Article
Dissociating between anticipation and receipt of food related rewards in patients with binge eating disorder using an abstract incentive delay task
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Published: | March 17, 2014 |
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Background: Binge eating disorder (BED) is a prevalent eating disorder characterized by recurrent binge eating episdes associated with a sense of loss of control over eating. The underlying neural mechanisms of BED are largely unknown, but an elevated sensitivity for primary rewards such as food, mediated via alterations in neural reward pathways, has been proposed. Understanding these mechanisms can help in the development of improved prevention and treatment strategies. Therefore, the aim of the present study was to identify the underlying neural mechanisms of reward processing in BED.
Material/Methods: We used an fMRI probe to elicit neural responses to food related reward. The task allows to distinguish between the anticipation and the receipt of abstract food related reward. 28 subjects with BED and 26 healthy control subjects underwent functional magnetic resonance imaging whilst completing the task.
Results: During the expectation of a food reward compared to the expectation of no reward; patients with BED showed a reduced activation in the dorsal striatum as compared to healthy controls. During the receipt of a food reward compared to the receipt of no reward, patients showed a stronger activation in the primary gustatory cortex (insula), medial orbitofrontal cortex, lateral orbitofrontal/inferior frontal cortex, as well as the precuneus.
Conclusion: Our results indicate that BED patients may show hedonically driven overeating (“liking”) represented by increased orbitofrontal cortex activation, coupled with decreased incentive salience (“wanting”) of food rewards represented by decreased dorsal striatum activation. This study provides first evidence of differential brain activation to both the expectation and receipt of food related rewards in patients with BED.