Differential Neural Responses to Food Images in Women with Bulimia versus Anorexia Nervosa

Department of Neuroscience, Uppsala University, Uppsala, Sweden.
PLoS ONE (Impact Factor: 3.23). 07/2011; 6(7):e22259. DOI: 10.1371/journal.pone.0022259
Source: PubMed


Previous fMRI studies show that women with eating disorders (ED) have differential neural activation to viewing food images. However, despite clinical differences in their responses to food, differential neural activation to thinking about eating food, between women with anorexia nervosa (AN) and bulimia nervosa (BN) is not known.
We compare 50 women (8 with BN, 18 with AN and 24 age-matched healthy controls [HC]) while they view food images during functional Magnetic Resonance Imaging (fMRI).
In response to food (vs non-food) images, women with BN showed greater neural activation in the visual cortex, right dorsolateral prefrontal cortex, right insular cortex and precentral gyrus, women with AN showed greater activation in the right dorsolateral prefrontal cortex, cerebellum and right precuneus. HC women activated the cerebellum, right insular cortex, right medial temporal lobe and left caudate. Direct comparisons revealed that compared to HC, the BN group showed relative deactivation in the bilateral superior temporal gyrus/insula, and visual cortex, and compared to AN had relative deactivation in the parietal lobe and dorsal posterior cingulate cortex, but greater activation in the caudate, superior temporal gyrus, right insula and supplementary motor area.
Women with AN and BN activate top-down cognitive control in response to food images, yet women with BN have increased activation in reward and somatosensory regions, which might impinge on cognitive control over food consumption and binge eating.

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Available from: Steven C R Williams
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    • "Schienle and colleagues (2009) reported increased mediai orbitai frontal cortex activation in patients with BED and greater cingulate cortex and insula activation in BN patients in response to food images relative to controls . In response to food (versus non-food) images, women with BN showed greater neural activation in thè visual cortex, right dorsolateral prefrontal cortex, righi insular cortex, and precentrai gyrus, while women with AN showed greater activation in thè right dorsolateral prefrontal cortex, cerebellum, and right precuneus (Brooks et al., 2011). A recent positron emission tomographic (PET) study found dopamine dysfunction in thè caudate of obese humans with BED compared to obese humans without BED (Wang et al., 2011). "

    Full-text · Chapter · Dec 2015
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    • "correlate with activity in the left dorsolateral prefrontal cortex (DLPFC), left anterior cingulate cortex (ACC), bilateral cerebellum, bilateral PMC/SMA, and right insula. In previous studies, the DLPFC was found to be activated in AN subjects when they were instructed to imagine eating food presented to them in images (Brooks et al., 2011, 2012c,), most probably due to the DLPFC's role in cognitive rumination that aids appetite suppression, as is also reported in the magnetoencephalographic study of Yoshikawa et al. (2014). Further, Yoshikawa et al. reported that the left SMA, which is involved in motor-related functions (Roland et al., 1980), may have a role in appetite suppression. "
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    ABSTRACT: The role of rumination at the beginning of eating disorder (ED) is not well understood. We hypothesized that impulsivity, rumination and restriction could be associated with neural activity in response to food stimuli in young individuals with eating disorders (ED). We measured neural responses with functional magnetic resonance imaging (fMRI), tested working memory (WM) and administered the Eating Disorders Examination Questionnaire (EDE-Q), Barratt Impulsivity Scale (BIS-11) and Obsessive-Compulsive Inventory (OCI-R) in 15 adolescent females with eating disorder not otherwise specified (EDNOS) (mean age 15 years) and 20 age-matched healthy control females. We found that EDNOS subjects had significantly higher scores on the BIS 11, EDE-Q and OCI-R scales. Significantly increased neural responses to food images in the EDNOS group were observed in the prefrontal circuitry. OCI-R scores in the EDNOS group also significantly correlated with activity in the prefrontal circuitry and the cerebellum. Significantly slower WM responses negatively correlated with bilateral superior frontal gyrus activity in the EDNOS group. We conclude that ruminations, linked to WM, are present in adolescent females newly diagnosed with EDNOS. These may be risk factors for the development of an eating disorder and may be detectable before disease onset.
    Full-text · Article · Oct 2014 · Psychiatry Research: Neuroimaging
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    • "AN is associated with a myriad of physical and psychological comorbidities, high levels of mortality and disability [1]. Significant advances have been made over the last decade in our understanding of the neural correlates of AN, with research highlighting both structural [9] [25] [37]; and functional [6] [30] [34] [39] alterations in the brain. These neuroimaging studies reveal gray and white matter alterations, and disturbances in limbic, frontal and parietal areas, in addition to alterations in the functioning of neurotransmitters including serotonin and dopamine at different stages of AN. "
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    ABSTRACT: Background: Existing treatments for adults with anorexia nervosa (AN) have limited proven efficacy. New treatments that have been suggested involve targeted, brain-directed interventions such as transcranial direct current stimulation (tDCS). We describe findings from seven individuals with treatment-resistant AN who received 10 sessions of anodal tDCS, over the left dorsolateral prefrontal cortex (DLPFC). Material and method: In this open-label, single-arm study, seven patients received anodal tDCS (2mA) for 25 minutes over the left dorsolateral prefrontal cortex daily for ten days. Assessments pre-tDCS, post-tDCS and one month later included the Eating Attitude Test (EAT), Eating Disorder Inventory (EDI) and Beck Depression Inventory (BDI). Results: Three patients improved in all three rating scales immediately after the treatment sessions and one month later. Two patients showed improvement at the end of treatment but returned to the baseline after one month. One subject improved only on the BDI scale but not eating scales. The scores in the three rating scales were unaffected by treatment in the remaining patient. There was a significant effect of time (pre, post and 1 month later) on the three rating scores; BDI (P = 0.016), EDI (P = 0.018) and EAT (P = 0.016) and a significant correlation between the percent improvement of BDI and EAT (p = 0.01), and between BDI and EDI (P = 0.006). Conclusions: These findings suggest that tDCS has potential as an adjuvant treatment for AN and deserves further study.
    Full-text · Article · Sep 2014 · Restorative neurology and neuroscience
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