Intact value-based decision-making during intertemporal choice in women with remitted anorexia nervosa? An fMRI study
Acute Disease
Adolescent
Adult
Anorexia Nervosa
/ diagnostic imaging
Brain
/ diagnostic imaging
Case-Control Studies
Child
Choice Behavior
Decision Making
Female
Functional Neuroimaging
Gyrus Cinguli
/ diagnostic imaging
Humans
Magnetic Resonance Imaging
Mental Health Recovery
Neural Pathways
/ diagnostic imaging
Remission Induction
Thinness
/ physiopathology
Young Adult
Journal
Journal of psychiatry & neuroscience : JPN
ISSN: 1488-2434
Titre abrégé: J Psychiatry Neurosci
Pays: Canada
ID NLM: 9107859
Informations de publication
Date de publication:
01 03 2020
01 03 2020
Historique:
entrez:
10
10
2019
pubmed:
10
10
2019
medline:
11
11
2021
Statut:
ppublish
Résumé
Extreme restrictive food choice in anorexia nervosa is thought to reflect excessive self-control and/or abnormal reward sensitivity. Studies using intertemporal choice paradigms have suggested an increased capacity to delay reward in anorexia nervosa, and this may explain an unusual ability to resist immediate temptation and override hunger in the long-term pursuit of thinness. It remains unclear, however, whether altered delay discounting in anorexia nervosa constitutes a state effect of acute illness or a trait marker observable after recovery. We repeated the analysis from our previous fMRI investigation of intertemporal choice in acutely underweight patients with anorexia nervosa in a sample of weight-recovered women with anorexia nervosa (n = 36) and age-matched healthy controls (n = 36) who participated in the same study protocol. Follow-up analyses explored functional connectivity separately in both the weight-recovered/healthy controls sample and the acute/healthy controls sample. In contrast to our previous findings in acutely underweight patients with anorexia nervosa, we found no differences between weight-recovered patients with anorexia nervosa and healthy controls at either behavioural or neural levels. New analysis of data from the acute/healthy controls sample sample revealed increased coupling between dorsal anterior cingulate cortex and posterior brain regions as a function of decision difficulty, supporting the hypothesis of altered neural efficiency in the underweight state. This was a cross-sectional study, and the results may be task-specific. Although our results underlined previous demonstrations of divergent temporal reward discounting in acutely underweight patients with anorexia nervosa, we found no evidence of alteration in patients with weight-recovered anorexia nervosa. Together, these findings suggest that impaired valuebased decision-making may not constitute a defining trait variable or “scar” of the disorder.
Sections du résumé
Background
Extreme restrictive food choice in anorexia nervosa is thought to reflect excessive self-control and/or abnormal reward sensitivity. Studies using intertemporal choice paradigms have suggested an increased capacity to delay reward in anorexia nervosa, and this may explain an unusual ability to resist immediate temptation and override hunger in the long-term pursuit of thinness. It remains unclear, however, whether altered delay discounting in anorexia nervosa constitutes a state effect of acute illness or a trait marker observable after recovery.
Methods
We repeated the analysis from our previous fMRI investigation of intertemporal choice in acutely underweight patients with anorexia nervosa in a sample of weight-recovered women with anorexia nervosa (n = 36) and age-matched healthy controls (n = 36) who participated in the same study protocol. Follow-up analyses explored functional connectivity separately in both the weight-recovered/healthy controls sample and the acute/healthy controls sample.
Results
In contrast to our previous findings in acutely underweight patients with anorexia nervosa, we found no differences between weight-recovered patients with anorexia nervosa and healthy controls at either behavioural or neural levels. New analysis of data from the acute/healthy controls sample sample revealed increased coupling between dorsal anterior cingulate cortex and posterior brain regions as a function of decision difficulty, supporting the hypothesis of altered neural efficiency in the underweight state.
Limitations
This was a cross-sectional study, and the results may be task-specific.
Conclusion
Although our results underlined previous demonstrations of divergent temporal reward discounting in acutely underweight patients with anorexia nervosa, we found no evidence of alteration in patients with weight-recovered anorexia nervosa. Together, these findings suggest that impaired valuebased decision-making may not constitute a defining trait variable or “scar” of the disorder.
Identifiants
pubmed: 31595737
doi: 10.1503/jpn.180252
pmc: PMC7828910
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
108-116Informations de copyright
© 2020 Joule Inc. or its licensors
Déclaration de conflit d'intérêts
V. Roessner has received payment for consulting and writing activities, independent of the current work, from Lilly, Novartis and Shire Pharmaceuticals; lecture honoraria from Lilly, Novartis, Shire Pharmaceuticals and Medice Pharma; and support for research from Shire and Novartis. He has carried out (and is currently carrying out) clinical trials in cooperation with the Novartis, Shire and Otsuka. J. King, F. Bernardoni, D. Geisler, F. Ritschel, A. Doose, S. Pauligk, K. Pásztor, K. Weidner, M. Smolka and S. Ehrlich declare no competing interests.
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