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Obsessive-compulsivity and working memory are associated with differential prefrontal cortex and insula activation in adolescents with a recent diagnosis of an eating disorder
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Barnendokrinologisk forskning/Gustafsson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
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2014 (English)In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 224, no 3, 246-253 p.Article in journal (Refereed) Published
Abstract [en]

The role of rumination at the beginning of eating disorder (ED) is not well understood. We hypothesised that impulsivity, rumination and restriction could be associated with neural activity in response to food stimuli in young individuals with eating disorders (ED). We measured neural responses with functional magnetic resonance imaging (fMRI), tested working memory (WM) and administered the eating disorders examination questionnaire (EDE-Q), Barratt impulsivity scale (BIS-11) and obsessive-compulsive inventory (OCI-R) in 15 adolescent females with eating disorder not otherwise specified (EDNOS) (mean age 15 years) and 20 age-matched healthy control females. We found that EDNOS subjects had significantly higher scores on the BIS 11, EDE-Q and OCI-R scales. Significantly increased neural responses to food images in the EDNOS group were observed in the prefrontal circuitry. OCI-R scores in the EDNOS group also significantly correlated with activity in the prefrontal circuitry and the cerebellum. Significantly slower WM responses negatively correlated with bilateral superior frontal gyrus activity in the EDNOS group. We conclude that ruminations, linked to WM, are present in adolescent females newly diagnosed with EDNOS. These may be risk factors for the development of an eating disorder and may be detectable before disease onset.

Place, publisher, year, edition, pages
2014. Vol. 224, no 3, 246-253 p.
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:uu:diva-238468DOI: 10.1016/j.pscychresns.2014.10.001ISI: 000345527900014PubMedID: 25456522OAI: oai:DiVA.org:uu-238468DiVA: diva2:771109
Funder
Formas, 2011-10552-21603-18
Available from: 2014-12-12 Created: 2014-12-12 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Assessment of Function, Structure and Working Memory in Adolescents with a Recent Diagnosis of an Eating Disorder
Open this publication in new window or tab >>Assessment of Function, Structure and Working Memory in Adolescents with a Recent Diagnosis of an Eating Disorder
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Body, weight and shape related obsessions and ruminations are characteristic traits of individuals with eating disorders (ED) that are found to predate the onset of the disorder. Individuals with chronic ED display altered neural activation in response to food stimuli, and are reported to have volumetric differences compared to healthy individuals, which is likely an effect of prolonged starvation. ED individuals are also seen to dispose an attentional bias to food stimuli, even when perceived sub-consciously, which are reported to interfere with cognitive tasks, including working memory (WM). However, whether the differences in neural activation and structure are present in adolescents with a recent ED diagnosis is not known.

In paper I we describe how images of high- and low-calorie foods resulted in greater responses in the prefrontal circuitry in ED adolescents compared to healthy controls (HC). Obsessive-compulsive symptoms in ED individuals were associated with prefrontal circuitry and cerebellar activation, whereas faster reaction times to the WM were associated with greater superior frontal gyrus activity. The findings indicate that ED cognitions may be linked to WM abilities, both of which are associated with frontal cortex functioning. WM performance is examined further in paper II, where we found that the presence of subliminal food images were seen to disrupt WM performance in terms of slower reaction times and less correct responses in ED but not HC. The WM interference was associated with increased activity in the parietal and superior temporal cortex. WM interference caused by subliminal food stimuli may reflect a pre-attentive bias to food in adolescents with ED, which could be a risk factor for further development of an ED.

The structural differences in brain volume between adolescents with ED and HC were examined in paper III. ED symptoms were found to be associated with volume differences in insular cortex and superior temporal gyrus, whereas obsessive-compulsive symptoms were associated with reduced volumes in the putamen and cerebellum. These volumetric differences in regions implicated in restraint, obsessions and WM are likely to precede structural variations caused by starvation as seen in chronic ED’s. Connectivity from these regions, in addition to other regions believed to be implicated in ED, was studied in paper IV. Fronto-parietal regions as well as the insula showed increased connectivity in ED, whereas connectivity from the mesolimbic reward regions did not differ from HC. Regions with increased connectivity in ED are involved with self-awareness, body image and ED related ruminations, connections that could influence how one’s body is perceived.

In conclusion, the studies included in this thesis describes changes in functional activity, connectivity and brain volume in regions involved with ED cognitions, eating behaviour, and body image in adolescents recently diagnosed with an ED.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 47 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1117
Keyword
Eating disorders, anorexia nervosa, bulimia nervosa, eating disorders not otherwise specified, fmri
National Category
Medical and Health Sciences
Research subject
Neuroscience
Identifiers
urn:nbn:se:uu:diva-259050 (URN)978-91-554-9279-3 (ISBN)
Public defence
2015-09-11, C1:305, BMC, Husargatan 3, Uppsala, 10:00 (English)
Opponent
Supervisors
Available from: 2015-08-20 Created: 2015-07-24 Last updated: 2015-10-01

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Brooks, Samantha JSolstrand Dahlberg, LindaSwenne, IngemarRask-Andersen, MathiasSalonen-Ros, HelenaRosling, AgnetaLarsson, Elna-MarieSchiöth, Helgi B

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Brooks, Samantha JSolstrand Dahlberg, LindaSwenne, IngemarRask-Andersen, MathiasSalonen-Ros, HelenaRosling, AgnetaLarsson, Elna-MarieSchiöth, Helgi B
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Functional PharmacologyPediatricsDepartment of Women's and Children's HealthChild and Adolescent PsychiatryRadiology
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