Alterations in brain structures related to taste reward circuitry in ill and recovered anorexia nervosa and in bulimia nervosa.
Alterations in brain structures related to taste reward circuitry in ill and recovered anorexia nervosa and in bulimia nervosa.
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DOI：
10.1176/appi.ajp.2013.12101294
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发表时间：
2013-10
期刊：
影响因子：
--
通讯作者：
Mittal VA
中科院分区：
文献类型：
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作者：
Frank GK;Shott ME;Hagman JO;Mittal VA
神经性厌食症饮食失调的病理生理学仍然不清楚，但大脑结构的改变可能是功能上重要的生物标志物。在这里，我们评估了与大脑结构相关的味觉愉悦度和奖励敏感性，这可能与饮食失调中常见的食物回避有关。我们使用结构磁共振脑成像来研究目前患病的限制型个体（n = 19）或恢复性神经性厌食症（n = 24）、神经性贪食症（n = 19）和健康对照女性（n = 24）的灰质和白质体积。所有饮食失调组均显示内侧眶额皮质（直回）灰质体积增加。手动追踪证实了直回体积较大，并预测了所有组的味觉愉悦度。分析还表明诊断类别之间的其他形态学差异：与对照组相比，患病和恢复的神经性厌食症右侧脑岛灰质体积增加，而神经性贪食症左侧前腹侧岛叶灰质体积增加。此外，厌食症和神经性贪食症康复者的背侧纹状体体积减少，并预测饮食失调组对奖励的敏感性。与健康对照组相比，饮食失调组的右颞叶和顶叶区域的白质也减少了。值得注意的是，在控制一系列协变量（例如年龄、抑郁、焦虑、药物）时，结果仍然成立。内侧眶额皮层、岛叶和纹状体的大脑结构在饮食失调中发生改变，这表明与味觉愉悦和奖励价值相关的大脑回路发生了改变。
The pathophysiology of the eating disorder anorexia nervosa remains obscure, but structural brain alterations could be functionally important biomarkers. Here we assessed taste pleasantness and reward sensitivity in relation to brain structure, which might be related to food avoidance commonly seen in eating disorders. We used structural magnetic resonance brain imaging to study gray and white matter volumes in individuals with restricting type currently ill (n = 19) or recovered-anorexia nervosa (n = 24), bulimia nervosa (n= 19) and healthy control women (n=24). All eating disorder groups showed increased gray matter volume of the medial orbitofrontal cortex (gyrus rectus). Manually tracing confirmed larger gyrus rectus volume, and predicted taste pleasantness across all groups. The analyses also indicated other morphological differences between diagnostic categories: Ill and recovered-anorexia nervosa had increased right, while bulimia nervosa had increased left antero-ventral insula gray matter volumes compared to controls. Furthermore, dorsal striatum volumes were reduced in recovered-anorexia and bulimia nervosa, and predicted sensitivity to reward in the eating disorder groups. The eating disorder groups also showed reduced white matter in right temporal and parietal areas when compared to healthy controls. Notably, the results held when controlling for a range of covariates (e.g., age, depression, anxiety, medications). Brain structure in medial orbitofrontal cortex, insula and striatum is altered in eating disorders and suggests altered brain circuitry that has been associated with taste pleasantness and reward value.