title: Impaired inhibitory control in anorexia nervosa elicited by physical activity stimuli.
abstract: Besides food restriction, hyperactivity is considered a key behavioral trait of anorexia nervosa (AN), playing a major role in the pathogenesis and progression of the disorder. However, the underlying neurophysiology remains poorly understood. We used functional magnetic resonance imaging during two affective go/no-go tasks to probe inhibitory control in response to stimuli depicting physical activity vs inactivity and food vs non-food in AN patients compared with 26 healthy athlete and non-athlete controls. We hypothesized that neural correlates of behavioral inhibition are biased by the emotional information of the stimuli in AN patients, leading to a differential neural inhibitory pattern during the two tasks. Indeed, we found reduced response inhibition for food and non-food images in the putamen, while stimuli depicting physical activity resulted in an exaggerated response of the prefrontal cortex (PFC) and cerebellum in AN patients. However, both AN patients and athletes revealed an increased response in the somatosensory cortex to physical activity stimuli. These results suggest that physical activity stimuli might place an increased demand on the inhibitory control system in AN patients. The resulting hyperactivity of the PFC and cerebellum may lead to altered executive function and motor control, sustaining increased physical activity in AN patients.
authors.affiliation: fMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, GermanyfMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, GermanyfMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, Germany stephanie.kullmann@med.uni-tuebingen.de.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kullmann
authors.affiliation: fMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, Germany.
authors.forename: Katrin E
authors.initials: KE
authors.lastname: Giel
authors.affiliation: fMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, Germany.
authors.forename: Xiaochen
authors.initials: X
authors.lastname: Hu
authors.affiliation: fMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, Germany.
authors.forename: Stephan C
authors.initials: SC
authors.lastname: Bischoff
authors.affiliation: fMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Teufel
authors.affiliation: fMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, Germany.
authors.forename: Ansgar
authors.initials: A
authors.lastname: Thiel
authors.affiliation: fMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zipfel
authors.affiliation: fMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, GermanyfMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, GermanyfMEG Center, University of Tübingen, 72076 Tübingen, Germany, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany, German Center for Diabetes Research, 85764 Neuherberg, Germany, Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany, Department of Psychiatry, University of Bonn, 53105 Bonn, Germany, Institute of Nutritional Medicine, University Hohenheim, 70599 Stuttgart, Germany, and Institute of Sport Science, University Tübingen, 72076 Tübingen, Germany.
authors.forename: Hubert
authors.initials: H
authors.lastname: Preissl
mesh_terms: D000856:Anorexia Nervosa / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology; D056352:Athletes; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001931:Brain Mapping; D002531:Cerebellum / Q000473:pathology / Q000503:physiopathology; D004644:Emotions; D056344:Executive Function / Q000502:physiology*; D005260:Female; D005502:Food; D006801:Humans; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D009043:Motor Activity / Q000502:physiology*; D009483:Neuropsychological Tests; D010775:Photic Stimulation; D017397:Prefrontal Cortex / Q000473:pathology / Q000503:physiopathology; D013003:Somatosensory Cortex / Q000473:pathology / Q000503:physiopathology; D014796:Visual Perception / Q000502:physiology; D055815:Young Adult
keywords: anorexia nervosa; eating disorder; fMRI; reward; hyperactivity; inhibitory control