Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany. elke.gizewski @ uni-due.de
Neuropsychobiology. 2010 Aug;62(3):182-92. doi: 10.1159/000319360. Epub 2010 Jul 22.
There is evidence that patients with anorexia nervosa (AN) demonstrate specific cerebral activation patterns in response to visual food stimulation. We postulated that cerebral activation patterns could represent different perceptions of high-calorie images during hunger and satiety and could be determined by patients' subjective ratings.
After 6 h of starvation and also in a state of satiety, 12 female patients with AN and 12 normal-weight women were assessed by use of fMRI with high-calorie food images. All patients suffered from a restrictive type of AN. Heart rates, subjective ratings of satiety and valences of the visual stimuli were assessed.
Food stimuli presented during a state of hunger were associated with significant activation of the anterior cingulate cortex and insula in the control group and of the prefrontal and central cortices and insula in the AN group. During the hunger state activation in AN of the dorsal posterior cingulate cortex was revealed compared to the controls. In the state of satiety, activation of the left insula was observed in the AN group. Use of the food valence judgment as a covariate confirmed the insula activation and revealed additional activation of the orbitofrontal, cingulate and medial temporal cortices.
Our results indicate differences in cerebral activation patterns due to different perceptions of high-calorie food images, modulated by feelings of hunger or satiety, among AN patients with modulation by subjective ratings of food valence.
有证据表明,神经性厌食症(AN)患者在对视觉食物刺激做出反应时会表现出特定的大脑激活模式。我们假设大脑激活模式可以代表饥饿和饱腹感时对高热量图像的不同感知,并且可以通过患者的主观评分来确定。
在禁食 6 小时后,以及在饱腹状态下,12 名患有 AN 的女性患者和 12 名正常体重的女性被使用 fMRI 与高热量食物图像进行评估。所有患者均患有限制型 AN。评估了心率、饱腹感的主观评分和视觉刺激的效价。
在对照组中,饥饿状态下呈现的食物刺激与前扣带皮层和岛叶的显著激活有关,而在 AN 组中则与前额叶和中央皮层和岛叶的激活有关。与对照组相比,在饥饿状态下,AN 患者的后扣带皮层背侧被激活。在饱腹状态下,AN 组的左侧岛叶被激活。使用食物效价判断作为协变量证实了岛叶的激活,并显示出眶额、扣带和内侧颞叶皮质的额外激活。
我们的结果表明,由于对高热量食物图像的不同感知,以及饥饿或饱腹感的调节,AN 患者的大脑激活模式存在差异,并且受到食物效价主观评分的调节。