A Neural Signature of Anorexia Nervosa in the Ventral Striatal Reward System
A Neural Signature of Anorexia Nervosa in the Ventral Striatal Reward System
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DOI：
10.1176/appi.ajp.2009.09010071
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发表时间：
2010-02-01
影响因子：
17.7
通讯作者：
von Wietersheim, Joern
中科院分区：
文献类型：
--
作者：
Fladung, Anne-Katharina;Groen, Georg;von Wietersheim, Joern
目的：评估在压力和饮食条件下自我饥饿机制的动物研究表明，中脑边缘奖励系统在维持神经性厌食症的核心症状中起着关键作用，这一点得到了人类研究中初步经验证据的证实。作者研究了急性神经性厌食症女性患者腹侧纹状体系统对疾病特异性刺激的反应。方法：参与者是14名患有急性神经性厌食症的女性和14名匹配的健康对照女性，她们在评价视觉刺激时接受了功能性磁共振成像（fMRI），视觉刺激描绘了体重不足、正常体重、和超重的典型全身特征，根据标准化的身体质量指数。参与者被要求以自我指涉的方式处理每个刺激。每个重量类别的评级被用作对照task.Results：行为上，神经性厌食症的妇女提供了显着较高的积极评级，在响应体重不足的刺激比响应正常体重的刺激，而健康的比较妇女表现出更大的偏好正常体重的刺激相对于体重不足的刺激。功能上，腹侧纹状体活动表现出高度显着的组由刺激的相互作用，体重不足和正常体重的刺激。在神经性厌食症的妇女，激活是在处理体重不足的刺激相比，正常体重的刺激。相反的模式中观察到健康的比较women.Conclusions：这些研究结果是一致的预测在动物研究中的关键作用，人类的奖励系统在神经性厌食症，从而支持理论的饥饿依赖的维护的障碍。
Objective: Animal studies assessing mechanisms of self-starvation under conditions of stress and diet suggest a pivotal role for the mesolimbic reward system in the maintenance of core symptoms in anorexia nervosa, which is corroborated by initial empirical evidence in human studies. The authors examined activity in the ventral striatal system in response to disease-specific stimuli in women with acute anorexia nervosa.Method: Participants were 14 women with acute anorexia nervosa and 14 matched healthy comparison women who underwent functional magnetic resonance imaging (fMRI) during evaluation of visual stimuli depicting a female body with underweight, normal weight, and overweight canonical whole-body features according to standardized body mass indices. Participants were required to process each stimulus in a self-referring way. Ratings for each weight category were used as the control task.Results: Behaviorally, women with anorexia nervosa provided significantly higher positive ratings in response to underweight stimuli than in response to normal-weight stimuli, while healthy comparison women showed greater preference for normal-weight stimuli relative to underweight stimuli. Functionally, ventral striatal activity demonstrated a highly significant group-by-stimulus interaction for underweight and normal-weight stimuli. In women with anorexia nervosa, activation was higher during processing of underweight stimuli compared with normal-weight stimuli. The reverse pattern was observed in healthy comparison women.Conclusions: These findings are consistent with predictions in animal studies of the pivotal role of the human reward system in anorexia nervosa and thus support theories of starvation dependence in maintenance of the disorder.