Donnelly Brooke, Foroughi Nasim, Williams Mark, Touyz Stephen, Madden Sloane, Kohn Michael, Clark Simon, Sachdev Perminder, Peduto Anthony, Caterson Ian, Russell Janice, Hay Phillipa
Clinical Psychology Unit, School of Psychology, University of Sydney, Camperdown, NSW, Australia.
Peter Beumont Tertiary Eating Disorder Service, Department of Psychiatry, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Front Psychol. 2022 Apr 21;13:687849. doi: 10.3389/fpsyg.2022.687849. eCollection 2022.
Bulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating (BE) episodes. Overlap exists between ED diagnostic groups, with BE episodes presenting one clinical feature that occurs transdiagnostically. Neuroimaging of the responses of those with BN and BED to disorder-specific stimuli, such as food, is not extensively investigated. Furthermore, to our knowledge, there have been no previous published studies examining the neural response of individuals currently experiencing binge eating, to low energy foods. Our objective was to examine the neural responses to both low energy and high energy food images in three emotive categories (disgust; fear; and happy) in BN and BED participants.
Nineteen females with BN ( = 14) or BED ( = 5), comprising the binge eating group (BEG; = 19), and 19 age-matched healthy control (HC)'s completed thorough clinical assessment prior to functional MRI (fMRI). Neural response to low energy and high energy foods and non-food images was compared between groups using whole-brain exploratory analyses, from which six regions of interest (ROI) were then selected: frontal, occipital, temporal, and parietal lobes; insula and cingulate.
In response to low energy food images, the BEG demonstrated differential neural responses to all three low energy foods categories (disgust; fear; and happy) compared to HCs. Correlational analyses found a significant association between frequency of binge episodes and diminished temporal lobe and greater occipital lobe response. In response to high energy food images, compared to HC's, the BEG demonstrated significantly decreased neural activity in response to all high energy food images. The HC's had significantly greater neural activity in the limbic system, occipital lobe, temporal lobe, frontal lobe, and limbic system in response to high energy food images.
Results in the low energy food condition indicate that binge frequency may be related to increased aberrant neural responding. Furthermore, differences were found between groups in all ROI's except the insula. The neural response seen in the BEG to disgust food images may indicate disengagement with this particular stimuli. In the high energy food condition, results demonstrate that neural activity in BN and BED patients may decrease in response to high energy foods, suggesting disengagement with foods that may be more consistent with those consumed during a binge eating episode.
神经性贪食症（BN）和暴饮暴食症（BED）是进食障碍（EDs），其特征为反复出现暴饮暴食（BE）发作。进食障碍诊断组之间存在重叠，暴饮暴食发作是一种跨诊断出现的临床特征。对患有神经性贪食症和暴饮暴食症的人对特定疾病刺激（如食物）的反应进行神经成像研究尚未广泛开展。此外，据我们所知，之前没有发表过研究来检验当前正在经历暴饮暴食的个体对低能量食物的神经反应。我们的目的是研究神经性贪食症和暴饮暴食症参与者对低能量和高能量食物图像在三种情绪类别（厌恶、恐惧和快乐）中的神经反应。
19名患有神经性贪食症（n = 14）或暴饮暴食症（n = 5）的女性，组成暴饮暴食组（BEG；n = 19），以及19名年龄匹配的健康对照者（HC）在功能磁共振成像（fMRI）之前完成了全面的临床评估。使用全脑探索性分析比较了两组对低能量和高能量食物以及非食物图像的神经反应，然后从中选择了六个感兴趣区域（ROI）：额叶、枕叶、颞叶和顶叶；脑岛和扣带回。
在对低能量食物图像的反应中，与健康对照者相比，暴饮暴食组对所有三种低能量食物类别（厌恶、恐惧和快乐）都表现出不同的神经反应。相关性分析发现暴饮暴食发作频率与颞叶反应减弱和枕叶反应增强之间存在显著关联。在对高能量食物图像的反应中，与健康对照者相比，暴饮暴食组对所有高能量食物图像的神经活动均显著降低。健康对照者在边缘系统、枕叶、颞叶、额叶和边缘系统对高能量食物图像的神经活动显著增强。
低能量食物条件下的结果表明，暴饮暴食频率可能与异常神经反应增加有关。此外，除脑岛外，所有感兴趣区域在两组之间均发现了差异。暴饮暴食组对厌恶食物图像的神经反应可能表明对这种特定刺激的脱离。在高能量食物条件下，结果表明神经性贪食症和暴饮暴食症患者对高能量食物时神经活动可能会降低，这表明他们对可能与暴饮暴食发作期间所食用食物更一致的食物产生了脱离。
