Association of Brain Reward Learning Response With Harm Avoidance, Weight Gain, and Hypothalamic Effective Connectivity in Adolescent Anorexia Nervosa

Frank, Guido; DeGuzman, Marisa C.; Shott, Megan E.; Laudenslager, Mark L.; Rossi, Brogan; Pryor, Tamara

doi:10.1001/jamapsychiatry.2018.2151

Cited by 82 publications

(117 citation statements)

References 68 publications

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“…The fMRI studies employed varied approaches and paradigms to investigate the processing of taste‐related stimuli. Seven fMRI studies compared neural response for pure taste solutions (i.e., carriers of basic tastes that have no smell properties) versus neutral stimuli (see Frank et al, , ; Frank, Collier, Shott, & O'Reilly, ; Frank, Shott, Keffler, & Cornier, ; Monteleone et al, ; Olsavsky et al, ; Wagner et al, ). Three fMRI studies compared neural response for caloric and noncaloric taste stimuli (see Oberndorfer et al, ; Radeloff et al, ; Wagner et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…Three fMRI studies compared neural response for caloric and noncaloric taste stimuli (see Oberndorfer et al, ; Radeloff et al, ; Wagner et al, ). Seven studies used both taste and visual stimuli (see Cowdrey, Park, Harmer, & McCabe, ; Frank, Collier, Shott, & O'Reilly ; Frank, Shott, Keffler, & Cornier, ; Frank et al, , ; Frank, Shott, Rieder, & Pryor, ; Olsavsky et al, ). Three studies addressed the issue of hypothalamic functioning in response to taste stimuli (see Frank, Shott, Rieder, & Pryor, ; Frank et al, ; Van Opstal et al, ).…”

Section: Resultsmentioning

confidence: 99%

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Structural and functional brain correlates of altered taste processing in anorexia nervosa: A systematic review

Kot

Kucharska

Monteleone

et al. 2019

Euro Eating Disorders Rev

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Objective: A growing body of empirical literature indicates altered taste perception in individuals with anorexia nervosa (AN). However, it remains unknown whether the observed impairments in the neural processing of taste stimuli represent etiopathogenetic factors of AN or whether they are a secondary consequence of malnutrition.Method: In the current systematic review, scientific studies were identified using the MEDLINE, PsycINFO, and Scopus databases. A supplemental search was performed by searches through reference lists of the relevant publications and via Google Scholar.Results: On the basis of the searches conducted, 16 publications were identified and included in this literature review. The results of those studies point to disturbances in the structure and functioning of brain regions involved in taste processing in AN. Conclusions:The findings of the reviewed studies suggest that altered reward, interoceptive, and cognitive-emotional processing may contribute to abnormal taste processing in AN.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Structural and functional brain correlates of altered taste processing in anorexia nervosa: A systematic review

Kot

Kucharska

Monteleone

et al. 2019

Euro Eating Disorders Rev

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“…If encoding of this prediction error is essential to new learning, engagement in any alternative cognitive activity, including RNT, during the offset of the aversive cue could interfere with this process. Consistent with this possibility, recent neuroimaging work supports altered prediction error signaling in AN (Frank et al, 2018). Engagement in RNT during aversive experiences could also decrease working memory capacity and thus interrupt the update of corrective information necessary to shift expectancies and predictions (O'Reilly & Frank, 2006).…”

mentioning

confidence: 76%

“…For instance, RNT may function as a form of cognitive avoidance (Ehring & Watkins, 2008). Consistent with this possibility, recent neuroimaging work supports altered prediction error signaling in AN (Frank et al, 2018). Temporary avoidance of negative affect via RNT during an aversive experience also could be negatively reinforcing, thus maintaining beliefs about these affective states as harmful and intolerable.…”

mentioning

confidence: 82%

“…This might involve inducing RNT at various points in a learning-related experimental paradigm and testing the effects of RNT on attention toward salient stimuli, learning, and memory for the experience. Further, neuroimaging paradigms that permit assessment of neural signals associated with anticipating and experiencing negative stimuli (Frank et al, 2018) should directly assess participants' engagement in RNT throughout learning, and explore whether engagement in RNT influences neural activity (e.g., prediction error signal).…”

Section: Future Researchmentioning

confidence: 99%

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Could repetitive negative thinking interfere with corrective learning? The example of anorexia nervosa

Reilly

Lavender

Berner

et al. 2018

Intl J Eating Disorders

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Identifying processes that may interfere with corrective learning during treatments for anorexia nervosa (AN) may help to improve the effectiveness of existing interventions. We propose that certain cognitive processes characteristic of the AN temperament may help explain previous findings in AN suggesting difficulty updating previously learned associations and learning from feedback. Specifically, we hypothesize that engagement in repetitive negative thinking (RNT), including worry and rumination, could interfere with corrective learning that is critical to the success of behavioral treatments. In doing so, we draw from existing work in anxiety and mood disorders linking RNT to the maintenance of symptoms and poorer response to cognitivebehavioral treatments. Next, we outline hypothesized mechanisms through which engagement in RNT before, during, and after exposure to aversive stimuli could interfere with learning in AN. We then provide recommendations for how these hypothesized associations could be tested in future research. Although prior work has suggested that RNT processes are common among individuals with AN, this work has been primarily descriptive in nature. We propose that extending this work through direct examination of the impact of active engagement in RNT on corrective learning could aid in identifying AN maintenance processes that could be explicitly targeted in treatment.

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Reward System Abnormalities in Anorexia Nervosa

Steinglass

Foerde

2018

JAMA Psychiatry

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Anorexia nervosa (AN) is associated with the highest mortality rate of any psychiatric illness 1 as well as significant health care costs and lost wages. While there have been notable advances in understanding biobehavioral mechanisms of AN, the brain systems that underlie the illness remain poorly understood. Clinically, it is widely accepted that the critical first step in treatment is renourishment-that is, restoring individuals to a healthy body weight. Yet knowing that the primary medical intervention is simply to eat does not, in itself, change behavior. In fact, even after full weight restoration, individuals with AN continue to restrict caloric and fat intake, which is associated with poor longer-term outcomes. 2 The severity and persistence of this illness makes understanding the pathophysiology and neural mechanisms of AN a research priority.In a bottom-up approach to identifying brain mechanisms of illness, neural systems that have been well characterized in healthy individuals are probed to test hypotheses about abnormalities in psychiatric illness. In this issue of JAMA Psychiatry, Frank et al 3 present the most recent findings from programmatic research examining reward and related neural systems in AN. Their model hypothesizes that the dopamine system is affected by AN-induced starvation. They propose that this is reflected in heightened prediction error response, a neural activation pattern associated with dopamine and thought to be a critical learning signal in the brain, 4 and that stress and high anxiety influence prediction error to perpetuate illness. This kind of integrative model of complex illness with programmatic testing of neurobiological hypotheses is an aspiration in the field of eating disorders. The work draws together ideas about harm avoidance traits, high cortisol levels, and abnormal neural responses to taste, which have been examined to some extent in prior work. 5 Furthermore, this study includes data from 56 adolescents and young adults with AN, 3 a sample size much larger than most studies in this field.In the study task, participants were presented with a stimulus and learned which images would be followed by receipt of a sweet taste. The associations become probabilistic, and on some trials, the predictions were violated and sweet liquid was delivered in response to the wrong stimulus or not delivered when it was expected. 3 Prediction error occurred when the sweet taste was either omitted or was received unexpectedly. Functional magnetic resonance imaging measures the blood oxygen leveldependent signal response in areas known to reflect the dopamine prediction error signal, such as the striatum. The ingestion of sweet taste as an outcome is presented as having relevance in

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Association of Brain Reward Learning Response With Harm Avoidance, Weight Gain, and Hypothalamic Effective Connectivity in Adolescent Anorexia Nervosa

Cited by 82 publications

References 68 publications

Structural and functional brain correlates of altered taste processing in anorexia nervosa: A systematic review

Structural and functional brain correlates of altered taste processing in anorexia nervosa: A systematic review

Could repetitive negative thinking interfere with corrective learning? The example of anorexia nervosa

Reward System Abnormalities in Anorexia Nervosa

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