Thinking about Eating Food Activates Visual Cortex with Reduced Bilateral Cerebellar Activation in Females with Anorexia Nervosa: An fMRI Study

Abstract

BackgroundWomen with anorexia nervosa (AN) have aberrant cognitions about food and altered activity in prefrontal cortical and somatosensory regions to food images. However, differential effects on the brain when thinking about eating food between healthy women and those with AN is unknown.MethodsFunctional magnetic resonance imaging (fMRI) examined neural activation when 42 women thought about eating the food shown in images: 18 with AN (11 RAN, 7 BPAN) and 24 age-matched controls (HC).ResultsGroup contrasts between HC and AN revealed reduced activation in AN in the bilateral cerebellar vermis, and increased activation in the right visual cortex. Preliminary comparisons between AN subtypes and healthy controls suggest differences in cortical and limbic regions.ConclusionsThese preliminary data suggest that thinking about eating food shown in images increases visual and prefrontal cortical neural responses in females with AN, which may underlie cognitive biases towards food stimuli and ruminations about controlling food intake. Future studies are needed to explicitly test how thinking about eating activates restraint cognitions, specifically in those with restricting vs. binge-purging AN subtypes.

Elevated cognitive control over reward processing in recovered female patients with anorexia nervosa

“…10,[28][29][30] Taken together, these studies suggest that anorexia nervosa may be characterized by a dominance of executive brain circuits, perhaps as a mechanism to predict and control anxiety produced by certain stimuli or by the possibility of failure. 31 The aims of the present study were two-fold: Given the sparse and contradictory literature on reward processing in patients with anorexia nervosa, we first wanted to compare neur al responses to anticipation and receipt of monetary rewards in recovered patients and closely matched female healthy controls using an established paradigm.…”

“…The study by Wagner and colleagues 10 not only reported an absence of a differential anteroventral striatal response, but also showed an increased activation in dorsal (executive) parts of the striatum and the prefrontal and parietal cortices, which has been interpreted as the neural correlates of strategic (as opposed to hedonic) means of responding to reward. During the presentation of visual food cues (i.e., another paradigm that does not place strong demands on cognitive control), patients with acute anorexia nervosa, restrictive subtype, showed increased DLPFC activity, 28 and DLPFC activity in patients with atypical anorexia nervosa was predicted by working memory performance and the amount of obsessivecompulsive symptoms. 29 Dorsolateral PFC volume in patients with anorexia nervosa seems to be positively related to dietary restraint (i.e., cognitive strategies to inhibit appetite).…”

A core eating network and its modulations underlie diverse eating phenomena

“…In direct comparisons between BN and AN patients, BN patients exhibited greater activation in the insula, caudate, supplementary motor area, and superior temporal gyrus, while also showing significantly decreased activation in the parietal lobe and PCC. In a related experiment, Brooks et al (2012) asked AN patients to think about eating the food shown in images. Relative to normal eaters, AN patients showed reduced activation in the bilateral cerebellar vermis (associated with feeding behavior), together with increased activation in dlPFC and visual cortex, again suggesting greater control.…”

Eating Disorders as New Forms of Addiction

“…Patients with AN, for example, tend to react with an increase in visual responses and prefrontal cortical activity that seem to be in accordance with their cognitive biases and excessive control over intake [52]. When patients with AN, BN, and controls are compared, each group seems to have a more or less specific pattern of response.…”