Neurocognitive findings in young adults with binge eating disorder

Abstract

Objectives: Binge-eating disorder (BED) has been associated with cognitive impairment, including on measures of impulsivity, but it is not clear in prior literature whether these deficits may have been associated with obesity, rather than BED per se. Impulsivity may play a role in predisposing people towards BED as well as in the chronicity of symptoms. The aim of this study was to examine cognitive functions between BED and healthy controls matched for age, gender, and body mass indices. Methods: Individuals with BED and healthy controls were recruited from the general community using media advertisements. After providing informed consent, study participants completed a clinical interview and computerised neuropsychological testing. Group differences were analysed. Results: Groups did not differ significantly on age, gender, education levels, or body mass indices. The BED group (N ¼ 17) exhibited significantly impaired stop-signal response inhibition (Stop-Signal Task) and executive planning (Stockings of Cambridge Task) compared to healthy controls (N ¼ 17). Spatial working memory and set-shifting were intact. Discussion: BED appears to be associated with motor disinhibition and impaired executive planning even controlling for obesity. Longitudinal work is needed to clarify whether motor impulsivity predisposes people to BED, and/or contributes to persistence of symptoms over time. KEY POINTS Binge-eating disorder is common, under-recognised, and associated with untoward physical and health sequelae. The neurobiological basis of binge-eating disorder is unclear; cognitive testing may offer insights. Many prior cognitive studies have not controlled for potential confounds, especially group differences in body mass indices (BMI). Obesity in itself has been linked with cognitive dysfunction. Here, we compared cognition between people with binge-eating disorder and controls, matched for BMI and other measures. Binge-eating disorder was associated with impaired response inhibition and executive planning. These results inform neurobiological models of binge-eating disorder and may suggest new treatment targets for this condition.

Clinical binge eating, but not uncontrolled eating, is associated with differences in executive functions: Evidence from meta-analytic findings

“…Depressive symptoms were correlated with overall neuropsychological inefficiencies BED group: psychiatric disorder not specified (n = 10) Cognitive Flexibility : WCST (perseverative errors), TMT (B-A). Working Memory : BDS, FDS Inhibition : BRIEF-A (behavioral index), Stroop test (trial3/trial1) Others : RCFT (central coherence), IGT (total net score) Duchesne et al, 2010 38(29) 38(34) 34.35 36.24 _ _ Whole sample: specific phobia (12%), generalized anxiety disorder (10%), dysthymic disorder (6%), panic disorder (9%), agoraphobia (4%), social phobia (5%), alcohol abuse/dependence (3%), posttraumatic stress disorder (3%), premenstrual dysphoric disorder (2%), obsessive–compulsive disorder (2%), and others (1%) Cognitive Flexibility : WCST (perseverative errors), TMT-B, BADS Rule Shift Cards (n° errors) Working Memory : BDS, FDS Inhibition : Stroop test (correct answers, color-word trial) Others : BADS Action Program Test (n° stages completed), BADS Zoo Map Test (trial 1, n° errors), BADS Modified Six Elements Eneva et al, 2017 55(55) 77(77) 32.1 28.4 _ Presence of psychiatric disorders did not significantly correlate with performance on any executive function measures BED group: mood disorder (n = 5), anxiety (n = 10) Cognitive Flexibility : DKEFS-trail making switching, NIH dimensional change card sort Working Memory : NIH working memory Inhibition : DKEFS color word interference inhibition, NIH flanker inhibitory control Others : DKEFS verbal fluency, design fluency and tower achievement Grant & Chamberlain, 2020 17(11) 17(11) 24.62 32.63 HAM-D, HAM-A BED group reported subclinical levels of depression and anxiety. No further control BED group: agoraphobia (n = 2), social phobia (n = 1), cannabis use disorder (n = 1), antisocial personality disorder (n = 1) Cognitive Flexibility : IED (total errors, adjusted for stages not completed) Working Memory : One Touch Stockings of Cambridge task (problems solved on first choice), Spatial Working Memory Task* (total errors) Inhibition : SST (stop-signal reaction time) Others : CGT (quality of decision making) Kittel et al, 2017 22(18) 44(36) 14.99 85.66* BDI-II S-Diff in depression sym...…”

Scrutinizing Domains of Executive Function in Binge Eating Disorder: A Systematic Review and Meta-Analysis

“…Six additional studies not included in the meta-analysis reported mixed findings. In three studies, there was no evidence of altered performance in the BED group compared to obese (18,37,41) or normal weight controls (18,33). In one study (56), individuals with BED showed poorer performance compared to normal weight controls on all indexes of the WCST, apart from perseverative errors.…”

“…People with BED showed higher rates of decision-making impairments compared to normal weight controls in three studies. On the other hand, others reported no significant differences in this domain between BED and obese controls (36,37) and normal weight controls (33).…”

“…Five studies (23,35,37,43,49) were included in a meta-analysis examining inhibitory control using the Stop Signal Task (n = 359). No significant differences between the BED group and the obese control group were found, with a pooled effect size of 0.17 (95% IC: −0.40, 0.74, z = 0.58, p = 0.562).…”

Is physical exercise and dietary therapy a feasible alternative to cognitive behavior therapy in treatment of eating disorders? A randomized controlled trial of two group therapies

“…Such effects may be explained both neurobiological, psychosocial, and behavioral changes (Ashdown‐Franks et al, ; Lubans et al, ; Mullen & Hall, ). If physical activity is included in the treatment of BN and BED, such changes may be relevant to expect as both disorders are acknowledged as cognitive and neurobiological in nature (Donnelly et al, ; Grant & Chamberlain, ). Both immediate and longitudinal effects from moderate intensity physical activity have shown positive cognitive effect by improving eating behavior and self‐regulation in healthy students (Lowe, Hall, Vincent, & Luu, ; Oaten & Cheng, ).…”