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Altered prefrontal activation during the inhibition of eating responses in women with bulimia nervosa

Published online by Cambridge University Press:  25 February 2022

Laura A. Berner Open the ORCID record for Laura A. Berner [Opens in a new window] ,
Samantha R. Winter ,
Hasan Ayaz ,
Patricia A. Shewokis ,
Meltem Izzetoglu ,
Rachel Marsh ,
Jennifer A. Nasser ,
Alyssa J. Matteucci  and
Michael R. Lowe
Laura A. Berner*
Affiliation:
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Samantha R. Winter
Affiliation:
Google Health, Google LLC, Mountain View, CA, USA
Hasan Ayaz
Affiliation:
Drexel University, Philadelphia, PA, USA University of Pennsylvania, Philadelphia, PA, USA Center for Injury Research and Prevention at Children's Hospital of Philadelphia, Philadelphia, PA, USA
Patricia A. Shewokis
Affiliation:
Drexel University, Philadelphia, PA, USA
Meltem Izzetoglu
Affiliation:
Villanova University, Villanova, PA, USA
Rachel Marsh
Affiliation:
Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, USA
Jennifer A. Nasser
Affiliation:
Drexel University, Philadelphia, PA, USA
Alyssa J. Matteucci
Affiliation:
The Wharton School, University of Pennsylvania, Philadelphia, PA, USA
Michael R. Lowe
Affiliation:
Drexel University, Philadelphia, PA, USA
*
Author for correspondence: Laura A. Berner, E-mail: laura.berner@mssm.edu
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Abstract

Background

The sense of ‘loss of control’ (LOC), or a feeling of being unable to stop eating or control what or how much one is eating, is the most salient aspect of binge eating. However, the neural alterations that may contribute to this experience and eating behavior remain poorly understood.

Methods

We used functional near-infrared spectroscopy (fNIRS) to measure activation in the prefrontal cortices of 23 women with bulimia nervosa (BN) and 23 healthy controls (HC) during two tasks: a novel go/no-go task requiring inhibition of eating responses, and a standard go/no-go task requiring inhibition of button-pressing responses.

Results

Women with BN made more commission errors on both tasks. BN subgroups with the most severe LOC eating (n = 12) and those who felt most strongly that they binge ate during the task (n = 12) showed abnormally reduced bilateral ventromedial prefrontal cortex (vmPFC) and right ventrolateral prefrontal cortex (vlPFC) activation associated with eating-response inhibition. In the entire BN sample, lower eating-task activation in right vlPFC was related to more frequent and severe LOC eating, but no group differences in activation were detected on either task when this full sample was compared with HC. BN severity was unrelated to standard-task activation.

Conclusions

Results provide initial evidence that diminished PFC activation may directly contribute to more severe eating-specific control deficits in BN. Our findings support vmPFC and vlPFC dysfunction as promising treatment targets, and indicate that eating-specific tasks and fNIRS may be useful tools for identifying neural mechanisms underlying dysregulated eating.

Keywords

Bulimia nervosafNIRSinhibitory controlloss-of-control eatingprefrontal cortex
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 8 , June 2023 , pp. 3580 - 3590
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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