Altered reward processing in women recovered from anorexia nervosa
Altered reward processing in women recovered from anorexia nervosa
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DOI：
10.1176/appi.ajp.2007.07040575
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发表时间：
2007-12-01
影响因子：
17.7
通讯作者：
Kaye, Walter H.
中科院分区：
文献类型：
--
作者：
Wagner, Angela;Aizenstein, Howard;Kaye, Walter H.
目的：众所周知，神经性厌食症患者是苦行者，能够忍受食物的自我克制，以及生活中的大多数舒适和快乐。基于以往神经性厌食症患者纹状体多巴胺结合改变的研究结果，作者试图评估这种疾病患者纹状体前腹侧纹状体对奖赏和损失的反应。方法：采用事件相关功能磁共振成像技术研究纹状体对简单金钱奖赏任务的反应。为了避免营养不良的混杂效应，作者比较了13名健康对照妇女和13名从限制性神经性厌食症中恢复过来的妇女，这些妇女体重正常，月经周期规律，没有暴饮暴食或通便。结果：恢复妇女的尾状核血流动力学活性高于对照妇女。只有康复的女性在特质焦虑和输赢期间尾状核血流动力学信号的百分比变化之间显示出显著的正相关关系。相反，在前腹侧纹状体，对照女性区分正反馈和负反馈，而康复女性对这两种情况的反应相似。结论：神经性厌食症患者康复后可能难以区分正反馈和负反馈。尾状核是一个将行动与结果联系在一起的区域，它的夸大激活可能构成了一种对奖励刺激做出反应的“战略性”(而不是享乐性)手段的尝试。作者假设，神经性厌食症患者在信息处理方面存在失衡，识别刺激的情感意义的能力受损，但与计划和结果有关的神经回路流量增加。
Objective: Individuals with anorexia nervosa are known to be ascetic and able to sustain self-denial of food as well as most comforts and pleasures in life. Building on previous findings of altered striatal dopamine binding in anorexia nervosa, the authors sought to assess the response of the anterior ventral striatum to reward and loss in this disorder.Method: Striatal responses to a simple monetary reward task were investigated using event-related functional magnetic resonance imaging. To avoid the confounding effects of malnutrition, the authors compared 13 healthy comparison women and 13 women who had recovered from restricting-type anorexia nervosa and had I year of normal weight and regular menstrual cycles, without binge eating or purging.Results: Recovered women showed greater hemodynamic activation in the caudate than comparison women. Only the recovered women showed a significant positive relationship between trait anxiety and the percentage change in hemodynamic signal in the caudate during either wins or losses. In contrast, in the anterior ventral striatum, comparison women distinguished positive and negative feedback, whereas recovered women had similar responses to both conditions.Conclusions: individuals who have recovered from anorexia nervosa may have difficulties in differentiating positive and negative feedback. The exaggerated activation of the caudate, a region involved in linking action to outcome, may constitute an attempt at "strategic" (as opposed to hedonic) means of responding to reward stimuli. The authors hypothesize that individuals with anorexia nervosa have an imbalance in information processing, with impaired ability to identify the emotional significance of a stimulus but increased traffic in neurocircuits concerned with planning and consequences.