On Weight and Waiting: Delay Discounting in Anorexia Nervosa Pretreatment and Posttreatment.
On Weight and Waiting: Delay Discounting in Anorexia Nervosa Pretreatment and Posttreatment.
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DOI：
10.1016/j.biopsych.2014.12.016
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发表时间：
2015-11-01
影响因子：
10.6
通讯作者：
Steinglass JE
中科院分区：
文献类型：
--
作者：
Decker JH;Figner B;Steinglass JE
患有神经性厌食症（AN）的人会抑制食欲，为了长期目标而放弃眼前的奖励。我们研究了治疗前后AN的延迟折扣及其神经相关因素，以测试疾病持续的潜在机制。AN住院患者（n=59）和健康对照（HC, n=39）在两个时间点执行延迟折扣任务。一个子集（n=30 AN, n=22 HC）在任务期间参与了fMRI扫描。这项任务包括一系列具有可变延迟时间的货币选择，产生个人贴现率——货币随时间贬值的比率。在治疗前，与HC相比，AN组表现出对延迟奖励的偏好（即，较低的折扣率）；体重恢复后，AN与HC无差异。相对于延迟的选择，体重不足的AN表现出较慢的反应时间；这种情况在治疗后发生了逆转。体重过轻的AN表现为纹状体和前扣带背侧神经活动异常；行为正常化与奖励区（纹状体和背前扣带）和决策区（背外侧前额叶皮层和顶叶皮层）的激活增加有关。AN的营养不良状态可能会放大为了长期目标而放弃眼前回报的倾向。结果表明，表现为“过度自我控制”的行为与前额叶的增强招募并不相符。相反，这些结果指出了扣带回纹状体回路的改变，这为决策神经系统异常在AN延续中的潜在作用提供了新的见解。
Individuals with anorexia nervosa (AN) override the drive to eat, forgoing immediate rewards in favor of longer-term goals. We examined delay discounting and its neural correlates in AN before and after treatment to test a potential mechanism of illness persistence. Inpatients with AN (n=59) and healthy controls (HC, n=39) performed a delay discounting task at two timepoints. A subset (n=30 AN, n=22 HC) participated in fMRI scanning during the task. The task consisted of a range of monetary choices with variable delay times, yielding individual discount rates—the rate by which money loses value over time. Before treatment, the AN group showed a preference for delayed over earlier rewards (i.e., less steep discount rates) compared with HC; after weight restoration, AN did not differ from HC. Underweight AN showed slower response times for earlier versus delayed choices; this reversed with treatment. Underweight AN showed abnormal neural activity in striatum and dorsal anterior cingulate; normalization of behavior was associated with increased activation in reward regions (striatum and dorsal anterior cingulate) and decision-making regions (dorsolateral prefrontal cortex and parietal cortex). The undernourished state of AN may amplify the tendency to forgo immediate rewards in favor of longer-term goals. The results suggest that behavior that looks phenotypically like “excessive self-control” does not correspond with enhanced prefrontal recruitment. Rather, the results point to alterations in cingulo-striatal circuitry that offer new insights on the potential role of abnormalities in decision-making neural systems in the perpetuation of AN.
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影响因子：
56.9
作者：
Hare, Todd A.;Camerer, Colin F.;Rangel, Antonio
通讯作者：
Rangel, Antonio
DOI：
10.1111/j.1460-9568.2012.08058.x
发表时间：
2012-04
期刊：
The European journal of neuroscience
影响因子：
--
作者：
Kurth-Nelson Z;Bickel W;Redish AD
通讯作者：
Redish AD
影响因子：
5.7
作者：
Ballard K;Knutson B
通讯作者：
Knutson B
影响因子：
2.9
作者：
Carr, KD
通讯作者：
Carr, KD
影响因子：
25
作者：
Kable, Joseph W.;Glimcher, Paul W.
通讯作者：
Glimcher, Paul W.