Anorexia nervosa and obesity are associated with opposite brain reward response
Open accessAbstract
Anorexia nervosa (AN) is a severe psychiatric disorder associated with food avoidance and malnutrition. In this study, we wanted to test whether we would find brain reward alterations in AN, compared with individuals with normal or increased body weight. We studied 21 underweight, restricting-type AN (age M 22.5, SD 5.8 years), 19 obese (age M 27.1, SD 6.7 years), and 23 healthy control women (age M 24.8, SD 5.6 years), using blood oxygen level-dependent functional magnetic resonance brain imaging together with a reward-conditioning task. This paradigm involves learning the association between conditioned visual stimuli and unconditioned taste stimuli, as well as the unexpected violation of those learned associations. The task has been associated with activation of brain dopamine reward circuits, and it allows the comparison of actual brain response with expected brain activation based on established neuronal models. A group-by-task condition analysis (family-wise-error-corrected P<0.05) indicated that the orbitofrontal cortex differentiated all three groups. The dopamine model reward-learning signal distinguished groups in the anteroventral striatum, insula, and prefrontal cortex (P<0.001, 25 voxel cluster threshold), with brain responses that were greater in the AN group, but lesser in the obese group, compared with controls. These results suggest that brain reward circuits are more responsive to food stimuli in AN, but less responsive in obese women. The mechanism for this association is uncertain, but these brain reward response patterns could be biomarkers for the respective weight state.
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During reward conditioning, AN patients show abnormally high SN activity relative to controls and an increased preference for delayed rewards over immediate rewards.
“During reward conditioning, AN patients show abnormally high SN activity relative to controls (Frank et al., 2012), and an increased preference for delayed rewards over immediate rewards.”
From Cortico-striatal-thalamic loop circuits of the salience network: A central pathway in psychiatric disease and treatment (2016) · cites this paper as Frank et al., 2012
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- Authors
- Frank, G. K. W., Reynolds, J. R., Shott, M. E., Jappe, L., Yang, T. T., Tregellas, J. R., & O'Reilly, R. C.
- Affiliations
- University of Colorado Anschutz (US)
- University of Denver (US)
- University of Minnesota (US)
- University of California San Diego (US)
- Corresponding author
- Frank, Guido K W
- Venue
- Neuropsychopharmacology
- Published
- 2012-05-02
- Volume
- 37
- Issue
- 9
- Pages
- 2031-2046
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- PMC
- PMC3398719
- OpenAlex
- W2109310636
- Cited by
- 311
- References
- 73
- Citations by year
- 2026: 8 · 2025: 19 · 2024: 14 · 2023: 8 · 2022: 9 · 2021: 18 · 2020: 56 · 2019: 20 · 2018: 22 · 2017: 30 · 2016: 31 · 2015: 28 · 2014: 25 · 2013: 22 · 2012: 1
- FWCI
- 27.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH085734, K23MH080135)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- anorexia nervosa, obesity, orbitofrontal cortex, reward conditioning, food reward, insula, prefrontal cortex, body weight, women, biomarkers
- MeSH terms
- Adolescent, Adult, Anorexia Nervosa, Brain, Conditioning, Operant, Female, Humans, Nerve Net, Obesity, Reward, Sucrose, Taste, Young Adult
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