title: Frontocingular dysfunction in bulimia nervosa when confronted with disease-specific stimuli.
abstract: OBJECTIVE
  Bulimia nervosa (BN) is characterized by dysregulation of impulse control, in other words, uncontrolled eating. Functional neuroimaging studies have been sparse and have used variable methodologies.
  
  
  METHODS
  Thirteen medication-free female BN patients and 13 female healthy controls were investigated by functional magnetic resonance imaging using a disease-specific food paradigm. Stimuli were rated after the scanning procedure.
  
  
  RESULTS
  Bulimia nervosa patients showed increased fear ratings and a trend for increased disgust. Magnetic resonance imaging data of 10 BN patients could be analysed. Three BN patients had to be excluded from the analysis because of minimal blood oxygen level dependent signals. Compared with healthy controls, BN patients showed less activation of the anterior cingulate cortex, which extended into the lateral prefrontal cortex. Furthermore, the right temporal pole showed decreased reactivity.
  
  
  CONCLUSIONS
  This study substantiates a key role of lateral prefrontal dysfunction in BN, a brain region involved in impulse control. Furthermore, the anterior cingulate cortex, which plays a key role in emotion processing, is dysfunctional. A major limitation of this study is the small sample size.
authors.affiliation: University of Freiburg, Department of Psychosomatic Medicine and Psychotherapy, Freiburg, Germany. andreas.joos@uniklinik-freiburg.de.
authors.forename: Andreas A B
authors.initials: AA
authors.lastname: Joos
authors.forename: Barbara
authors.initials: B
authors.lastname: Saum
authors.forename: Almut
authors.initials: A
authors.lastname: Zeeck
authors.forename: Evgeniy
authors.initials: E
authors.lastname: Perlov
authors.forename: Volkmar
authors.initials: V
authors.lastname: Glauche
authors.forename: Armin
authors.initials: A
authors.lastname: Hartmann
authors.forename: Tobias
authors.initials: T
authors.lastname: Freyer
authors.forename: Angelika
authors.initials: A
authors.lastname: Sandholz
authors.forename: Thomas
authors.initials: T
authors.lastname: Unterbrink
authors.forename: Ludger Tebartz
authors.initials: LT
authors.lastname: van Elst
authors.forename: Oliver
authors.initials: O
authors.lastname: Tüscher
mesh_terms: D000328:Adult; D052018:Bulimia Nervosa / Q000503:physiopathology* / Q000523:psychology*; D016022:Case-Control Studies; D004644:Emotions; D005260:Female; D005502:Food; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D010781:Photography; D017397:Prefrontal Cortex / Q000503:physiopathology*; D055815:Young Adult