Neurocircuity of eating disorders.
OBJECTIVE
This chapter reviews brain imaging findings in anorexia and bulimia nervosa which characterize brain circuitry that may contribute to the pathophysiology of eating disorders (EDs).
Recent imaging studies provide evidence of disturbed gustatory processing in EDs which involve the anterior insula as well as striatal regions. These results raise the possibility that individuals with anorexia nervosa have altered appetitive mechanism that may involve sensory, interoceptive, or reward processes. Furthermore, evidence of altered reward mechanisms is supported by studies that suggest that individuals with anorexia nervosa and bulimia nervosa share a trait toward similar anterior ventral striatal pathway dysregulation. This shared trait disturbance of the modulation of reward and emotionality may create a vulnerability for dysregulated appetitive behaviors. However, those with anorexia nervosa may be able to inhibit appetite and have extraordinary self-control because of exaggerated dorsal cognitive circuit function, whereas individuals with bulimia nervosa are vulnerable to overeating when they get hungry, because they have less ability to control their impulses.


CONCLUSIONS
Current therapeutic interventions have modest success. Better understanding of neurocircuits that may be related to altered appetite, mood, impulse control, and other symptoms underlying the pathophysiology of EDs might improve psychotherapeutic and drug treatment strategies.
Department of Psychiatry, University of California, San Diego, CA, USA. whkaye@gmail.com
Walter H
WH
Kaye
Angela
A
Wagner
Julie L
JL
Fudge
Martin
M
Paulus
D001066:Appetite; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001931:Brain Mapping; D001068:Feeding and Eating Disorders / Q000145:classification / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D059906:Neuroimaging
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