Intact value-based decision-making during intertemporal choice in women with remitted anorexia nervosa? An fMRI study

Strengthened Default Mode Network Activation During Delay Discounting in Adolescents with Anorexia Nervosa After Partial Weight Restoration: A Longitudinal fMRI Study

“…In contrast, Decker et al [16] found normalization of a greater preference for delayed rewards (i.e., shallower DD), following a brief treatment, to be associated with abnormal fMRI activation in brain regions involved in both reward valuation and executive decision-making in adult patients. The current longitudinal study builds on our previous cross-sectional fMRI studies of DD which found both (1) faster and more consistent choice behavior and (2) decreased FPN activation, suggestive of altered neural efficiency of decision-making in acAN, relative to HC [40], and no evidence of either behavioral or neural alterations in recAN [23]. Although our previous behavioral study found no longitudinal changes in behavioral DD parameters [20], this does not preclude the possibility of meaningful changes in fMRI activation.…”

“…The task was programmed using the Presentation ® software (version 16.1, Neurobehavioral Systems, Inc., Berkeley, CA, USA). Participants performed the same two-part DD task as in our previous cross-sectional fMRI studies [23,40], at both time points. The task has been shown to demonstrate an ability to distinguish between age groups known to differ in self-control [49] and an overall good test-retest reliability, both on a behavioral and neural level in adolescents [50].…”

“…Behavioral data were analyzed as in our previous cross-sectional fMRI studies in AN [23,40] and originally described in Ripke et al [49]. For comparison of the discount parameter k estimated at TP1 and TP2 (paired-samples t-test), we used log-transformed values because they better fit a normal distribution.…”

“…Trials with illogical choices (defined as decisions for a reward whose subjective value was lower than half of the alternative option [49]) and those without a response were regarded as invalid and excluded from all analyses. As in our previous fMRI studies [23,40], an additional behavioral measure was mean reaction time (RT) on the valid trials of the main fMRI session. RT data were analyzed with a 2 (chosen reward: SS vs. LL) × 2 (time point: TP1 vs. TP2) repeated-measures ANOVA.…”

“…Consistent with the notion of excessive self-control and an increased capacity to forgo immediate (food) rewards in the pursuit of long-term goals (thinness) in AN, several studies have reported shallower DD in acutely underweight patients (acAN), relative to healthy controls (HC) [16][17][18][19]. However, these observations were made in adults with a relatively long duration of illness and some studies have not detected group differences in discounting behavior [20,21], suggesting that a shallower DD might not reflect a defining trait variable of AN, no studies have found any altered DD in long-term weight-recovered AN (recAN) [20,[22][23][24].…”