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Deficient Activity in the Neural Systems That Mediate Self-regulatory Control in Bulimia Nervosa
Open accessAbstract
CONTEXT: Disturbances in neural systems that mediate voluntary self-regulatory processes may contribute to bulimia nervosa (BN) by releasing feeding behaviors from regulatory control. OBJECTIVE: To study the functional activity in neural circuits that subserve self-regulatory control in women with BN. DESIGN: We compared functional magnetic resonance imaging blood oxygenation level-dependent responses in patients with BN with healthy controls during performance of the Simon Spatial Incompatibility task. SETTING: University research institute. PARTICIPANTS: Forty women: 20 patients with BN and 20 healthy control participants. Main Outcome Measure We used general linear modeling of Simon Spatial Incompatibility task-related activations to compare groups on their patterns of brain activation associated with the successful or unsuccessful engagement of self-regulatory control. RESULTS: Patients with BN responded more impulsively and made more errors on the task than did healthy controls; patients with the most severe symptoms made the most errors. During correct responding on incongruent trials, patients failed to activate frontostriatal circuits to the same degree as healthy controls in the left inferolateral prefrontal cortex (Brodmann area [BA] 45), bilateral inferior frontal gyrus (BA 44), lenticular and caudate nuclei, and anterior cingulate cortex (BA 24/32). Patients activated the dorsal anterior cingulate cortex (BA 32) more when making errors than when responding correctly. In contrast, healthy participants activated the anterior cingulate cortex more during correct than incorrect responses, and they activated the striatum more when responding incorrectly, likely reflecting an automatic response tendency that, in the absence of concomitant anterior cingulate cortex activity, produced incorrect responses. CONCLUSIONS: Self-regulatory processes are impaired in women with BN, likely because of their failure to engage frontostriatal circuits appropriately. These findings enhance our understanding of the pathogenesis of BN by pointing to functional abnormalities within a neural system that subserves self-regulatory control, which may contribute to binge eating and other impulsive behaviors in women with BN.
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“Our fMRI findings among women with bulimia suggest that their failure to engage frontostriatal circuits appropriately contributes to their impairments in behavioral self-regulation (87).”
From Functional disturbances within frontostriatal circuits across multiple childhood psychopathologies (2009) · cites this paper as [87]
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“On task-based fMRI, BN patients display low frontostriatal activity on a number of cognitive control tasks, including the Simon Spatial task (Marsh et al., 2009b, 2011) and Go/No-Go (Skunde et al., 2016).”
BackgroundMethodLavender, J. M., Wonderlich, S. A., Engel, S. G., Gordon, K. H., Kaye, W. H., & Mitchell, J. E. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.05.010 · Cited by 512
“Moreover, recent studies have revealed abnormal functioning in neurocircuitry underlying executive processes in AN and BN (e.g., Lock et al., 2011; Marsh et al., 2009, 2011; Wagner et al., 2007; Zastrow et al., 2009), which is relevant to dysregulated behaviors in BN and overregulated behaviors in…”
Background
Metadata
- Authors
- Marsh, R., Steinglass, J. E., Gerber, A. J., Graziano O’Leary, K., Wang, Z., Murphy, D., Walsh, B. T., & Peterson, B. S.
- Affiliations
- New York State Psychiatric Institute (US)
- ORCID
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2009-01-01
- Volume
- 66
- Issue
- 1
- Pages
- 51
- ISSN
- 0003-990X (ISSN-L)
- PMC
- PMC2759684
- OpenAlex
- W2071018088
- Cited by
- 190
- References
- 62
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 11 · 2023: 10 · 2022: 3 · 2021: 5 · 2020: 14 · 2019: 6 · 2018: 12 · 2017: 18 · 2016: 13 · 2015: 14 · 2014: 11 · 2013: 21 · 2012: 14
- FWCI
- 15.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (K-02-74677)
- National Institute of Mental Health (K01MH077652, R01MH090062)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- bulimia nervosa, frontostriatal circuits, anterior cingulate cortex, striatum, prefrontal cortex, impulsivity, binge eating, women
- MeSH terms
- Adolescent, Adult, Brain, Caudate Nucleus, Corpus Striatum, Discrimination, Psychological, Dominance, Cerebral, Female, Frontal Lobe, Gyrus Cinguli, Humans, Image Processing, Computer-Assisted, Impulsive Behavior, Internal-External Control, Magnetic Resonance Imaging, Nerve Net, Orientation, Oxygen, Pattern Recognition, Visual, Psychomotor Performance, Reference Values, Prefrontal Cortex, Bulimia Nervosa
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