Prefrontal Responses during Proactive and Reactive Inhibition Are Differentially Impacted by Stress in Anorexia and Bulimia Nervosa

Westwater, Margaret L.; Mancini, Flavia; Gorka, Adam X.; Shapleske, Jane; Serfontein, Jaco; Grillon, Christian; Ernst, Monique; Ziauddeen, Hisham; Fletcher, Paul C.

doi:10.1523/jneurosci.2853-20.2021

Cited by 12 publications

(13 citation statements)

References 71 publications

(106 reference statements)

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“…Both patient groups reported increased routines relative to the control group; however, automaticity scores were only increased in the BN group. We previously found that women with BN, but not AN-BP, in this cohort have impairments in proactive inhibition (2), and the present findings offer further evidence of distinct self-regulatory deficits across these two disorders. Nevertheless, nonsignificant group differences in slips-ofaction task performance highlights outstanding challenges in relation to our understanding of dysregulated learning in eating disorders and its neural correlates.…”

Section: Discussionsupporting

confidence: 77%

“…As a detailed explanation of the study protocol has been reported previously (2,34), we provide a summary here. Following a telephone screening, potential volunteers completed an outpatient screening session prior to scanning, which included body composition testing, blood sampling, cognitive testing and two, semi-structured clinical interviews [e.g., the SCID-5 (35) and EDE v16 (36)] to establish current diagnoses of AN-BP, BN and comorbid psychiatric conditions.…”

Section: Study Proceduresmentioning

confidence: 99%

“…The primary diagnostic distinction between AN-BP and BN relates to an individual's body mass index (BMI), wherein individuals with AN-BP are underweight and those with BN are not (1). Neuroimaging studies have begun to characterize the neural correlates of these illnesses, identifying alterations in the structure and function of brain regions that subserve learning, self-regulatory control and bodily perception in affected individuals (2)(3)(4)(5)(6). However, as perturbed metabolic functioning is increasingly implicated in AN and, to a lesser degree, BN (7,8), a more comprehensive understanding of their neurocognitive mechanisms will require consideration of interacting metabolic processes, both peripherally and within the brain.…”

Section: Introductionmentioning

confidence: 99%

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Characterizing cerebral metabolite profiles in anorexia and bulimia nervosa and their associations with habitual behavior

Westwater

Murley

Diederen

et al. 2021

Preprint

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Background: Anorexia nervosa (AN) and bulimia nervosa (BN) are associated with altered brain structure and function, as well as increased habitual behavior. This neurobehavioral profile may implicate neurochemical changes in the pathogenesis of these illnesses. Altered glutamate, myo-inositol and N-acetyl aspartate (NAA) concentrations are reported in restrictive AN, yet whether these extend to binge-eating disorders, or relate to habitual traits in affected individuals, remains unknown. Methods: Using single-voxel proton magnetic resonance spectroscopy, we measured glutamate, myo-inositol and NAA in 85 women [n=22 AN (binge-eating/purging subtype; AN-BP), n=33 BN, n=30 controls]. Spectra were acquired from the right inferior lateral prefrontal cortex and the right occipital cortex. To index habitual behavior, participants performed an instrumental learning task and completed the Creature of Habit Scale. Exploratory analyses examined associations between metabolites and habitual behavior. Results: Women with AN-BP, but not BN, had reduced myo-inositol and NAA concentrations relative to controls in both voxels. Patient groups had intact performance on the instrumental learning task; however, both groups reported increased routine behaviors compared to controls. Women with BN also reported greater automatic behaviors, and automaticity was related to reduced prefrontal glutamate and NAA in the AN-BP group. Discussion: Findings extend previous reports of reduced myo-inositol and NAA levels in AN to AN-BP, which may reflect disrupted axonal-glial signaling. Although we found inconsistent support for increased habitual behavior in AN-BP and BN, we identified preliminary associations between prefrontal metabolites and automaticity in AN-BP. These results provide further evidence of unique neurobiological profiles across binge-eating disorders.

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Section: Discussionsupporting

confidence: 77%

Section: Study Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characterizing cerebral metabolite profiles in anorexia and bulimia nervosa and their associations with habitual behavior

Westwater

Murley

Diederen

et al. 2021

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“…Increased compulsivity, manifesting as compulsive restriction of food intake and compulsive exercise is also in line with previous research (Davis and Kaptein, 2006;Godier and Park, 2014), as well as a higher level of negative urgency impulsive, particularly in cohorts of heightened impulsivity during negative emotional states (e.g. binge/purging AN or BN) (Westwater et al, 2019). The increased level of PUI is also in line with previous research.…”

Section: Discussionsupporting

confidence: 91%

Taming the chimera-hydra

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“…This suggests that the acute kind of stress which is typically induced in a laboratory or neuroimaging setting does not make patients with BN lose control. Indeed, a previous study finds that such acute stress does not reduce inhibitory control in patients with BN (51). However, studies in daily life do find that negative emotions such as stress increase before a BE episode in patients with BN (52,53).…”

Section: Discussionmentioning

confidence: 96%

The effect of stress on delay discounting in bulimia nervosa and alcohol use disorder: a functional magnetic resonance imaging study.

Leenaerts

Ceccarini²,

Weygandt³

et al. 2022

Preprint

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Background:Stress could induce neurobiological changes in patients with bulimia nervosa (BN) and alcohol use disorder (AUD) that increase delay discounting (DD), making the short-term benefits of coping through eating or drinking outweigh long-term negative consequences. Therefore, this study explores differences in DD between patients (BN or AUD) and healthy controls (HC), the impact of stress on food and alcohol DD, and the associated changes in brain activity.Methods:A total of 102 female participants (AUD: 27, BN: 25, HC: 50; age range: 18-38 years) underwent repeated fMRI scanning while performing three DD tasks (DDT). Initially, all participants performed a monetary DDT. Then, participants performed a food or alcohol DDT before and after stress induction with the Montreal Imaging Stress Task (MIST). Specifically, patients with BN completed a food DDT,patients with AUD completed an alcohol DDT and HC were randomly allocated to either DDT.Results:No differences were found in the DD of money, food or alcohol between patients and controls before stress. However, stress increased the DD of alcohol in patients with AUD, but not in HC. Stress also increased the DD of food in HC, but not in patients with BN. Furthermore, stress caused patients with AUD to display a lower activity of the right supplementary motor area while discounting alcohol. Stress also caused HC to display a lower activity of the middle/super frontalcortex and a higher activity of the motor cortex while discounting food, but caused patients with BN to display a higher activity of the occipital cortex.Conclusion:The results suggest that stress induces neurobiological changes in patients with AUD which cause them to prefer more immediately available alcohol. However, the results observed in patients with BN suggest a more complex relation between stress and food.

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Prefrontal Responses during Proactive and Reactive Inhibition Are Differentially Impacted by Stress in Anorexia and Bulimia Nervosa

Cited by 12 publications

References 71 publications

Characterizing cerebral metabolite profiles in anorexia and bulimia nervosa and their associations with habitual behavior

Characterizing cerebral metabolite profiles in anorexia and bulimia nervosa and their associations with habitual behavior

Taming the chimera-hydra

The effect of stress on delay discounting in bulimia nervosa and alcohol use disorder: a functional magnetic resonance imaging study.

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