RT Journal Article
SR Electronic
T1 Intact value-based decision-making during intertemporal choice in women with remitted anorexia nervosa? An fMRI study
JF Journal of Psychiatry and Neuroscience
JO J Psychiatry Neurosci
FD Canadian Medical Association
SP 108
OP 116
DO 10.1503/jpn.180252
VO 45
IS 2
A1 Joseph A. King
A1 Fabio Bernardoni
A1 Daniel Geisler
A1 Franziska Ritschel
A1 Arne Doose
A1 Sophie Pauligk
A1 Konrad Pásztor
A1 Kerstin Weidner
A1 Veit Roessner
A1 Michael N. Smolka
A1 Stefan Ehrlich
YR 2020
UL http://jpn.ca/content/45/2/108.abstract
AB 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 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.