Altered brain activity in women recovered from bulimic-type eating disorders after a glucose challenge: a pilot study.
OBJECTIVE
It is not known whether individuals with bulimic-type eating disorders have a dysregulation of brain pathways that modulate appetite. Taste plays a role in the regulation of appetite and the purpose of the current study was to determine whether bulimic women have alterations in the physiologic response to the blind administration of glucose.


METHODS
To avoid the confounding effects of a current eating disorder, and to assess possibly trait-related disturbances, we studied 10 subjects recovered (> or = 1 year) from a bulimic-type eating disorder and 6 control women. Subjects were administered a solution of glucose or artificial saliva (control solution) in alternating blocks during a functional magnet resonance imaging scan.


RESULTS
Individuals who recovered from a bulimic-type eating disorder had significantly lower activation in the right anterior cingulate cortex (ACC; Montreal Neurological Institute [MNI] coordinates x = 8, y = 22, z = 28; cluster size = 18 voxels, T = 5.11, Z-score = 3.78) and in the left cuneus (occipital cortex; MNI coordinates x = -12, y = -78, z = 10; cluster size = 21 voxels, T = 4.27, Z-score = 3.36), when glucose was compared with artificial saliva.


CONCLUSIONS
The ACC plays a role in the anticipation of reward. Individuals with bulimic-type eating disorders may have a reduced reward response to nutrients, and thus may be vulnerable to overeating. However, this is a small sample and the current study will need replication in a larger sample size with investigation of additional regions of interest.
Frank
Guido K
GK
Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA.
Wagner
Angela
A
Achenbach
Sarah
S
McConaha
Claire
C
Skovira
Kellie
K
Aizenstein
Howard
H
Carter
Cameron S
CS
Kaye
Walter H
WH
D000328:Adult; D015992:Body Mass Index; D001921:Brain / Q000378:metabolism* / Q000503:physiopathology*; D052018:Bulimia Nervosa / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D003289:Convalescence; D005947:Glucose / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D010865:Pilot Projects
D005947:Glucose