title: Abnormal Social Reward Responses in Anorexia Nervosa: An fMRI Study.
abstract: Patients with anorexia nervosa (AN) display impaired social interactions, implicated in the development and prognosis of the disorder. Importantly, social behavior is modulated by reward-based processes, and dysfunctional at-brain-level reward responses have been involved in AN neurobiological models. However, no prior evidence exists of whether these neural alterations would be equally present in social contexts. In this study, we conducted a cross-sectional social-judgment functional magnetic resonance imaging (fMRI) study of 20 restrictive-subtype AN patients and 20 matched healthy controls. Brain activity during acceptance and rejection was investigated and correlated with severity measures (Eating Disorder Inventory -EDI-2) and with personality traits of interest known to modulate social behavior (The Sensitivity to Punishment and Sensitivity to Reward Questionnaire). Patients showed hypoactivation of the dorsomedial prefrontal cortex (DMPFC) during social acceptance and hyperactivation of visual areas during social rejection. Ventral striatum activation during rejection was positively correlated in patients with clinical severity scores. During acceptance, activation of the frontal opercula-anterior insula and dorsomedial/dorsolateral prefrontal cortices was differentially associated with reward sensitivity between groups. These results suggest an abnormal motivational drive for social stimuli, and involve overlapping social cognition and reward systems leading to a disruption of adaptive responses in the processing of social reward. The specific association of reward-related regions with clinical and psychometric measures suggests the putative involvement of reward structures in the maintenance of pathological behaviors in AN.
authors.affiliation: Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain; Melbourne Neuropsychiatry Centre, The Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
authors.forename: Esther
authors.initials: E
authors.lastname: Via
authors.affiliation: Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Soriano-Mas
authors.affiliation: Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sánchez
authors.affiliation: Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; IMIM Research Institute at the Hospital de Mar, clinical research group in human pharmacology and neuroscience, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Forcano
authors.affiliation: Melbourne Neuropsychiatry Centre, The Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Harrison
authors.affiliation: Melbourne Neuropsychiatry Centre, The Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Davey
authors.affiliation: MRI Research Unit, Hospital del Mar, CIBERSAM G21, Barcelona, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Pujol
authors.affiliation: Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Martínez-Zalacaín
authors.affiliation: Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Menchón
authors.affiliation: Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Aranda
authors.affiliation: Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: Narcís
authors.initials: N
authors.lastname: Cardoner
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000503:physiopathology*; D001921:Brain / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012201:Reward; D012919:Social Behavior