Document Detail

Hunger Does Not Motivate Reward in Women Remitted from Anorexia Nervosa.
MedLine Citation:
PMID:  25481622     Owner:  NLM     Status:  Publisher    
BACKGROUND: Hunger enhances sensitivity to reward, yet individuals with anorexia nervosa (AN) are not motivated to eat when starved. This study investigated brain response to rewards during hunger and satiated states to examine whether diminished response to reward could underlie food restriction in AN.
METHODS: Using a delay discounting monetary decision task known to discriminate brain regions contributing to processing of immediate rewards and cognitive control important for decision making regarding future rewards, we compared 23 women remitted from AN (RAN group; to reduce the confounding effects of starvation) with 17 healthy comparison women (CW group). Monetary rewards were used because the rewarding value of food may be confounded by anxiety in AN.
RESULTS: Interactions of Group (RAN, CW) × Visit (hunger, satiety) revealed that, for the CW group, hunger significantly increased activation in reward salience circuitry (ventral striatum, dorsal caudate, anterior cingulate cortex) during processing of immediate reward, whereas satiety increased activation in cognitive control circuitry (ventrolateral prefrontal cortex, insula) during decision making. In contrast, brain response in reward and cognitive neurocircuitry did not differ during hunger and satiety in the RAN group. A main effect of group revealed elevated response in the middle frontal gyrus for the RAN group compared with the CW group.
CONCLUSIONS: Women remitted from AN failed to increase activation of reward valuation circuitry when hungry and showed elevated response in cognitive control circuitry independent of metabolic state. Decreased sensitivity to the motivational drive of hunger may explain the ability of individuals with AN to restrict food when emaciated. Difficulties in valuating emotional salience may contribute to inabilities to appreciate the risks inherent in this disorder.
Christina E Wierenga; Amanda Bischoff-Grethe; A James Melrose; Zoe Irvine; Laura Torres; Ursula F Bailer; Alan Simmons; Julie L Fudge; Samuel M McClure; Alice Ely; Walter H Kaye
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-22
Journal Detail:
Title:  Biological psychiatry     Volume:  -     ISSN:  1873-2402     ISO Abbreviation:  Biol. Psychiatry     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-12-7     Completed Date:  -     Revised Date:  2014-12-8    
Medline Journal Info:
Nlm Unique ID:  0213264     Medline TA:  Biol Psychiatry     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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