Mind-body Research, Biomedical Sciences Group, KU Leuven, Belgium.
Curr Opin Psychiatry. 2023 Nov 1;36(6):443-448. doi: 10.1097/YCO.0000000000000895. Epub 2023 Aug 24.
Studies increasingly show the importance of reward processing in binge eating and provide evidence of associated changes in the neurobiological reward system. This review gives an up-to-date overview of the neurobiological substrates of reward processing subconstructs in binge eating. Neural findings are linked to different behavioral theories and the clinical relevance is discussed.
Increased neural responses in the orbitofrontal cortex, anterior cingulate cortex as well as striatum during anticipation and receipt of food rewards are found in association to binge eating. Increased model-free learning is also found and associated with altered brain reward reactivity. Data in rest report reduced striatal dopamine release and lower frontostriatal connectivity. Mechanisms of onset of binge eating are less clear, but specific personality traits, related to frontostriatal dysconnectivity, probably increase the risk of binge eating onset.
Both structural and task-based imaging studies show differences in the neurobiological reward system in binge eating. These changes are linked to specific reward processing, such as altered reward responsiveness to food cues, reinforcement learning, and habitual behavior. Findings are lined with different behavioral theories of binge eating, and a staging model is described, from onset to full illness development. Understanding the specific underlying aberrant reward mechanism in binge eating, associated with different stages of the illness, enables caregivers to focus their treatment more precisely.
越来越多的研究表明，在暴食行为中，奖励处理很重要，并为神经生物学奖励系统的相关变化提供了证据。这篇综述概述了暴食行为中奖励处理亚结构的神经生物学基础，概述了最新的研究进展。将神经发现与不同的行为理论联系起来，并讨论了其临床意义。
在预期和获得食物奖励时，眶额皮层、前扣带皮层和纹状体中的神经反应增加与暴食行为有关。还发现了无模型学习的增加，并与大脑奖励反应的改变有关。在静息状态下，数据显示纹状体多巴胺释放减少，额纹状体连接减少。暴食行为的发病机制尚不清楚，但特定的人格特质，与额纹状体连接中断有关，可能会增加暴食行为的发病风险。
结构和基于任务的成像研究都显示出暴食行为中神经生物学奖励系统的差异。这些变化与特定的奖励处理有关，例如对食物线索的奖励反应、强化学习和习惯性行为的改变。这些发现与暴食行为的不同行为理论相一致，并描述了一个从发病到完全发病的阶段模型。了解暴食行为中与疾病不同阶段相关的特定异常奖励机制，使护理人员能够更精确地关注治疗。
