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Hilbert A, Rösch SA, Petroff D, Prettin C, Lührs M, Ehlis AC, Schmidt R. Near-infrared spectroscopy and electroencephalography neurofeedback for binge-eating disorder: an exploratory randomized trial. Psychol Med 2024; 54:675-686. [PMID: 37964437 DOI: 10.1017/s0033291723002350] [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] [Indexed: 11/16/2023]
Abstract
BACKGROUND Binge-eating disorder (BED) co-occurs with neurobehavioral alterations in the processing of disorder-relevant content such as visual food stimuli. Whether neurofeedback (NF) directly targeting them is suited for treatment remains unclear. This study sought to determine feasibility and estimate effects of individualized, functional near-infrared spectroscopy-based real-time NF (rtfNIRS-NF) and high-beta electroencephalography-based NF (EEG-NF), assuming superiority over waitlist (WL). METHODS Single-center, assessor-blinded feasibility study with randomization to rtfNIRS-NF, EEG-NF, or WL and assessments at baseline (t0), postassessment (t1), and 6-month follow-up (t2). NF comprised 12 60-min food-specific rtfNIRS-NF or EEG-NF sessions over 8 weeks. Primary outcome was the binge-eating frequency at t1 assessed interview-based. Secondary outcomes included feasibility, eating disorder symptoms, mental and physical health, weight management-related behavior, executive functions, and brain activity at t1 and t2. RESULTS In 72 patients (intent-to-treat), the results showed feasibility of NF regarding recruitment, attrition, adherence, compliance, acceptance, and assessment completion. Binge eating improved at t1 by -8.0 episodes, without superiority of NF v. WL (-0.8 episodes, 95% CI -2.4 to 4.0), but with improved estimates in NF at t2 relative to t1. NF was better than WL for food craving, anxiety symptoms, and body mass index, but overall effects were mostly small. Brain activity changes were near zero. CONCLUSIONS The results show feasibility of food-specific rtfNIRS-NF and EEG-NF in BED, and no posttreatment differences v. WL, but possible continued improvement of binge eating. Confirmatory and mechanistic evidence is warranted in a double-blind randomized design with long-term follow-up, considering dose-response relationships and modes of delivery.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - Sarah Alica Rösch
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - David Petroff
- Clinical Trial Centre Leipzig, University of Leipzig, Leipzig, Germany
| | | | - Michael Lührs
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Brain Innovation B.V., Maastricht, The Netherlands
| | - Ann-Christin Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
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Yan WS, Liu MM, Liu SJ. A Behavioral and Event-Related Potentials Study of Food-Related Inhibitory Control in Probable Binge Eating Disorder. Psychol Res Behav Manag 2023; 16:4737-4748. [PMID: 38024662 PMCID: PMC10676687 DOI: 10.2147/prbm.s441949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
Background Similar to addictive disorders, deficits on cognitive control might be involved in the onset and development of Binge Eating Disorder (BED). However, it remains unclear whether general or food-related inhibitory control impairments would be basically linked to overeating and binge eating behaviors. This study thus aimed to investigate behavioral performance and electrophysiological correlates of food-related inhibitory control among individuals with binge eating behavior. Methods Sixty individuals with probable BED (pBED) and 60 well-matched healthy controls (HCs) were assessed using the typical Stop-Signal Task, a revised Go/No Go Task, and a food-related Go/No Go Task. Besides, another separate sample, including 35 individuals with pBED and 35 HCs, completed the food-related Go/No Go Task when EEG signals were recorded with the event-related potentials (ERPs). Results The data revealed that the pBED group performed worse with a longer SSRT on the Stop-Signal Task compared with HCs (Cohen's d = 0.58, p = 0.002). Moreover, on the food-related Go/No Go Task, the pBED group had a lower success rate of inhibition in no-go trials (Cohen's d = 0.47, p = 0.012). The ERPs data showed that in comparison with HCs, the pBED group exhibited increased P300 latency (FC1, FC2, F3, F4, FZ) in the no-go trials of the food-related Go/No Go Task (Cohen's d 0.56-0.73, all p < 0.05). Conclusion These findings suggested that individuals with binge eating could be impaired in both non-specific and food-related inhibitory control aspects, and the impairments in food-related inhibitory control might be linked to P300 abnormalities, implying a behavioral-neurobiological dysfunction mechanism implicated in BED.
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Affiliation(s)
- Wan-Sen Yan
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, People’s Republic of China
- Guizhou Research Institute for Health Development, Guizhou Medical University, Guiyang, People’s Republic of China
| | - Meng-Meng Liu
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, People’s Republic of China
| | - Su-Jiao Liu
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, People’s Republic of China
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Wimmer J, Rösch SA, Schmidt R, Hilbert A. Neurofeedback strategies in binge-eating disorder as predictors of EEG-neurofeedback regulation success. Front Hum Neurosci 2023; 17:1234085. [PMID: 38021247 PMCID: PMC10645064 DOI: 10.3389/fnhum.2023.1234085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Treatment options such as neurofeedback (NF) that directly target the link between aberrant brain activity patterns and dysfunctional eating behaviors in binge-eating disorder (BED) are emerging. However, virtually nothing is known about mental strategies used to modulate food-specific brain activity and the associated brain-based or subjective success of specific strategies. This study firstly investigated the use of mental strategies in response to individually appetitive food cues in adults with BED and overweight or obesity based on a randomized-controlled trial providing electroencephalography (EEG)- or real-time functional near-infrared spectroscopy (rtfNIRS)-NF to BED. Methods Strategy reports written by participants were classified with qualitative content analysis. Additionally, the mental strategies employed by the N = 23 patients who received EEG-NF targeting the reduction of fronto-central high beta activity were analyzed quantitatively through their link with subjective and EEG-NF regulation success. Results The following eight categories, ordered by frequency in descending order, were found: "Behavior," "Imagination," "Emotion," "Distraction," "Thought," "Concentration," "Self-Talk" and "No Strategy." Linear mixed models revealed "Imagination," "Behavior," and "Thought" strategies as positive predictors of EEG-NF regulation success (defined as high beta activity during regulation beneath the baseline), and "Concentration" as a negative predictor of subjective (i.e., self-reported) NF regulation success. Discussion In conclusion, our study offers a classification system that may be used in future studies assessing strategy use for regulating food-related responses in patients with BED and associated overweight/obesity, providing valuable information on potential benefits of specific strategies and transferability to situations outside the NF treatment.
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Affiliation(s)
- Jytte Wimmer
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
| | - Sarah Alica Rösch
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
- International Max Planck Research School NeuroCom, Leipzig, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
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Hilbert A. Psychological and Medical Treatments for Binge-Eating Disorder: A Research Update. Physiol Behav 2023:114267. [PMID: 37302642 DOI: 10.1016/j.physbeh.2023.114267] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/23/2023] [Accepted: 06/08/2023] [Indexed: 06/13/2023]
Abstract
Binge-eating disorder (BED), characterized by recurrent binge eating in the absence of regular weight-compensatory behaviors, is the most common eating disorder, associated with pronounced mental and physical sequelae. An increasing body of research documents the efficacy of diverse approaches to the treatment of this disorder, summarized in meta-analyses. This research update narratively reviewed randomized-controlled trials (RCTs) on the psychological and medical treatment of BED published between January 2018 to November 2022, identified through a systematic literature search. A total of 16 new RCTs and 3 studies on previous RCTs providing efficacy- and safety-related data were included. Regarding psychotherapy, confirmatory evidence supported the use of integrative-cognitive therapy and, with lower effects, brief emotion regulation skills training for binge eating and associated psychopathology. Behavioral weight loss treatment was revealed to be efficacious for binge eating, weight loss, and psychopathology, but its combination with naltrexone-bupropion did not augment efficacy. New treatment approaches were explored, including e-mental-health and brain-directed treatments, mostly targeting emotion and self-regulation. Additionally, different therapeutic approaches were evaluated in complex stepped-care models. In light of these advances, future research is necessary to further optimize effects of evidence-based treatments for BED, through improvement of existing or development of new treatments, based on mechanistic and/or interventional research, and/or tailoring treatments to personal characteristics in a precision medicine approach.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.
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Leenaerts N, Jongen D, Ceccarini J, Van Oudenhove L, Vrieze E. The neurobiological reward system and binge eating: A critical systematic review of neuroimaging studies. Int J Eat Disord 2022; 55:1421-1458. [PMID: 35841198 DOI: 10.1002/eat.23776] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Changes in reward processing are hypothesized to play a role in the onset and maintenance of binge eating (BE). However, despite an increasing number of studies investigating the neurobiological reward system in individuals who binge eat, no comprehensive systematic review exists on this topic. Therefore, this review has the following objectives: (1) identify structural and functional changes in the brain reward system, either during rest or while performing a task; and (2) formulate directions for future research. METHODS A search was conducted of articles published until March 31, 2022. Neuroimaging studies were eligible if they wanted to study the reward system and included a group of individuals who binge eat together with a comparator group. Their results were summarized in a narrative synthesis. RESULTS A total of 58 articles were included. At rest, individuals who binge eat displayed a lower striatal dopamine release, a change in the volume of the striatum, frontal cortex, and insula, as well as a lower frontostriatal connectivity. While performing a task, there was a higher activity of the brain reward system when anticipating or receiving food, more model-free reinforcement learning, and more habitual behavior. Most studies only included one patient group, used general reward-related measures, and did not evaluate the impact of comorbidities, illness duration, race, or sex. DISCUSSION Confirming previous hypotheses, this review finds structural and functional changes in the neurobiological reward system in BE. Future studies should compare disorders, use measures that are specific to BE, and investigate the impact of confounding factors. PUBLIC SIGNIFICANCE STATEMENT This systematic review finds that individuals who binge eat display structural and functional changes in the brain reward system. These changes could be related to a higher sensitivity to food, relying more on previous experiences when making decisions, and more habitual behavior. Future studies should use a task that is specific to binge eating, look across different patient groups, and investigate the impact of comorbidities, illness duration, race, and sex.
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Affiliation(s)
- Nicolas Leenaerts
- Mind-body Research, Biomedical Sciences Group, KU Leuven, Leuven, Belgium
| | - Daniëlle Jongen
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
| | - Jenny Ceccarini
- Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium.,Cognitive & Affective Neuroscience Laboratory, Department of Psychological & Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Elske Vrieze
- Mind-body Research, Biomedical Sciences Group, KU Leuven, Leuven, Belgium
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Forester G, Schaefer LM, Dodd DR, Johnson JS. The potential application of event-related potentials to enhance research on reward processes in eating disorders. Int J Eat Disord 2022; 55:1484-1495. [PMID: 36214253 PMCID: PMC9633412 DOI: 10.1002/eat.23821] [Citation(s) in RCA: 2] [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] [Received: 07/06/2022] [Revised: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Reward-related processes have been posited as key mechanisms underlying the onset and persistence of eating disorders, prompting a growing body of research in this area. Existing studies have primarily utilized self-report, behavioral, and functional magnetic resonance imaging measures to interrogate reward among individuals with eating disorders. However, limitations inherent in each of these methods (e.g., poor temporal resolution) may obscure distinct neurocognitive reward processes, potentially contributing to underdeveloped models of reward dysfunction within eating disorders. The temporal precision of event-related potentials (ERPs), derived from electroencephalography, may thus offer a powerful complementary tool for elucidating the neurocognitive underpinnings of reward. Indeed, a considerable amount of research in other domains of psychopathology (e.g., depression, substance use disorders), as well as studies investigating food reward among non-clinical samples, highlights the utility of ERPs for probing reward processes. However, no study to date has utilized ERPs to directly examine reward functioning in eating disorders. METHODS In this paper, we review evidence underscoring the clinical utility of ERP measures of reward, as well as a variety of reward-related tasks that can be used to elicit specific ERP components with demonstrated relevance to reward processing. We then consider the ways in which these tasks/components may be used to help answer a variety of open questions within the eating disorders literature on reward. RESULTS/DISCUSSION Given the promise of ERP measures of reward to the field of eating disorders, we ultimately hope to spur and guide research in this currently neglected area. PUBLIC SIGNIFICANCE Abnormalities in reward functioning appear to contribute to eating disorders. Event-related potentials (ERPs) offer temporally precise measures of neurocognitive reward processing and thus may be important tools for understanding the relationship between reward and disordered eating. However, research in this area is currently lacking. This paper attempts to facilitate the use of ERPs to study reward among individuals with eating disorders by reviewing the relevant theories and methods.
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Affiliation(s)
| | - Lauren M. Schaefer
- Center for Biobehavioral Research, Sanford Research
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences
| | | | - Jeffrey S. Johnson
- Center for Biobehavioral Research, Sanford Research
- Department of Psychology, North Dakota State University
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Braeutigam S, Scaife JC, Aziz T, Park RJ. A Longitudinal Magnetoencephalographic Study of the Effects of Deep Brain Stimulation on Neuronal Dynamics in Severe Anorexia Nervosa. Front Behav Neurosci 2022; 16:841843. [PMID: 35692383 PMCID: PMC9178415 DOI: 10.3389/fnbeh.2022.841843] [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: 12/22/2021] [Accepted: 04/22/2022] [Indexed: 11/28/2022] Open
Abstract
Anorexia Nervosa (AN) is a debilitating psychiatric disorder characterized by the relentless pursuit of thinness, leading to severe emaciation. Magnetoencephalography (MEG)was used to record the neuronal response in seven patients with treatment-resistant AN while completing a disorder-relevant food wanting task. The patients underwent a 15-month protocol, where MEG scans were conducted pre-operatively, post-operatively prior to deep brain stimulation (DBS) switch on, twice during a blind on/off month and at protocol end. Electrodes were implanted bilaterally into the nucleus accumbens with stimulation at the anterior limb of the internal capsule using rechargeable implantable pulse generators. Three patients met criteria as responders at 12 months of stimulation, showing reductions of eating disorder psychopathology of over 35%. An increase in alpha power, as well as evoked power at latencies typically associated with visual processing, working memory, and contextual integration was observed in ON compared to OFF sessions across all seven patients. Moreover, an increase in evoked power at P600-like latencies as well as an increase in γ-band phase-locking over anterior-to-posterior regions were observed for high- compared to low-calorie food image only in ON sessions. These findings indicate that DBS modulates neuronal process in regions far outside the stimulation target site and at latencies possibly reflecting task specific processing, thereby providing further evidence that deep brain stimulation can play a role in the treatment of otherwise intractable psychiatric disorders.
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Affiliation(s)
- Sven Braeutigam
- Oxford Centre for Human Brain Activity, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- Wellcome Centre For Integrative Neuroimaging, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- *Correspondence: Sven Braeutigam
| | - Jessica Clare Scaife
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Tipu Aziz
- Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- Department of Neurosurgery, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Rebecca J. Park
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
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Hernández-Rivero I, Blechert J, Miccoli L, Eichin KN, Fernández-Santaella MC, Delgado-Rodríguez R. Emotional reactivity to binge food and erotic cues in women with bulimia nervosa symptoms. J Eat Disord 2021; 9:120. [PMID: 34583783 PMCID: PMC8479974 DOI: 10.1186/s40337-021-00475-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Studies on food cue reactivity have documented that altered responses to high-calorie food are associated with bulimic symptomatology, however, alterations in sexual motivations and behaviors are also associated clinical features in this population, which justify their inclusion as a research target. Here, we study responses to erotic cues-alongside food, neutral and aversive cues-to gain an understanding of specificity to food versus a generalized sensitivity to primary reinforcers. METHODS We recorded peripheral psychophysiological indices -the startle reflex, zygomaticus, and corrugator responses-and self-reported emotional responses (valence, arousal, and dominance) in 75 women completing the Bulimia Test-Revised (BULIT-R). Multiple regression analysis tested whether BULIT-R symptoms were predicted by self-reported and psychophysiological responses to food versus neutral and erotic versus neutral images. RESULTS The results showed that individuals with higher bulimic symptoms were characterized by potentiated eye blink startle response during binge food (vs. neutral images) and more positive valence ratings during erotic (vs. neutral) cues. CONCLUSIONS The results highlight the negative emotional reactivity of individuals with elevated bulimic symptoms toward food cues, which could be related to the risk of progression to full bulimia nervosa and thereby addressed in prevention efforts. Results also point to the potential role of reactivity to erotic content, at least on a subjective level. Theoretical models of eating disorders should widen their conceptual scope to consider reactivity to a broader spectrum of primary reinforcers, which would have implications for cue exposure-based treatments. We examined appetitive and aversive cue responses in college women to investigate how bulimic symptoms relate to primary reinforcers such as food and erotic images. We recorded peripheral psychophysiological indices (the startle reflex, zygomaticus, and corrugator responses) and self-reported emotional responses (valence, arousal, and dominance) in 75 college women that were presented with the Spanish version of the Bulimia Test-Revised. The results showed that bulimic symptoms increase both psychophysiological defensiveness toward food cues and subjective pleasure toward erotic cues. The findings suggest a generalized sensitivity to primary reinforcers in the presence of bulimic symptoms, and emphasize the relevance of adopting a wider framework in research and treatment on bulimia nervosa.
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Affiliation(s)
- Isabel Hernández-Rivero
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071, Granada, España
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunnerstraße 34, 5020, Salzburg, Austria
| | - Laura Miccoli
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071, Granada, España
| | - Katharina Naomi Eichin
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunnerstraße 34, 5020, Salzburg, Austria
| | - M Carmen Fernández-Santaella
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071, Granada, España
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Effects of acute, sub-chronic and chronic chocolate consumption with different percent of cocoa/sugar on memory and EEG waves in rats. PHYSIOLOGY AND PHARMACOLOGY 2021. [DOI: 10.52547/phypha.26.3.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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