Intact value-based decision-making during intertemporal choice in women with remitted anorexia nervosa? An fMRI study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

Abstract

Background: Extreme restrictive food choice in anorexia nervosa is thought to reflect excessive self-control and/or abnormal reward sensitivity. Studies using intertemporal choice paradigms have suggested an increased capacity to delay reward in anorexia nervosa, and this may explain an unusual ability to resist immediate temptation and override hunger in the long-term pursuit of thinness. It remains unclear, however, whether altered delay discounting in anorexia nervosa constitutes a state effect of acute illness or a trait marker observable after recovery.

Methods: We repeated the analysis from our previous fMRI investigation of intertemporal choice in acutely underweight patients with anorexia nervosa in a sample of weight-recovered women with anorexia nervosa (n = 36) and age-matched healthy controls (n = 36) who participated in the same study protocol. Follow-up analyses explored functional connectivity separately in both the weight-recovered/healthy controls sample and the acute/healthy controls sample.

Results: In contrast to our previous findings in acutely underweight patients with anorexia nervosa, we found no differences between weight-recovered patients with anorexia nervosa and healthy controls at either behavioural or neural levels. New analysis of data from the acute/healthy controls sample sample revealed increased coupling between dorsal anterior cingulate cortex and posterior brain regions as a function of decision difficulty, supporting the hypothesis of altered neural efficiency in the underweight state.

Limitations: This was a cross-sectional study, and the results may be task-specific.

Conclusion: Although our results underlined previous demonstrations of divergent temporal reward discounting in acutely underweight patients with anorexia nervosa, we found no evidence of alteration in patients with weight-recovered anorexia nervosa. Together, these findings suggest that impaired valuebased decision-making may not constitute a defining trait variable or “scar” of the disorder.

Details

Original languageEnglish
Pages (from-to)108-116
Number of pages9
JournalJournal of psychiatry & neuroscience : JPN
Volume45
Issue number2
Publication statusPublished - 1 Mar 2020
Peer-reviewedYes

External IDs

PubMedCentral PMC7828910
Scopus 85083293444
ORCID /0000-0002-2864-5578/work/142233474
ORCID /0000-0003-2132-4445/work/142236350
ORCID /0000-0002-5112-405X/work/142242683
ORCID /0000-0002-5026-1239/work/142250311
ORCID /0000-0001-5398-5569/work/150329467

Keywords

Sustainable Development Goals

Keywords

  • Acute Disease, Adolescent, Adult, Anorexia Nervosa/diagnostic imaging, Brain/diagnostic imaging, Case-Control Studies, Child, Choice Behavior, Decision Making, Female, Functional Neuroimaging, Gyrus Cinguli/diagnostic imaging, Humans, Magnetic Resonance Imaging, Mental Health Recovery, Neural Pathways/diagnostic imaging, Remission Induction, Thinness/physiopathology, Young Adult