Food choice and neural reward systems in adolescents with anorexia nervosa and atypical anorexia nervosa.

IF 6.5 1区医学 Q1 PSYCHIATRY

Journal of Child Psychology and Psychiatry Pub Date : 2024-10-31 DOI:10.1111/jcpp.14066

E Caitlin Lloyd, Jonathan Posner, Janet Schebendach, Alexandra F Muratore, Susie Hong, Jessica Ojeda, Elizabeth Rafanello, Joanna E Steinglass, Karin Foerde

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Abstract

Background: Adolescence is a critical developmental period for the study of anorexia nervosa (AN), an illness characterized by extreme restriction of food intake. The maturation of the reward system during adolescence combined with recent neurobiological models of AN led to the hypothesis that early on in illness, restrictive food choices would be associated with activity in nucleus accumbens reward regions, rather than caudate regions identified among adults with AN.

Methods: Healthy adolescents (HC, n = 41) and adolescents with AN or atypical AN (atypAN, n = 76) completed a Food Choice Task during fMRI scanning. Selection of high-fat foods and choice-related activation in nucleus accumbens and anterior caudate regions-of-interest (ROIs) were compared between individuals with AN/atypAN and HC. Associations were examined between choice-related activation and choice preferences among the AN group. Exploratory analyses examined associations between choice-related activation and psychological assessments among the patient group.

Results: Adolescents with AN or atypAN selected fewer high-fat foods than HC (t = -5.92, p < .001). Counter to predictions, there were no significant group differences in choice-related activation in the ROIs. Among individuals with AN or atypAN, choice-related neural activity in the anterior caudate was significantly negatively associated with high-fat food selections in the task (r = -.32, p = .024). In exploratory analyses, choice-related anterior caudate activation was positively associated with psychological measures of illness severity among patients (p's < .05, uncorrected).

Conclusions: In this large cohort of adolescents with AN/atypAN, there was no evidence of altered reward system engagement during food choice. While there was no group difference in choice-related caudate activation, the associations with choices and psychological measures continue to suggest that this neural region is implicated in illness. Longitudinal analyses will clarify whether neural variability relates to longer-term course.

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神经性厌食症和非典型厌食症青少年的食物选择和神经奖赏系统。

背景：青春期是研究神经性厌食症（AN）的关键发育时期，这种疾病的特点是极度限制食物摄入。青春期奖赏系统的成熟与神经性厌食症的最新神经生物学模型相结合，导致了这样一种假设：在患病初期，限制性食物选择与伏隔核奖赏区的活动有关，而不是与成人神经性厌食症患者中发现的尾状核区有关。方法：健康青少年（HC，n = 41）和患有神经性厌食症或非典型神经性厌食症的青少年（atypAN，n = 76）在进行 fMRI 扫描时完成食物选择任务。对患有自闭症/非典型自闭症的青少年与患有自闭症/非典型自闭症的青少年进行了食物选择任务，并比较了自闭症/非典型自闭症青少年与患有自闭症/非典型自闭症的青少年选择高脂肪食物的情况以及与选择相关的凹凸核和尾状核前部感兴趣区（ROIs）的激活情况。研究还考察了AN组中选择相关激活与选择偏好之间的关联。探索性分析研究了患者组中选择相关激活与心理评估之间的关联：在这一大群患有自闭症/非自闭症的青少年中，没有证据表明在选择食物时奖赏系统的参与发生了改变。虽然在与选择相关的尾状核激活方面没有组间差异，但与选择和心理测量的关联继续表明，这一神经区域与疾病有关。纵向分析将明确神经变异是否与长期病程有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Child Psychology and Psychiatry 医学-精神病学

CiteScore

13.80

自引率

5.30%

发文量

169

审稿时长

1 months

期刊介绍： The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including: Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents. Diagnosis: Research on the identification and classification of childhood disorders. Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health. Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders. Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health. Genetics: Genetic factors contributing to the development of childhood disorders. JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health. The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.