Brain responses to body image stimuli but not food are altered in women with bulimia nervosa

BMC Psychiatry

Ulrike Schmidt⁴  Iain C Campbell⁴  Philippe-Olivier Harvey⁵  Chris M Andrew²  Rudolf Uher⁶  Andrew Simmons¹  Vincent Giampietro²  Frederique Van den Eynde³ 

[1]NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King’s College London, London, UK

[2]Institute of Psychiatry, Department of Neuroimaging, King’s College London, London, UK

[3]Institute of Psychiatry, King’s College London, PO Box 59, De Crespigny Park, SE5 8AF, London, UK

[4]Department of Psychological Medicine, Section of Eating Disorders Institute of Psychiatry, King’s College London, London, UK

[5]Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada

[6]Department of Psychiatry, Dalhousie University, Halifax, NS, Canada

关键词: Craving;    Anxiety;    Insula;    Bulimia nervosa;    Functional magnetic resonance imaging;   

Others  :  1123891
DOI  :  10.1186/1471-244X-13-302

 received in 2013-05-23, accepted in 2013-09-03,  发布年份 2013

【 摘 要 】

Background

Research into the neural correlates of bulimia nervosa (BN) psychopathology remains limited.

Methods

In this functional magnetic resonance imaging study, 21 BN patients and 23 healthy controls (HCs) completed two paradigms: 1) processing of visual food stimuli and 2) comparing their own appearance with that of slim women. Participants also rated food craving and anxiety levels.

Results

Brain activation patterns in response to food cues did not differ between women with and without BN. However, when evaluating themselves against images of slim women, BN patients engaged the insula more and the fusiform gyrus less, compared to HCs, suggesting increased self-focus among women with BN whilst comparing themselves to a ‘slim ideal’. In these BN patients, exposure to food and body image stimuli increased self-reported levels of anxiety, but not craving.

Conclusions

Our findings suggest that women with BN differ from HCs in the way they process body image, but not in the way they process food stimuli.

【 授权许可】

   
2013 Van den Eynde et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Smink FR, van Hoeken D, Hoek HW: Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 2012, 14(4):406-414.
• [2]Mitchell JE, Agras S, Crow S, Halmi K, Fairburn CG, Bryson S, Kraemer H: Stepped care and cognitive-behavioural therapy for bulimia nervosa: randomised trial. Br J Psychiatry 2011, 198(5):391-397.
• [3]Lavender A, Startup H, Naumann U, Samarawickrema N, Dejong H, Kenyon M, van den Eynde F, Schmidt U: Emotional and social mind training: a randomised controlled trial of a new group-based treatment for bulimia nervosa. PLoS One 2012, 7(10):e46047.
• [4]Marsh R, Horga G, Wang Z, Wang P, Klahr KW, Berner LA, Walsh BT, Peterson BS: An fMRI study of self-regulatory control and conflict resolution in adolescents with bulimia nervosa. Am J Psychiatry 2011. doi:10.1176/appi.ajp.2011.11010094
• [5]Marsh R, Steinglass JE, Gerber AJ, Graziano O'Leary K, Wang Z, Murphy D, Walsh BT, Peterson BS: Deficient activity in the neural systems that mediate self-regulatory control in bulimia nervosa. Arch Gen Psychiatry 2009, 66(1):51-63.
• [6]Frank GK, Reynolds JR, Shott ME, O'Reilly RC: Altered temporal difference learning in bulimia nervosa. Biol Psychiatry 2011, 70(8):728-735.
• [7]Bohon C, Stice E: Reward abnormalities among women with full and subthreshold bulimia nervosa: a functional magnetic resonance imaging study. Int J Eat Disord 2011, 44(7):585-595.
• [8]Wagner A, Aizenstein H, Venkatraman VK, Bischoff-Grethe A, Fudge J, May JC, Frank GK, Bailer UF, Fischer L, Putnam K, et al.: Altered striatal response to reward in bulimia nervosa after recovery. Int J Eat Disord 2010, 43(4):289-294.
• [9]Garcia-Garcia I, Narberhaus A, Marques-Iturria I, Garolera M, Radoi A, Segura B, Pueyo R, Ariza M, Jurado MA: Neural responses to visual food cues: insights from functional magnetic resonance imaging. Eur Eat Disord Rev 2013, 21(2):89-98.
• [10]Uher R, Murphy T, Brammer MJ, Dalgleish T, Phillips ML, Ng VW, Andrew CM, Williams SCR, Campbell IC, Treasure J: Medial prefrontal cortex activity associated with symptom provocation in eating disorders. Am J Psychiatr 2004, 161(7):1238-1246.
• [11]Schienle A, Schäfer A, Hermann A, Vaitl D: Binge-eating disorder: reward sensitivity and brain activation to images of food. Biol Psychiatry 2009, 65(8):654-661.
• [12]Joos AA, Saum B, Zeeck A, Perlov E, Glauche V, Hartmann A, Freyer T, Sandholz A, Unterbrink T, Elst LT, et al.: Frontocingular dysfunction in bulimia nervosa when confronted with disease-specific stimuli. Eur Eat Disord Rev 2011. doi:10.1002/erv.1150
• [13]Brooks SJ OGOD, Uher R, Friederich HC, Giampietro V, Brammer M, Williams SC, Schioth HB, Treasure J, Campbell IC: Differential neural responses to food images in women with bulimia versus anorexia nervosa. PLoS One 2011, 6(7):e22259.
• [14]Kim KR, Ku J, Lee JH, Lee H, Jung YC: Functional and effective connectivity of anterior insula in anorexia nervosa and bulimia nervosa. Neurosci Lett 2012, 521(2):152-157.
• [15]Brooks SJ, O'Daly OG, Uher R, Friederich H-C, Giampietro V, Brammer M, Williams SCR, Schioth HB, Treasure J, Campbell IC: Differential neural responses to food images in women with bulimia versus anorexia nervosa. PLoS One 2011, 6(7):e22259.
• [16]Demos KE, Kelley WM, Heatherton TF: Dietary restraint violations influence reward responses in nucleus accumbens and amygdala. J Cogn Neurosci 2011, 23(8):1952-1963.
• [17]Friederich HC, Brooks S, Uher R, Campbell IC, Giampietro V, Brammer M, Williams SCR, Herzog W, Treasure J: Neural correlates of body dissatisfaction in anorexia nervosa. Neuropsychologia 2010, 48(10):2878-2885.
• [18]Vocks S, Busch M, Grönemeyer D, Schulte D, Herpertz S, Suchan B: Neural correlates of viewing photographs of one's own body and another woman's body in anorexia and bulimia nervosa: An fMRI study. J Psychiatry Neurosci 2010, 35(3):163-176.
• [19]Spangler DL, Allen MD: An fMRI investigation of emotional processing of body shape in bulimia nervosa. Int J Eat Disord 2011. doi:10.1002/eat.20899
• [20]Mohr HM, Roder C, Zimmermann J, Hummel D, Negele A, Grabhorn R: Body image distortions in bulimia nervosa: investigating body size overestimation and body size satisfaction by fMRI. Neuroimage 2011, 56(3):1822-1831.
• [21]Miyake Y, Okamoto Y, Onoda K, Kurosaki M, Shirao N, Yamawaki S: Brain activation during the perception of distorted body images in eating disorders. Psychiatry Res 2010, 181(3):183-192.
• [22]Uher R, Murphy T, Friederich HC, Dalgleish T, Brammer MJ, Giampietro V, Phillips ML, Andrew CM, Ng VW, Williams SCR, et al.: Functional neuroanatomy of body shape perception in healthy and eating-disordered women. Biol Psychiatry 2005, 58(12):990-997.
• [23]Craig AD: How do you feel–now? The anterior insula and human awareness. Nat Rev Neurosci 2009, 10(1):59-70.
• [24]Craig AD: Significance of the insula for the evolution of human awareness of feelings from the body. Ann N Y Acad Sci 2011, 1225:72-82.
• [25]Nunn K, Frampton I, Fuglset TS, Torzsok-Sonnevend M, Lask B: Anorexia nervosa and the insula. Med Hypotheses 2011, 76(3):353-357.
• [26]Kaye WH, Wagner A, Fudge JL, Paulus M: Neurocircuity of eating disorders. Curr Top Behav Neurosci 2010, 6:37-57.
• [27]Claes L, Hart TA, Smits D, Van den Eynde F, Mueller A, Mitchell JE: Validation of the social appearance anxiety scale in female eating disorder patients. Eur Eat Disord Rev 2011. doi:10.1002/erv.1147
• [28]Koskina A, Van den Eynde F, Meisel S, Campbell I, Schmidt U: Social appearance anxiety and bulimia nervosa. Eating Weight Disord 2011, 16(2):e142-e145.
• [29]First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, research version, Non-Patient edition. (SCID-I/NP). New York: Biometrics Research, New York State Psychiatric Institute; 2002. November 2002
• [30]First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, research version, Patient Edition. (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute; 2002. November 2002
• [31]Mond JM, Myers TC, Crosby RD, Hay PJ, Rodgers B, Morgan JF, Lacey JH, Mitchell JE: Screening for eating disorders in primary care: EDE-Q versus SCOFF. Behav Res Ther 2008, 46(5):612-622.
• [32]Fairburn: Eating Disorder Examination (Edition 16.0D) and Eating Disorder Examination Questionnaire (EDE-Q 6.0). In Cognitive therapy and eating disorders. Edited by Fairburn CG. New York, USA: Guildford Press; 2009:265-313.
• [33]Cepeda-Benito A, Gleaves DH, Williams TL, Erath SA: The development and validation of the state and trait food-cravings questionnaires. Behav Ther 2000, 31(1):151-173.
• [34]Hart TA, Flora DB, Palyo SA, Fresco DM, Holle C, Heimberg RG: Development and examination of the social appearance anxiety scale. Assessment 2008, 15(1):48-59.
• [35]Thompson JK, Heinberg L, Tantleff S: The Physical Appearance Comparison Scale (PACS). The Behavior Therapist 1991, 14:174.
• [36]Lovibond PF, Lovibond SH: The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther 1995, 33(3):335-343.
• [37]Uher R, Brammer MJ, Murphy T, Campbell IC, Ng VW, Williams SC, Treasure J: Recovery and chronicity in anorexia nervosa: brain activity associated with differential outcomes. Biol Psychiatry 2003, 54(9):934-942.
• [38]Friederich HC, Uher R, Brooks S, Giampietro V, Brammer M, Williams SCR, Herzog W, Treasure J, Campbell IC: I'm not as slim as that girl: Neural bases of body shape self-comparison to media images. Neuroimage 2007, 37(2):674-681.
• [39]Ashworth F, Pringle A, Norbury R, Harmer CJ, Cowen PJ, Cooper MJ: Neural response to angry and disgusted facial expressions in bulimia nervosa. Psychol Med 2011, 41(11):1-10.
• [40]Simmons A, Moore E, Williams SC: Quality control for functional magnetic resonance imaging using automated data analysis and Shewhart charting. Magn Reson Med 1999, 41(6):1274-1278.
• [41]Cohen D: Statistical power analysis for the behavioral sciences. 2nd edition. Hillsdale, NJ: Erlbaum; 1988.
• [42]Brammer MJ, Bullmore ET, Simmons A, Williams SC, Grasby PM, Howard RJ, Woodruff PW, Rabe-Hesketh S: Generic brain activation mapping in functional magnetic resonance imaging: a nonparametric approach. Magn Reson Imaging 1997, 15(7):763-770.
• [43]Thirion B, Pinel P, Meriaux S, Roche A, Dehaene S, Poline JB: Analysis of a large fMRI cohort: Statistical and methodological issues for group analyses. Neuroimage 2007, 35(1):105-120.
• [44]Bullmore ET, Suckling J, Overmeyer S, Rabe-Hesketh S, Taylor E, Brammer MJ: Global, voxel, and cluster tests, by theory and permutation, for a difference between two groups of structural MR images of the brain. IEEE Trans Med Imaging 1999, 18(1):32-42.
• [45]Litt A, Plassmann H, Shiv B, Rangel A: Dissociating valuation and saliency signals during decision-making. Cereb Cortex 2011, 21(1):95-102.
• [46]Frank GK, Wagner A, Achenbach S, McConaha C, Skovira K, Aizenstein H, Carter CS, Kaye WH: Altered brain activity in women recovered from bulimic-type eating disorders after a glucose challenge: a pilot study. Int J Eat Disord 2006, 39(1):76-79.
• [47]Siep N, Roefs A, Roebroeck A, Havermans R, Bonte M, Jansen A: Fighting food temptations: the modulating effects of short-term cognitive reappraisal, suppression and up-regulation on mesocorticolimbic activity related to appetitive motivation. NeuroImage 2012, 60(1):213-220.
• [48]Gorini A, Griez E, Petrova A, Riva G: Assessment of the emotional responses produced by exposure to real food, virtual food and photographs of food in patients affected by eating disorders. Ann Gen Psychiatr 2010, 9:30. BioMed Central Full Text
• [49]Van den Eynde F, Koskina A, Syrad H, Guillaume S, Broadbent H, Campbell IC, Schmidt U: State and trait food craving in people with bulimic eating disorders. Eat Behav 2012, 13(4):414-417.
• [50]Modinos G, Ormel J, Aleman A: Activation of anterior insula during self-reflection. PLoS One 2009, 4(2):e4618.
• [51]Mohr HM, Zimmermann J, Roder C, Lenz C, Overbeck G, Grabhorn R: Separating two components of body image in anorexia nervosa using fMRI. Psychol Med 2010, 40(9):1519-1529.
• [52]Peelen MV, Downing PE: The neural basis of visual body perception. Nat Rev Neurosci 2007, 8(8):636-648.
• [53]Vocks S, Schulte D, Busch M, Grönemeyer D, Herpertz S, Suchan B: Changes in neuronal correlates of body image processing by means of cognitive-behavioural body image therapy for eating disorders: a randomized controlled fMRI study. Psychol Med 2011, 48(1):1-9.
• [54]Vocks S, Busch M, Grönemeyer D, Schulte D, Herpertz S, Suchan B: Differential neuronal responses to the self and others in the extrastriate body area and the fusiform body area. Cogn Affect Behav Neurosci 2010, 10(3):422-429.
• [55]Muehlhan M, Lueken U, Wittchen HU, Kirschbaum C: The scanner as a stressor: evidence from subjective and neuroendocrine stress parameters in the time course of a functional magnetic resonance imaging session. Int J Psychophysiol 2011, 79(2):118-126.
• [56]Lueken U, Muehlhan M, Wittchen HU, Kellermann T, Reinhardt I, Konrad C, Lang T, Wittmann A, Strohle A, Gerlach AL, et al.: (Don't) panic in the scanner! How panic patients with agoraphobia experience a functional magnetic resonance imaging session. Eur Neuropsychopharmacol 2011, 21(7):516-525.
• [57]Blechert J, Feige B, Joos A, Zeeck A, Tuschen-Caffier B: Electrocortical processing of food and emotional pictures in anorexia nervosa and bulimia nervosa. Psychosom Med 2011, 73(5):415-421.