci Biobehav Rev 2016; 63:223-38. [PMID: 26850211 DOI: 10.1016/j.neubiorev.2016.01.013] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/25/2016] [Accepted: 01/31/2016] [Indexed: 02/07/2023]
Abstract
Relatively little is known about the neuropathophysiology of binge-eating disorder (BED). Here, the evidence from neuroimaging, neurocognitive, genetics, and animal studies are reviewed to synthesize our current understanding of the pathophysiology of BED. Binge-eating disorder may be conceptualized as an impulsive/compulsive disorder, with altered reward sensitivity and food-related attentional biases. Neuroimaging studies suggest there are corticostriatal circuitry alterations in BED similar to those observed in substance abuse, including altered function of prefrontal, insular, and orbitofrontal cortices and the striatum. Human genetics and animal studies suggest that there are changes in neurotransmitter networks, including dopaminergic and opioidergic systems, associated with binge-eating behaviors. Overall, the current evidence suggests that BED may be related to maladaptation of the corticostriatal circuitry regulating motivation and impulse control similar to that found in other impulsive/compulsive disorders. Further studies are needed to understand the genetics of BED and how neurotransmitter activity and neurocircuitry function are altered in BED and how pharmacotherapies may influence these systems to reduce BED symptoms.
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Affiliation(s)
- Robert M Kessler
- Department of Radiology, University of Alabama at Birmingham School of Medicine, 619 19th St. South, Birmingham, AL 35249, United States.
| | - Peter H Hutson
- Shire, 300 Shire Way, Lexington, MA 02421, United States.
| | - Barry K Herman
- Shire, 300 Shire Way, Lexington, MA 02421, United States.
| | - Marc N Potenza
- Department of Psychiatry, Department of Neurobiology, Child Study Center, CASAColumbia and Connecticut Mental Health Center, Yale University School of Medicine, 34 Park St., New Haven, CT 06519, United States.
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Diagnostic validity of behavioural and psychometric impulsivity measures: An assessment in adolescent and adult populations. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2015.11.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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50
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Ptacek R, Stefano GB, Weissenberger S, Akotia D, Raboch J, Papezova H, Domkarova L, Stepankova T, Goetz M. Attention deficit hyperactivity disorder and disordered eating behaviors: links, risks, and challenges faced. Neuropsychiatr Dis Treat 2016; 12:571-9. [PMID: 27042070 PMCID: PMC4780667 DOI: 10.2147/ndt.s68763] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists in adulthood. It is defined by inattention and/or hyperactivity-impulsivity. ADHD is associated with many comorbidities, including eating disorders (EDs). In the last decade, studies have reported that ADHD is linked with binge EDs, bulimia nervosa, and anorexia nervosa. Many postulates have been proposed to explain the association: 1) impulsive behavior in ADHD patients leads to disordered eating behavior; 2) other psychologic comorbidities present in ADHD patients account for eating behavior; 3) poor eating habits and resulting nutritional deficiencies contribute to ADHD symptoms; and 4) other risk factors common to both ADHD and EDs contribute to the coincidence of both diseases. Additionally, sex differences become a significant issue in the discussion of EDs and ADHD because of the higher incidence of bulimia nervosa and anorexia nervosa in females and the ability of females to mask the symptoms of ADHD. Interestingly, both EDs and ADHD rely on a common neural substrate, namely, dopaminergic signaling. Dopaminergic signaling is critical for motor activity and emotion, the latter enabling the former into a combined motivated movement like eating. This linkage aids in explaining the many comorbidities associated with ADHD. The interconnection of ADHD and EDs is discussed from both a historical perspective and the one based on the revealing nature of its comorbidities.
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Affiliation(s)
- Radek Ptacek
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic; Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - George B Stefano
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic; MitoGenetics Research Institute, MitoGenetics, LLC, Farmingdale, NY, USA
| | - Simon Weissenberger
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Devang Akotia
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Jiri Raboch
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Hana Papezova
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Lucie Domkarova
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Tereza Stepankova
- Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic
| | - Michal Goetz
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
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