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Increased anterior cingulate cortex response precedes behavioural adaptation in anorexia nervosa

View Article: PubMed Central - PubMed

ABSTRACT

Patients with anorexia nervosa (AN) are characterised by increased self-control, cognitive rigidity and impairments in set-shifting, but the underlying neural mechanisms are poorly understood. Here we used functional magnetic resonance imaging (fMRI) to elucidate the neural correlates of behavioural adaptation to changes in reward contingencies in young acutely ill AN patients. Thirty-six adolescent/young adult, non-chronic female AN patients and 36 age-matched healthy females completed a well-established probabilistic reversal learning task during fMRI. We analysed hemodynamic responses in empirically-defined regions of interest during positive feedback and negative feedback not followed/followed by behavioural adaptation and conducted functional connectivity analyses. Although overall task performance was comparable between groups, AN showed increased shifting after receiving negative feedback (lose-shift behaviour) and altered dorsal anterior cingulate cortex (dACC) responses as a function of feedback. Specifically, patients had increased dACC responses (which correlated with perfectionism) and task-related coupling with amygdala preceding behavioural adaption. Given the generally preserved task performance in young AN, elevated dACC responses specifically during behavioural adaption is suggestive of increased monitoring for the need to adjust performance strategies. Higher dACC-amygdala coupling and increased adaptation after negative feedback underlines this interpretation and could be related to intolerance of uncertainty which has been suggested for AN.

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gPPI results.Statistical maps (whole-brain analysis, p < 0.001 uncorrected, cluster extent k> = 30) showing regions of group differences in functional connectivity across task conditions (warm colours). Global peak at x = 25, y =β€‰βˆ’10, z =β€‰βˆ’8 [F(2,140) = 9.9, p < 0.001]. Seventy-seven percent of the cluster overlaps with the right centromedial amygdala (coloured in green) defined by the JΓΌlich probabilistic atlas104.
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f2: gPPI results.Statistical maps (whole-brain analysis, p < 0.001 uncorrected, cluster extent k> = 30) showing regions of group differences in functional connectivity across task conditions (warm colours). Global peak at x = 25, y =β€‰βˆ’10, z =β€‰βˆ’8 [F(2,140) = 9.9, p < 0.001]. Seventy-seven percent of the cluster overlaps with the right centromedial amygdala (coloured in green) defined by the JΓΌlich probabilistic atlas104.

Mentions: Having discovered a group x feedback interaction in the dACC, we asked whether the degree of feedback-dependent neural responses in this region functionally covaried with that in other regions of the brain. In a whole brain analysis, one region showed a group difference in functional connectivity with the dACC across feedback conditions (group x feedback interaction): the right amygdala (Fig. 2). Comparison of extracted beta-values suggested that functional coupling between these two regions was highest in AN during the lose-shift behaviour but reduced during lose-stay (SI Figure 2.2).


Increased anterior cingulate cortex response precedes behavioural adaptation in anorexia nervosa
gPPI results.Statistical maps (whole-brain analysis, p < 0.001 uncorrected, cluster extent k> = 30) showing regions of group differences in functional connectivity across task conditions (warm colours). Global peak at x = 25, y =β€‰βˆ’10, z =β€‰βˆ’8 [F(2,140) = 9.9, p < 0.001]. Seventy-seven percent of the cluster overlaps with the right centromedial amygdala (coloured in green) defined by the JΓΌlich probabilistic atlas104.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5304157&req=5

f2: gPPI results.Statistical maps (whole-brain analysis, p < 0.001 uncorrected, cluster extent k> = 30) showing regions of group differences in functional connectivity across task conditions (warm colours). Global peak at x = 25, y =β€‰βˆ’10, z =β€‰βˆ’8 [F(2,140) = 9.9, p < 0.001]. Seventy-seven percent of the cluster overlaps with the right centromedial amygdala (coloured in green) defined by the JΓΌlich probabilistic atlas104.
Mentions: Having discovered a group x feedback interaction in the dACC, we asked whether the degree of feedback-dependent neural responses in this region functionally covaried with that in other regions of the brain. In a whole brain analysis, one region showed a group difference in functional connectivity with the dACC across feedback conditions (group x feedback interaction): the right amygdala (Fig. 2). Comparison of extracted beta-values suggested that functional coupling between these two regions was highest in AN during the lose-shift behaviour but reduced during lose-stay (SI Figure 2.2).

View Article: PubMed Central - PubMed

ABSTRACT

Patients with anorexia nervosa (AN) are characterised by increased self-control, cognitive rigidity and impairments in set-shifting, but the underlying neural mechanisms are poorly understood. Here we used functional magnetic resonance imaging (fMRI) to elucidate the neural correlates of behavioural adaptation to changes in reward contingencies in young acutely ill AN patients. Thirty-six adolescent/young adult, non-chronic female AN patients and 36 age-matched healthy females completed a well-established probabilistic reversal learning task during fMRI. We analysed hemodynamic responses in empirically-defined regions of interest during positive feedback and negative feedback not followed/followed by behavioural adaptation and conducted functional connectivity analyses. Although overall task performance was comparable between groups, AN showed increased shifting after receiving negative feedback (lose-shift behaviour) and altered dorsal anterior cingulate cortex (dACC) responses as a function of feedback. Specifically, patients had increased dACC responses (which correlated with perfectionism) and task-related coupling with amygdala preceding behavioural adaption. Given the generally preserved task performance in young AN, elevated dACC responses specifically during behavioural adaption is suggestive of increased monitoring for the need to adjust performance strategies. Higher dACC-amygdala coupling and increased adaptation after negative feedback underlines this interpretation and could be related to intolerance of uncertainty which has been suggested for AN.

No MeSH data available.


Related in: MedlinePlus